It’s open enrollment season and families are working to figure out the healthcare plans that are best for their needs.
As we age, those needs and choices change.
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“Medicare beneficiaries are individuals that are 65 years and older, any age, if they’re disabled, typically for two years or those with end stage renal disease or Lou Gehrig’s,” said Ohio Senior Health Insurance Information Program (OSHIIP)Director Christina Reeg.
“Everybody that qualifies for Medicare has two general options either original Medicare or Medicare Advantage plan, so this is the time of year that we really help all of those individuals navigate their choices.”
Reeg said open enrollment is their busiest time. When it comes to choosing your plan, she recommends not doing so based on an advertisement. “Because they’re usually promoting added benefits, the enticements to enroll in those plans like gym memberships and debit cards.”
It’s best to focus on health and medical benefits of insurance when selecting a plan.
“Original Medicare, it consists of Medicare Part A, hospital coverage and Medicare Part B, the medical coverage,” she said. “There’s no network of doctors and hospitals; you go to any doctor or provider in the United States that takes Medicare and it’s covered.
But Reeg said there are a lot of out-of-pocket costs with original Medicare.
“Most individuals that choose that option have secondary insurance…and then they select a stand alone prescription drug plan.”
She said a con is that you might be paying a little more monthly to have Medicare, the supplement, and the drug coverage.
Medicare Advantage, or Part C, is an alternative.
“Medicare Advantage are private plans that have contracted with Medicare on a one-year term to provide benefits at least as good as original Medicare, so the benefit is you have one card, you’re using one service, it’s typically lower monthly premiums,” said Reeg. “Some plans have no additional monthly premium, but most are managed care in which they work with a network of doctors and hospitals and providers.”
Reeg said that if you enroll in Medicare Advantage, you should be aware of what providers are in that network.
“If you have a doctor or specialist, you’re not willing to give up, make sure that they are currently in that network because those networks can change mid-year,” she said. “We’ve got 2.5 million Medicare beneficiaries and we’ve just seen the tip this past year, so we now have more Medicare beneficiaries on Medicare Advantage plans.”
OSHIIP offers free, objective health insurance information. You can call 800.686.1578 Monday-Friday from 7:30a-5:00pm or email OSHIIPmail@insurance.ohio.gov
