What you need to know about enrolling in Medicare.

Medicare Open Enrollment: What You Need to Know

Answers to frequently asked questions about enrolling in Medicare.

What you need to know about enrolling in Medicare.
By SHARE

According to the federal government's Center for Medicare Services, Medicare enrollees aren't eligible for during open-enrollment: they can sign up for the health plan three months before the month of their 65th birthday, but the eligibility ends on the third month after the birthday month. But don't wait until the last minute.

"The reason you want to start early is you don't want any gap" in medical coverage, Muschler said. "You need to review your options and how you will use your coverage."

Things to consider: What doctors will you use? Do you have a preferred health-care provider or hospitals? What are your health needs? Will your plan travel with you if you move? What about a spouse, and dependents – are they covered? Can you afford higher premiums for broader coverage?

Self-education is job one for the new enrollee, Muschler said. Coming up is an outline of some available resources that can help.

Q: Should I sign up for Obamacare instead?

A: Not if you're enrolled in or eligible for Medicare. The Health Insurance Marketplace under the Affordable Care Act is designed to help younger people who don't have health insurance.

Even if you're still on the job and have health insurance through your employer, if you're 65 or older the new Health Insurance Marketplace isn't for you. Moreover, it's illegal for someone who knows that you have Medicare to sell you a Marketplace plan.

Q: What about the gap in Medicare Part D prescription-drug coverage – the so-called "donut hole"?

A: Obamacare helps shrink the payment gap that kept some seniors from getting prescriptions they needed but couldn't afford.

Last year, in the early phases of the ACA, seniors enrolled in Medicare Part D got a 50 percent discount on brand-name drugs and 14 percent off on generics. As health-care reform proceeds, out-of-pocket prescription-drug expenses will drop each year until the donut hole closes in 2020.

In fact, according to the Center for Medicare Services, key parameters for Part D prescription drug coverage will actually go down next year compared to this year. For example, the Part D deductible will fall from $325 to $310, and the donut hole will shrink by $200 – reforms that will put more money back into the pockets of Medicare beneficiaries.

Q: What about Medicare Part B – will premiums go up because of the ACA?

A: No; in fact, they might get lower.

The AARP has predicted that health-care reforms could hold down the costs of Part B premiums, if not lower them. Congress established an official formula for setting Medicare Part B premiums years ago and that formula won't change under Obamacare.

Q: I've heard some scary things: that Medicare could go away, and Obamacare could replace it.

A: There are no plans to replace Medicare.

The life of the Medicare Trust fund will be extended to at least 2029 — a 12-year extension due to reductions in waste, fraud and abuse, and Medicare costs, which will provide seniors with future savings on premiums and coinsurance.

Q: What kind of information do I need to sign up for Medicare?

A: You'll need the basics – name, address, Social Security number and current health insurance information – and a few extras if you're married, have dependents or meet certain conditions.

That includes your spouse's and children's Social Security or health care information; your employer's name and address if you get health care through a group plan; and information about your Worker's Compensation claims or federal disability benefits, if they apply. The Medicare Initial Enrollment Questionnaire, along with a complete list of documents you'll need, is available online at Medicare.gov, or at your local Social Security office.

Q: Okay, I think I understand. But If I need more information, where can I get it?

A: There are lots of resources around that can help clear up any lingering confusion.

That includes Medicare advisory companies like Allsup; web sites by advocacy groups for seniors such as AARP; private insurance companies and nonprofit public-interest entities like the Kaiser Family Foundation also have strong online presences and hotlines. U.S. News & World Report also has a guide that offers information for consumers who are seeking to understand or purchase Medicare plans.


TAGS:
Medicare
health care
health care reform
health insurance
Best Medicare Plans

To search for top-rated Medicare Advantage or prescription drug plans in your state, select your state: