Medicare Enrollment

It’s not too soon to start thinking about Medicare’s Open Enrollment, also known as the Annual Election Period, which runs each year from October 15 to December 7.

Learning about your Medicare options can be confusing and time-consuming, but help is out there.

Some basics: Medicare Part A helps cover inpatient hospital, skilled nursing and hospice care. Part B helps cover doctor’s services, outpatient care, medical supplies and preventive services. The government’s Medicare plan, which you are eligible for beginning at age 65 or for some disabled individuals before 65 (part A & B), is referred to as Original Medicare. People with Original Medicare often sign up separately for Part D (prescription drug coverage) and they may also purchase a separate Medigap insurance plan for benefits not covered by Parts A & B.

Medicare Advantage Plans, also called Medicare Part C, offered by private insurance companies such as Humana, provide all the benefits of Parts A and B and may also offer Part D prescription drug coverage as well as other benefits...sometimes at no additional charge beyond Original Medicare.

Catherine Field, Intermountain Market President of Humana, says it may be helpful to work with a licensed health insurance agent or broker when deciding between Original Medicare, Medicare Advantage Plans, Prescription Drug Plans and Medicare supplement plans.

Local independent Medicare Broker, Gail Blankenship, agrees. “It is helpful to have someone with in-depth knowledge of plans and provider networks in the local area—as well as someone who is committed to providing year-round advice and support if questions arise,” she says. “Brokers provide services to Medicare consumers at no charge with the goal of getting each person enrolled in the right plan for them,” adds Blankenship. “Brokers are paid by the insurance carrier when an enrollment occurs.”

Catherine Field offers these questions to ask to help you make an informed choice:

1. Are my doctors, hospitals and specialists in network? Online tools exist to help you find doctors and hospitals in the plan’s network, or you have the option of working with an advisor.

2. Which plans will cover my prescription drugs? Your plan’s prescription drug coverage can change each year. Original Medicare does not cover most prescription drugs, but you can sign up for a Part D Prescription Drug plan separately. Or many Medicare Advantage Plans include prescription drug coverage. Online tools and advisors can help you estimate costs of drugs on various plans in order to make the best choice.

3. Are there new, innovative benefits I should consider? Medicare Advantage plans may cover vision, hearing and dental benefits, as well as additional benefits not covered by Original Medicare such as gym memberships. If you appreciate technology, virtual doctor visits may be included. And many Medicare Advantage plans now offer transportation to doctor appointments and other new services.

4. Will a zero-monthly premium (as offered by some Medicare Advantage plans) save me money? Private insurers help keep premiums down through networks, disease and chronic care management and preventive services, but may limit your choices to in-network options.

5. Do I need to sign up for Medicare Parts A and B if I’m still working? If you or your spouse have health insurance from an employer, you can probably delay enrolling in Medicare until the employment coverage stops, although you should still check in with Medicare in advance of turning 65. To keep your employer health insurance, it must be at least as good of coverage as Medicare provides. When your employer coverage ends, you’re entitled to a special enrollment period of up to eight months to sign up without incurring late penalties.

6. For military veterans, how do you know the difference between your VA benefits and Medicare benefits? Medicare and VA healthcare benefits are separate and do not work together. If working with an advisor to help select the Medicare plan that best serves you, let them know if you are eligible for VA health care.

As with any major decision, advises Field, proper research will go a long way toward making the best plan choice for your personal health care needs. Resources are available to help you in this process, including local seminars, licensed sales agents, Washington State health insurance volunteers (known as SHIBA – see SHIBA article this page) and websites such as medicare.gov, www.insurance. wa.gov/shiba and private insurers like humana.com/Medicare. You can also call 1-800-MEDICARE (1-800-633- 4227) (or TTY: 1-877-486-2048) 24 hours a day, seven days a week.

Need Help with Medicare Open Enrollment? SHIBA can help!

...by Donna Wells, SHIBA & Consumer Advocacy

For the more than 550,000 Medicare beneficiaries in King, Pierce and Snohomish counties, this is an important time of year. Medicare’s Open Enrollment Period – sometimes called the Annual Election Period – runs each year from October 15 to December 7. During this time, those on Medicare:

• can switch from Original Medicare to a Medicare Advantage plan – and vice versa

• with Original Medicare can join, drop or switch a Part D prescription drug plan

• with a Medicare Advantage plan can switch to a different Medicare Advantage plan.

Your new coverage will start January 1.

The Statewide Health Insurance Benefits Advisors (SHIBA) program is ready to help you with these decisions! In its 40th year of serving, SHIBA provides free, unbiased and confidential help with Medicare and other health care options to people of all ages and backgrounds across our state. We train and certify our volunteer advisors, who are available for one-on-one, in-person and phone counseling.

Our volunteer advisors can help you compare prescription drug plans, Original Medicare vs. Medicare Advantage plans and other information to help you make an informed decision about what Medicare plans work best for your personal situation. If you qualify, our SHIBA advisors can also help you apply for any programs that’ll save you money on Medicare costs. Medicare is not a one-size fits all program. Each person’s needs, situation and benefits are different – and that includes spouses who may have their own unique Medicare plan.

Before you make your decision, consider the following tips:

• Review all letters and notices from your current plan as plan costs and coverage can change every year.

• Make a list of all current prescription drugs you take, the doses and how often. Then, use the Plan Finder at www.medicare.gov to compare Part D plans.

• Review the 2020 Medicare & You handbook. You should receive it by mid-October.

• Attend a SHIBA workshop (check out our online events calendar at www.insurance.wa.gov/shiba) or make an appointment for one-on-one counseling with a SHIBA advisor.

For help with your Medicare questions before you sign up:

• Call our Insurance Consumer Hotline at 1-800-562-6900 and ask to speak with a SHIBA volunteer in King, Pierce or Snohomish County; or

Contact SHIBA’s community partners directly:

• King County: Sound Generations at 206-727-6221

• Pierce County: Sound Outreach at 253-596-0918

• Snohomish County: Homage Senior Services at 425-290-1276

• You can also check out SHIBA at www.insurance.wa.gov/shiba.