(BPT) - Have your health needs changed over the last year? Medicare plans can change every year, and your health situation can also change. That means your current plan might not meet your current needs.
Medicare Annual Enrollment, which runs Oct. 15 – Dec. 7, is the perfect time to review your plan to make sure you have the right plan for your health needs at an affordable cost for the upcoming year. With inflation hitting people’s pocketbooks, reviewing your plan this year is more important than ever.
Choosing a Medicare plan can be confusing, but the National Council on Aging (NCOA) and Aetna Medicare have teamed up to help beneficiaries cut through the clutter. They have answered some of the most common questions about Medicare.
How much does Medicare cost?
How much you pay for Medicare depends on the choices you make about coverage. A common misconception about Medicare is that it pays for everything. But in reality, i does not. You can choose Original Medicare — with or without a prescription drug plan — or a Medicare Advantage plan that combines hospital, medical and sometimes prescription drug coverage in one plan.
Original Medicare includes:
In addition, people with Medicare can choose coverage through:
When researching Medicare plans, it’s important to ask yourself some basic questions. These can help you understand your unique health needs and goals and choose a plan that will best help achieve them. It’s important to consider:
What are out-of-pocket costs?
Out-of-pocket costs are what you pay for your medical expenses that aren’t reimbursed by your insurance. Each part of Medicare has different out-of-pocket costs that can include premiums, deductibles and copayments or coinsurance. Medicare Advantage plans cap your annual out-of-pocket spending, but Original Medicare does not.
Some plans have deductibles. A deductible is the amount you must spend before your Medicare plan pays for your insurance benefit. If you have a hospital stay, for example, Medicare Part A will kick in after you pay your deductible. Copays are a fixed amount, and coinsurance is a percentage you pay for covered services and medications after you’ve paid your deductible.
For Medicare Part B, you generally pay 20% of the cost for each Medicare-covered service. So, if a medical service costs $100, Medicare pays $80 and you pay $20. Each Medicare Advantage plan has an out-of-pocket maximum, which is the most you will pay annually for medical services that are covered by the plan during a plan year.
How does prescription drug coverage work?
If you choose Original Medicare, you can purchase a stand-alone Medicare Part D plan to cover the cost of prescriptions. If you choose a Medicare Advantage plan, prescription drug coverage may be included. What drugs are covered, which pharmacies are in-network and how much you pay will depend on which plan you choose.
To use your prescription drug plan for the first time at the pharmacy, all you need to do is bring your Medicare card, photo ID and plan membership card to an in-network pharmacy. You can fill your prescriptions as you need them, or you can enroll in an automatic refill program.
The choice is yours
Medicare Annual Enrollment is your chance to make sure your plan fits your needs and budget. Take the time to review your options and enroll during Oct. 15 – Dec. 7. Visit NCOA or Aetna Medicare for more tips and guidance.