In Your Prime: Don’t wait to sign up for Medicare

‘People will spend more time choosing a new phone ... but the consequences for choosing the wrong insurance plan are much larger.’

There’s a simple message during this Medicare open enrollment season, which is running now through Dec. 7: choose your plan carefully. It could save you thousands of dollars.

Expert Erin Singleton has worked with countless Medicare beneficiaries and has seen people make many of the same mistakes.

“People will spend more time choosing a new phone than an insurance plan,” she said, “but the consequences for choosing the wrong insurance plan are much larger.”

One way to avoid the wrong plan? Ask questions. Health care is complicated, say case managers, so if you don’t know what a term means, let alone what a plan really covers, ask questions until you find out all the information you need to decide.

Other expert tips include:

1. Know the deadlines, and don’t miss them. For instance, patients may not realize that they will face a penalty and be unable to enroll in Part B until the next open enrollment period if they miss the current one.

2. Have employer or retirement benefits? You may still need to enroll in Medicare. Many plans require people who are eligible for Medicare to enroll in a Medicare plan. If you are unsure, you should contact your benefit administrator - you may discover that your current plan will only cover 20 percent of your costs.

3. Know the difference between different types of Medicare plans - there may be one that is better for your needs. People often do not know the difference between Medicare Part A, B and Part D, let alone the difference between a Medi- Gap plan, a Special Needs Plan and a Medicare Advantage plan. The PAF case managers reported working with cancer patients who did not realize that they qualified for a Special Needs Plan and missed out on beneficial coverage perks.

4. Look beyond your monthly premium. Your plan will inevitably require out of-pocket spending beyond your monthly premium. Consider copay and coinsurance costs, along with potential out of-network costs, particularly for Medicare Advantage plans.

5. Make sure you have a prescription drug plan. People may be unaware and unhappy that they must enroll and pay a separate premium for a drug coverage plan. When you choose a prescription drug plan, choose based on your current medications along with those you may need in the upcoming year.

6. New to Medicare? Consider a Medigap supplement plan. New enrollees have six months to enroll in a supplement plan without being subject to restrictions based on pre-existing conditions. These plans cover copays, coinsurance and deductibles, along with coverage during travel outside the United States. You’ll have to pay an additional monthly premium but may save thousands of dollars over the course of your plan.

7. Don’t be fooled by advertising. PAF case managers report that many patients assume that Medicare Advantage plans-particularly those labeled “Complete”-will cover 100 percent of costs, even though they will only cover the same 80 percent of costs as traditional Medicare. Medicare Advantage plans may also impose a narrow network on beneficiaries, leaving patients subject to burdensome out-of pocket costs if they see an out of-network provider.

8. Review, review, review: Medicare plans, much like an employer-sponsored or Marketplace plan, can change their benefit structure annually. Even if your plan stays the same, your own medical needs may change. Review your coverage every year to make sure that you are enrolled in the best plan for your needs. “Choosing the right plan is one of the most important choices you can make, for both your physical and financial health,” said Singleton. “Regardless of whether you are new to Medicare or already enrolled, all beneficiaries should take the time to choose the right plan for your current and projected needs.” And of course, the case managers have one last piece of advice:

9. Don’t wait until the last minute! Choosing the right plan takes a lot of time, but with projected health care costs in retirement up to $280,000 for a couple on Medicare, you can’t be too careful. Patient Advocate Foundation is a national nonprofit organization that provides free case management services to patients diagnosed with a chronic, debilitating or life-threatening condition.

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