Tuesday, November 29, 2016

COLUMN | Making the wrong choice with Medicare can prove costly

By Toni Tantlinger

It’s decision time for the 55 million Americans covered by Medicare.

Open enrollment, when people can enroll in Medicare or make changes to their plans, runs every year from Oct. 15 to Dec. 7. But anyone who thinks that signing up for the medical plan for seniors is simple could be in for a rude awakening – and a costly one.

“People need to realize that enrolling in Medicare can be complicated,” says Chris Orestis, a senior-care advocate and author of the books “Help on the Way” and “A Survival Guide to Aging.”

“If you don’t pay attention you can end up missing needed coverage or paying more out-of-pocket expenses in premiums, co-pays and deductibles than you realize – or can afford.”

This year open enrollment comes during a presidential election and a time when there are concerns about Medicare’s long-term future and whether it can remain solvent. At the final presidential debate, Donald Trump and Hillary Clinton were asked what they might do to make sure the program, first implemented in 1965, will be there for seniors for decades to come.

Trump said he would grow the economy, which in turn would help Medicare. Clinton said her plan is to reduce the cost of health care and to emphasize wellness.

But any future political decisions about Medicare can seem far off to anyone whose main concern is figuring out how they fit into what’s offered right now, says Orestis, CEO of Life Care Funding (www.lifecarefunding.com).

He says some important things to keep in mind or understand during Medicare enrollment include:

• Medicare coverage comes in two primary forms that participants can choose from. They are original Medicare, the traditional program administered through the federal government which anyone 65 and older qualifies for automatically, and Medicare Advantage plans, which are sold by private insurance companies. The Advantage plans sometimes offer additional services, such as routine vision, hearing and dental care.
• Most people probably have heard references to Medicare Part A or Medicare Part D. Here’s how that alphabet breaks down: Medicare Part A pays for hospital and skilled nursing facility care. Medicare Part B pays 80 percent of costs for doctors, outpatient services and medical equipment. Medicare Part C is a private Advantage Plan. Medicare Part D pays for prescriptions.
• Anyone who visits a doctor or has been hospitalized knows that deductibles and co-pays can add up quickly. That’s where Medicare Supplemental Insurance (Medigap) comes in. It’s a private insurance that pays the gaps in the varieties of Medicare coverage.
• Want to learn more? Orestis says a good place to check is the Center for Medicare and Medicaid Services website (www.cms.gov), which provides a wealth of information and resources to review and assist enrollment.

Orestis says it’s important to act as soon as possible and not wait until the last minute.
“When it comes to Medicare enrollment,” Orestis says, “not being informed and missing deadlines can cause delays and penalties that could have a negative impact on your coverage – and your wallet.”

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