Understanding Your Medicare A&B Options

If you are new to Medicare A&B or already have it, do you understand your options?  One of the most important times of year to make changes is Annual Enrollment Period (AEP) which is from Oct 15th– Dec 7th.  During this time, Medicare beneficiaries can add, drop or switch plans.  Medicare health plans as well as Prescription Drug Plans (Part D or PDP) can change in services, costs and of course coverages.  The AEP is a good time to look over your existing plan (if applicable) and/or compare other options.

When looking at Medicare Advantage plans, consider provider network and the prescription formulary.  Whatever product choice you make, you will want your current doctor to accept the plan you choose.  A prescription formulary is a list of prescriptions covered by that PDP or Part D plan.  You will want to make sure your current medications are covered in the formulary of any plan you choose with prescription drug coverage.  In most cases, in this area your prescription drug coverage must come through the Medicare Advantage plan if that’s the type of plan you choose.  These plans, including stand alone PDP plans, are rated each year based on quality and performance.

Another choice is the Medicare Supplement policy which are sometimes referred to as Medigap plans.  Original Medicare has gaps in coverage so a Medicare Supplement plan can help to pay some of the costs that aren’t covered.  You can then add an optional stand alone PDP to go along with your Medicare Supplement plan.  There is no network for a Medicare Supplement plan but you will want to make sure your Provider accepts Medicare.  Any stand-alone Prescription Drug plan will provide coverage based on benefits and will also use a prescription formulary as well.  If your income is limited you may qualify for Extra Help on your PDP plan’s cost and benefits. 

Did you know Medicare Supplement plans, with most companies, can be changed any time of year?  This is not the case with Medicare Advantage or Part D plans where you can generally only make changes during AEP, Medicare Advantage Open Enrollment (Jan 1 – Mar 31), or with a Special Enrollment situation.

Whether you are getting ready to go on Medicare A&B soon, or if you are already on it and have a policy(ies) to go with it, it’s best to start researching your choices early.  You will want to make sure you get the plan with the benefits and services that are best for you.

~Bush and Associates has been serving the insurance needs of Caldwell County since 1980!  Get in touch with us by calling (828) 754-2601, texting 828-493-5821, emailing quotes@bushandassociates.net  or by stopping by our office at 916 Wilkesboro Blvd. Lenoir. 

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