Come October, Medicare enrollees can expect to see, once again, a deluge of advertisements urging them to pick this plan or that one during Fall Open Enrollment: the eight-week period from October 15 to December 7 when people can make changes to their coverage for the following year.
You can do several things to help get on top of the situation.
First, know what you have already, which starts with reading your plan’s benefits and seeing what changes they’re making for the coming year in hard copy or online (once it becomes available).
Second, re-acquaint yourself with the ways you can get your Medicare: à la carte (with Parts A and B from Medicare, plus a supplement/Medigap and a stand-alone Part D drug plan), or as a complete package (in the form of an Advantage plan that includes drugs and a variety of extra benefits Original Medicare doesn’t offer). But more than that, look at how Medicare coordinates with other retiree insurance. You may still be covered through your job or have the retirement plan from your former employer or union, or you could be eligible for COBRA, or for VA, Tricare, or FEHB benefits, not to mention Medicaid and Medicare Savings Programs for people with limited resources.
Chances are you won’t need to make any changes if you have retiree insurance from your job, but if you’re out there on your own, try to figure out what each insurance company is trying to sell you. Sometimes it’s a single item (like a Medigap or an Advantage plan). And sometimes it’s a variety of plans that run the gamut of benefits and costs—enough to make your head spin. Read the ads word for word, and the products they’re talking about will start to become obvious.
Now it’s time for the planfinders, to see how these plans stack up against similar ones. Use New York State’s planfinder (myportal.dfs.ny.gov/web/guest-applications/medicare-monthly-premiums) for the Medigap plans, and Medicare.gov for the Advantage plans and stand-alone Part Ds. Armed with your new understanding and research, you’ll be in a much better position to weigh the advice you get from brokers or volunteer counselors who are more than capable to help you make some final decisions.
TURNING 65
And if this is the year you’re turning 65 and getting ready to sign up for Medicare for the first time, here’s what you need to know.
Everyone gets an Initial Enrollment Period (IEP), which is the seven-month window surrounding your birthday month. So, if you turn 65 on June 16, the IEP will run from March 1st through the end of September. This is when you’ll sign up online or in-person at a Social Security office for both Part A (inpatient services) and Part B (providers, equipment, tests, etc.). It’s recommended you apply in the three months before your birthday month so you’ll be covered at the start of your birthday month.
Not everyone will use their IEP the same way. People taking Social Security or Railroad benefits earlier than 65 will be enrolled in Medicare automatically when the time comes. They’ll get a card in the mail and a letter from the Social Security Administration telling them what their monthly Part B premium is going to be through the end of the year, and they’ll use their IEP to pick up additional coverage. And you may not need the IEP at all. If you or your spouse are still working and are covered by an employer plan, you may be able to delay enrolling in Medicare until that coverage stops.
But everyone who has Parts A and B knows that Medicare doesn’t pay for everything, which is why during your IEP, you’ll probably want to buy additional insurance for the remaining bits and some drug coverage (Part D) as well.
And this is where it gets tricky with the IEP, because at this point there are a lot of choices to be made. Will you get that supplemental medical coverage through a separate policy (Medigap) or through a comprehensive Advantage plan (Part C), two entirely different structures? If you choose a Medigap, you’ll need a stand-alone Part D plan for your prescriptions; if you go with an Advantage plan, drugs are included. You may even be eligible for additional kinds of coverage, like VA, COBRA, or a number of other types of insurance, all of which have to be considered.
Give yourself time to sort these issues out. Use the planfinders, ask questions of Medicare, a broker, or the volunteer counselors through the Westchester Library System (see below). And it’s always good to know that you can pretty much change everything, every year, during Fall Open Enrollment. Parts A and B will always hum in the background as long as you pay your premium, but the changes to your medical and/or drug coverage will start at the beginning of the new year.
Westchester Medicare Counseling Resources:
Individual help with healthcare coverage for seniors is provided by Senior Benefits Individual Counseling (SBIC) volunteers at the John C. Hart Library in Shrub Oak and the Grinton I. Will Library in Yonkers throughout the year. Their schedule and two helplines—North county: 347-441-0566 and South county 914-417-9102—can be found on the WLS webpage https://seniors.westchesterlibraries.org/senior-benefits. A comprehensive, upbeat workshop explaining how Medicare works, “Demystifying Medicare,” is given many times in the spring and fall of each year. The online version and schedule of live upcoming events are available at https://seniors.westchesterlibraries.org/demystifyingmedicare. These programs are co-sponsored by the county’s Department of Senior Programs and Services and the Westchester Library System.
