If you meet any grumpy old men, or women, out there, be kind to them. They may be grumpy because Medicare is SOOO confusing. Have you ever tried reading up about it? Probably not, if you are not a senior. However, we are all headed towards that age range, and it is important to be knowledgeable about the Medicare program.
First thing you need to know about Medicare is that you become eligible on your 65th birthday. You have from three months before your birthday to three months after your birthday to enroll. It is not automatic. Turning 65 is pretty easy to do, so this part is easy. And you cannot be denied coverage just because of a medical condition. That is about the end of the easy portion.
The second thing you need to know is that Medicare comes in parts. And you want a lot of those parts but you don’t have to have all of the parts. And there are a lot of letters involved.
A, B, D, yes, and C. That’s my favorite order, even though that is not how I learned the alphabet in kindergarten. Medicare Part A covers the costs of hospital stays, as well as home health care. Medicare Part B covers the costs of doctors and outpatient services, including rehab and lab work. Part D covers prescription drugs. Part D is a separate program that you must enroll in, in addition to Part A and B. Medicare Part C is made up of other kinds of plans called Medicare Advantage plans, some of which include Parts A, B and D in one whole package. But some of them don’t. See? It got confusing, didn’t it?
Let’s talk about Medicare Advantage plans, because this is the most convoluted part. These MA plans are offered through health insurance companies. They are heavily regulated by the government, so each plan must include certain things, equivalent to traditional Medicare. However, each MA plan may offer more benefits, or lower co-payments, and therefore the costs will be different. United Healthcare is an insurance company that has Medicare Advantage plans that are promoted on the aarp.com web site. An individual must already be eligible and enrolled in a Part A and Part B plan to add on a Part C or Medicare Advantage plan. This is because these plans provide additional benefits, and do not replace Parts A and B.
As with most insurance plans, each Medicare Advantage plan will restrict your choice of doctors or providers to those in the plan’s network. This will occur with traditional Medicare also. Not all MA plans are available in all fifty states, so you will want to check with a local representative to help you choose among the available options in your region.
The third tricky thing about Medicare plans is that all enrollment and all changes to plans must be done during a designated enrollment period. This is typically the last two months of the year, although this year, it starts early, sometime in October. So be sure not to miss the enrollment period or you will be even grumpier.
