If you’re one of 60,000 Minnesotans turning 65 this year, your health plan should be top-of-mind.
In addition to planning fall outdoor activities and gatherings with family and friends, it is also the time to begin planning your transition to a Medicare health plan. By understanding your options and researching plan benefits, you can select a plan best suited to your health care needs. You can gain peace of mind knowing friendly and knowledgeable experts are available to help you navigate your transition to a Medicare health plan.
ABCDs of Medicare
The first step in your Medicare journey is understanding the different parts of Medicare and the services each covers. Parts A and B are known as original Medicare coverage and include hospital and medical insurance, respectively.
Individuals with Part A and or Part B will likely also need to purchase Part D, prescription drug coverage. Medicare Parts A and B are public plans administered by the government. Medicare Part C and D plans are offered by private health insurance companies contracted by Medicare.
You have several opportunities to enroll in a Medicare health plan beginning near when you turn 65. The two most common times individuals sign up for Medicare coverage are the initial enrollment and open enrollment periods. The initial enrollment period is a seven-month time period beginning three months before your birthday, and ending three months after the day you turn 65. This window of time includes your birth month. Annual open enrollment, which begins Oct. 15 each year, is your opportunity to make changes to your existing Medicare coverage, including switching to a Part C plan from Medicare Parts A and B. Any changes made to your coverage during open enrollment will go into effect on Jan. 1 the following calendar year.
To determine when you need to enroll, it’s best to consult a Medicare specialist who can walk you through your options and help you understand how and when you need to sign up to avoid a gap in coverage and any penalties.
If you choose Medicare Part C, you will be enrolled in a Medicare Advantage plan. Medicare Advantage plans offer all the benefits of Part A and Part B. Often, they also include prescription drug coverage (Part D). Many individuals select Medicare Advantage plans because they appreciate the convenience of having all of their health care benefits in one easy-to-understand package. Medicare Advantage plans often include vision and dental insurance, which are particularly important areas of your health to be vigilant about taking care of as you age. Many Medicare Advantage plans also offer perks beyond essential health care, such as fitness discounts and health coverage while traveling. After determining the level of coverage you need, you will be well-positioned to conduct an apple-to-apple plan comparison.
Comparing health plans may feel like a daunting task. By categorizing your research into four buckets — physicians, prescription drugs, overall cost, and extras — you’ll have a structured method for assessing your options.
If continuing to see the same doctors you have been visiting is important to you, you should look for a health plan that has relationships with many physicians, which you may hear called a “broad network.” If a health plan refers to a doctor as “in-network,” it means that physician accepts that type of insurance as payment for services rendered.
While most Medicare Advantage plans include prescription drug coverage, medication costs and what you pay out-of-pocket can vary greatly from plan to plan. If you regularly take one or more medications, it is important to make sure each is included in what is called the plan’s “formulary.” Keep in mind generic drugs are typically less expensive than brand name. Consult your pharmacist to determine if generic versions of your prescriptions are available. UCare has a prescription drug calculator, which can help you understand your costs.
Considering your anticipated health care costs is an enormously important factor in choosing a health plan, especially if you are retired and living on a fixed income. It is impossible to predict all your health care needs, but you should be able to estimate a planned spend based on any health conditions you have, how many specialists you visit and how often, and a number of other factors including your age and level of physical activity. Remember that certain preventive services you receive from doctors in your health plan’s network that are meant to keep you healthy are free. This includes annual wellness visits with your primary care physician.
Health plans are not one-size-fits-all. Beyond essential care, consider your lifestyle when shopping for a plan. For what are you willing to pay extra? If you don’t already participate in group workout classes or belong to a wellness center, it is unlikely you need a plan with fitness benefits. If you regularly see an ophthalmologist but paying for it out-of-pocket will be cost-prohibitive, you will want to select a plan with vision benefits. Other factors not directly related to your medical care, including the level of customer service the plan has a reputation for providing, should also factor into your decision.
Select and enroll
After carefully weighing your options by taking the above into account, you’re ready to select a plan. UCare’s free online health plan comparison tool allows you to explore your UCare plan options at your convenience from your phone or computer.
As you embark on your Medicare journey, and at every step along the way, remember you do not have to do it alone. One of many benefits of choosing a local health plan provider, is the availability of local representatives available to meet with you in-person at a location close to your home. Depending on your preference, you can enroll in-person, online, or over the phone.
For more information enabling you to select the best plan to suit your needs and wants, explore UCare’s comprehensive Medicare guide.