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Open Enrollment for Medicare Advantage, or Prescription Drug Plans

Begins October 15, ends December 7, 2012

 

Robert Fassbach, editor, www.seniorark.com

This is the moment when you must navigate the maze of choices regarding aspects of your Medicare coverage for 2013. Your choices are: (1) Traditional Medicare with perhaps an added Medigap policy for costs not covered by Medicare. (2) A private insurance plan hired by Medicare to provide your care, called Medicare Advantage. (3) A prescription drug private insurance policy called Part D. Some Medicare Advantage plans also provide Part D prescription drugs.

I would not begin to tell you these choices are clear, or easy to make, with certainty that you have made your best choices for 2013. You have been made a gambler, trying to guess what the coming year will bring for your health. What hospitalization are you likely to experience? What drugs might you need? Different choices that you make now provide different payouts next year. But choices must be made, so be careful. Find help if needed.

In 2012, for the year 2013, open season for enrolling in Medicare Advantage, or Part D prescription plans is October 15 through December 7, 2012. Medicare Advantage open enrollment allows people on Medicare to make a single plan election into, or out of a Medicare Advantage Plan if you wish to go back to traditional Medicare. Beneficiaries should carefully evaluate their plan options, not be pressured into making a quick decision and be on the look out for misleading sales pitches and promises that seem too good to be true.

If you already have a Medicare Advantage policy, or a Part D policy, read the 2013 terms very carefully, since companies change coverage or drugs covered  every year.

For a more detailed explanation of the process of deciding, read: 

Why You Must Review Your Medicare Advantage or Your Part D, Plan Today

 

 Medicare Advantage Plans are health plan options that are part of the Medicare program. They are run by private insurance companies.If you join one of these plans, you generally get all your Medicare-covered health care through that plan. This coverage can include prescription drug coverage. Medicare Advantage Plans include:

  • Medicare Health Maintenance Organization (HMOs)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service Plans
  • Medicare Special Needs Plans

Some Medicare Advantage Plans include a prescription drug benefit.

When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, generally there are extra benefits and lower co-payments than in the Original Medicare Plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services.

To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. The government pays the lion's share of the cost of any Medicare Advantage program, something around $800 to $1,000 per month for every Senior enrollee. But one must make a choice of any plan very carefully. You may need to seek out the assistance of a state representative to help you sift through the maze.

To determine which Medicare Advantage insurers, or Part D prescription drug insurers offer policies in your area, go to www.medicare.gov . At that site, you can compare plans with each other, and with traditional Medicare. If you select traditional Medicare, you will also be able to compare Medigap policies that cover some or most of the costs not covered by Medicare.

 

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