(WKBN) – On Dec. 7, open enrollment for Medicare ends. If you’ve turned 65 or are close to it, you’ve probably gotten mail telling you to sign up for it. We spoke to someone from Medical Mutual to break down what you need to know during this period.
On Oct. 15, enrollment for Medicare opened up for those 65 and older, and for people with certain disabilities.
“So there’s two different ways that members can get coverage. They can do a Medicare Advantage Plan which combines their Medicare Parts A, B and D, like drugs. So those plans typically have all of them covered in one, and that’s what this enrollment period is. The other option that members would have would be to keep their original Medicare, and then purchase a Medicare Supplement Plan that supplements Medicare, and then get a standalone prescription drug plan,” said Amanda McFarland, a senior account manager for Medical Mutual.
McFarland has almost 20 years of experience in insurance and says Part A is related to hospital services and Part B is related to lab work and going to the doctor.
“Medicare Part A is typically premium free, as long as you’ve worked enough quarters. Medicare Part B, you would enroll in and then there’s a set monthly premium for that. But again, if you’re not working and you’re retiring, you’re going to want those. Then the Part D or the Medicare Advantage, which is technically considered Part C, you actually purchase from a carrier. So A and B are through the government,” McFarland said.
Some people might have what Medicare offers already covered by employers, but if you sign up when you’re eligible, you can avoid the late penalties you would pay for for the rest of your life.
“Some of those Medicare Advantage Plans are zero premium. So if they’re looking to enroll in a plan, why not look at a Medicare Advantage Plan or even a low-cost prescription drug plan?” McFarland said.
You’re not limited to only enrolling during open enrollment though. If the carrier has a five-star rating — Medical Mutual, for example, will in 2023 — that rating is geared off of customer satisfaction. Then you can enroll anytime, and when it comes time for that, you can choose from an HMO or PPO plan.
“HMO… generally those plans have richer benefits because you’re limited to a select network of providers. If you go outside of that, you’re only covered for emergency, whereas a PPO plan you know the co-pays may be a little higher, but you have the ability to go wherever you want. So Medical Mutual for 2023, we will have a five out of five star rating for HMO and our PPO products. What that star rating does is it’s really geared off of customer satisfaction,” McFarland said.
The best coverage policy varies for each person. McFarland suggests finding a broker to help you out. If you don’t want to go that route, you can sign up at Medicare.gov.
“Are their providers in the network? Every carrier has a different provider network, so verifying that their providers are in that network as well as their prescriptions. So every carrier has a different, it’s called a formulary, so it’s a list of covered drugs that are each carrier covered. So those two are really important, and then from there you’ll drill down to how much is the plan cost,” McFarland said.