Medicare open enrollment has begun, and in Ocean County, where 21 percent of the population is 65 or older, that means many residents are wading through paperwork and weighing coverage options.
This year, enrollees have an extra month to examine their plans and choose new ones if they wish – the deadline for signing up, Dec. 7, remains the same, but enrollment began Oct. 15 instead of Nov. 15.
As usual, there are changes in coverage to go over, said Ocean County Office of Senior Services Director D. Jane Maloney. Read on for details on coverage, news about changes and resources for those dealing with the enrollment process.
Medicare Part A covers hospitalization, and B covers doctor’s visits and other services. Part A is usually free; Part B is optional and comes with a premium. Together, they’re often referred to as original or traditional Medicare, Maloney explained.
Original Medicare leaves a lot uncovered, so many people sign up for supplemental insurance to fill the holes. This Medigap coverage may cost more on a monthly basis, but it provides more complete protection.
Others opt for Medicare Advantage, or Part C, which instead allows recipients to sift through private but government-subsidized plans and pick one that fits their needs – one with a lower hospital deductible, for instance, or one that offers a low co-pay for medical equipment. The types and diversity of Medicare Supplement Insurance plans vary depending on where you live; you can find out what's available to you locally by using the Medicare Plan Finder on the Medicare website.
And then there’s Part D, Medicare’s prescription drug coverage plan, which was added in 2006. For those with Advantage, drug coverage is bundled with other benefits. But for those with original Medicare, Part D is offered as an extra stand-alone plan. Like Advantage, the Part D plans are privately run but are subsidized by the government, and while there are usually a few options to choose from, a plan may not be the same from year to year, said Maloney.
“Things change,” she said. “There are different premiums for all of these Part D stand-alone plans.”
And those Part D plans are certainly not one size fits all, she said.
“A husband and wife might go into the same health insurance plan, but they wouldn’t necessarily need the same Part D plan,” Maloney said. That’s why it’s key to go over your prescription needs in detail every year, she said, and switch to a new plan if those needs change.
Medicare Part B premiums are increasing, but not as much as expected. The government reports that the monthly Part B premium will be $99.90, which is $3.50 more than in 2011. Earlier this year, a government report projected an increase of $10.60.
New retirees were expected to have higher monthly premiums, but instead of paying $115.40, they’ll also pay the standard $99.90 rate.
The Part B deductible has decreased, too, from $162 in 2011 to $140 for next year, though Part A deductibles for hospital stays went up by $24 to $1,156.
Medicare Advantage plans are expected to be a little cheaper in 2012. The Huffington Post reported back in September that the government says Part C premiums will drop about 4 percent, averaging $32 a month.
For a comprehensive list of Part A and B premiums, deductibles and co-pays for 2012, see the PDF attached to this story.
Help for those who need it:
Wading through enrollment paperwork and figuring out whether a plan change is a good idea is complicated, said Maloney, but there are resources for Ocean County residents who want some assistance.
If you're enrolled in Medicare, mark these dates upon your calendar: October 15-December 7, 2011. That's Medicare's 2012 Amenable Enrollment period -- and you should note that it occurs on a monthly basis earlier this year than in the past. Aside from exceptions made for a couple of special circumstances, such for the reason that moving outside a plan's support area, this is really the only period when current enrollees tend to make coverage changes for the coming twelve months.
Here's a quick primer on how Medicare works:
<img src="http://imgs.gomedigap.com/gomedigap.jpg" alt="medicare supplement insurance" title="medicare supplement insurance" border=0 />
Eligibility. Medicare provides health-related benefits to people grow older 65 and older and those under 65 with positive disabilities or end-stage renal problem. For most people, the initial enrollment period is the particular seven-month period that begins ninety days before the month these people turn 65. If most people miss that window, you may enroll for at the first try between January 1 and March 31 every year, although your coverage won't get started on until July 1.
Medicare health insurance Options. Medicare offers several plans and coverage possibilities, including:
Medicare Part A, which covers in-patient facility, skilled nursing facility and also hospice services, as well as home health-related. People are usually enrollment automatically upon turning 65 and / or after having received Community Security disability benefits designed for 24 months. There's frequently no monthly premium.
Medicare A part B, which covers doctor's products and services, outpatient care and a lot of preventive services. It's optional there are a monthly premium. Most people are automatically enrolled simultaneously they begin Part AN IMPORTANT coverage, but you can go out by following recommendations accompanying your Medicare card (mailed a couple of months before your 65th birthday).
Medicare Section C (Medicare Advantage) plans, which are privately go alternatives to traditional Components A and B. Structured like HMO or PPO packages, they often include additional benefits that include prescription drugs, dental, vision and wellness programs. Monthly premiums may well be higher than regular Portion B, but they ordinarily have lower deductibles and copayments; at the same time, they require that buy the plan's provider networking. Medicare Supplement Insurance
Medicare Part D, which covers prescription drugs. It's optional and posesses a monthly premium. These privately run plans vary widely when considering cost, copayments and deductibles and additionally medications covered.
Medigap. Lots of individuals purchase additional Medigap (or Medicare Supplemental) insurance proposed by private insurers. It follows strict authorities coverage guidelines and helps find the money for many items not included in Medicare, including deductibles, copayments plus coinsurance.