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17 Apr 2024
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Come October, Medicare enrollees can expect to see, once again, a deluge of advertisements urging them to pick this plan or that one during Fall Open Enrollment: the eight-week period from October 15 to December 7 when people can make changes to their coverage for the following year.
You can do several things to help get on top of the situation.
First, know what you have already, which starts with reading your plan’s benefits and seeing what changes they’re making for the coming year in hard copy or online (once it becomes available).
Second, re-acquaint yourself with the ways you can get your Medicare: à la carte (with Parts A and B from Medicare, plus a supplement/Medigap and a stand-alone Part D drug plan), or as a complete package (in the form of an Advantage plan that includes drugs and a variety of extra benefits Original Medicare doesn’t offer). But more than that, look at how Medicare coordinates with other retiree insurance. You may still be covered through your job or have the retirement plan from your former employer or union, or you could be eligible for COBRA, or for VA, Tricare, or FEHB benefits, not to mention Medicaid and Medicare Savings Programs for people with limited resources.
Chances are you won’t need to make any changes if you have retiree insurance from your job, but if you’re out there on your own, try to figure out what each insurance company is trying to sell you. Sometimes it’s a single item (like a Medigap or an Advantage plan). And sometimes it’s a variety of plans that run the gamut of benefits and costs—enough to make your head spin. Read the ads word for word, and the products they’re talking about will start to become obvious.
Now it’s time for the planfinders, to see how these plans stack up against similar ones. Use New York State’s planfinder (myportal.dfs.ny.gov/web/guest-applications/medicare-monthly-premiums) for the Medigap plans, and Medicare.gov for the Advantage plans and stand-alone Part Ds. Armed with your new understanding and research, you’ll be in a much better position to weigh the advice you get from brokers or volunteer counselors who are more than capable to help you make some final decisions.
TURNING 65
And if this is the year you’re turning 65 and getting ready to sign up for Medicare for the first time, here’s what you need to know.
Everyone gets an Initial Enrollment Period (IEP), which is the seven-month window surrounding your birthday month. So, if you turn 65 on June 16, the IEP will run from March 1st through the end of September. This is when you’ll sign up online or in-person at a Social Security office for both Part A (inpatient services) and Part B (providers, equipment, tests, etc.). It’s recommended you apply in the three months before your birthday month so you’ll be covered at the start of your birthday month.
Not everyone will use their IEP the same way. People taking Social Security or Railroad benefits earlier than 65 will be enrolled in Medicare automatically when the time comes. They’ll get a card in the mail and a letter from the Social Security Administration telling them what their monthly Part B premium is going to be through the end of the year, and they’ll use their IEP to pick up additional coverage. And you may not need the IEP at all. If you or your spouse are still working and are covered by an employer plan, you may be able to delay enrolling in Medicare until that coverage stops.
But everyone who has Parts A and B knows that Medicare doesn’t pay for everything, which is why during your IEP, you’ll probably want to buy additional insurance for the remaining bits and some drug coverage (Part D) as well.
And this is where it gets tricky with the IEP, because at this point there are a lot of choices to be made. Will you get that supplemental medical coverage through a separate policy (Medigap) or through a comprehensive Advantage plan (Part C), two entirely different structures? If you choose a Medigap, you’ll need a stand-alone Part D plan for your prescriptions; if you go with an Advantage plan, drugs are included. You may even be eligible for additional kinds of coverage, like VA, COBRA, or a number of other types of insurance, all of which have to be considered.
Give yourself time to sort these issues out. Use the planfinders, ask questions of Medicare, a broker, or the volunteer counselors through the Westchester Library System (see below). And it’s always good to know that you can pretty much change everything, every year, during Fall Open Enrollment. Parts A and B will always hum in the background as long as you pay your premium, but the changes to your medical and/or drug coverage will start at the beginning of the new year.
Westchester Medicare Counseling Resources:
Individual help with healthcare coverage for seniors is provided by Senior Benefits Individual Counseling (SBIC) volunteers at the John C. Hart Library in Shrub Oak and the Grinton I. Will Library in Yonkers throughout the year. Their schedule and two helplines—North county: 347-441-0566 and South county 914-417-9102—can be found on the WLS webpage https://seniors.westchesterlibraries.org/senior-benefits. A comprehensive, upbeat workshop explaining how Medicare works, “Demystifying Medicare,” is given many times in the spring and fall of each year. The online version and schedule of live upcoming events are available at https://seniors.westchesterlibraries.org/demystifyingmedicare. These programs are co-sponsored by the county’s Department of Senior Programs and Services and the Westchester Library System.