Knowledge is power. Unfortunately, many of the 46 million Americans over 65 lack a full understanding of Medicare and this can have a negative impact on their wallet and their health care.
The Medicare Open Enrollment Period allows Californians to review their current health plan and decide whether their health coverage meets their needs. It’s imperative to review the offerings for 2016, because even if your plan is satisfactory now, coverage and expenses can change. And, if you don’t enroll by Dec. 7, changes cannot be made again until next year.
According to a study conducted by the Bankers Life Center for a Secure Retirement, more than half, 56 percent, of middle-income Baby Boomers age 47 to 64 reported knowing little about the Medicare program. One in four — even those within a few years of turning 65 — knew almost nothing about Medicare.
During the open enrollment period, it is crucial for Medicare beneficiaries to take charge of their health care and understand the plans and their coverage. The Centers for Medicare and Medicaid Services (CMS) reports that California has more than 6.1 million Medicare beneficiaries — the most in the US — so the demand for information is great.
Do your research, learn about Original Medicare and decide whether you need supplemental plans, including:
• Medicare Parts A and B: Original Medicare is comprised of two parts. Part A (hospital insurance) covers limited inpatient care at a hospital, skilled nursing facility and hospice. Services such as lab tests, inpatient surgery, doctor visits and home health care are covered in Part A as well. Part B (medical insurance) covers health care providers’ services, outpatient surgery and care, durable medical equipment, home health care and some preventive services.
• Medicare Part C: While Medicare covers most health care expenses, it doesn’t cover everything. As a result, many Americans are opting to buy private insurance in lieu of Original Medicare to cover services Medicare Part A and B doesn’t cover. Medicare Advantage plans, sometimes called “Part C” plans, are sold by private health insurance companies. The Kaiser Family Foundation states that about 38 percent of California’s Medicare beneficiaries are enrolled in a Medicare Advantage plan. Medicare Advantage plans tend to offer more benefits, such as prescription drugs, dental, vision, hearing and other preventive services that Original Medicare does not.
• Medicare Part D: This is the prescription drug coverage offered by Medicare, and is available in Advantage Plans or from a standalone Medicare Prescription Drug Plan (PDP).
Once you’ve researched Medicare, organize your health information. Before you start researching individual plans, compile a detailed list of medications and health care providers. Make a list of all of the costs associated with your current plan; not just the premium, but also the co-pays, co-insurance and deductibles. (Premiums, deductibles or copays can change every year, and no one wants to be surprised about their health or out-of-pocket expenses.)
The most important thing is to consider your current and future personal health needs, including any recent changes. This becomes particularly important when evaluating prescription drug coverage plans. Plan options vary greatly, and they can have a considerable impact on your household budget.
Take action well before the Dec. 7 deadline. First, visit medicare.gov, where you can access “Medicare & You,” the official publication from CMS, which includes everything you need to know about Medicare and enrollment. Medicare experts can also assist you over the phone if you prefer a conversation with a representative.
If you prefer speaking to someone local, free services are available to California residents through California Department of Aging’s Health Insurance Counseling and Advocacy Program (HICAP). You can call HICAP toll free at (800) 434-0222.
And, of course, there are many local, trusted insurance professionals with experience in Medicare, including supplements and Medicare Advantage, who can explain your options and help you make informed decisions.
Medicare’s Open Enrollment Period can be a stressful time, but it’s also a great opportunity for Californians to take charge of their health coverage. Now is the time to do your research, consider your options and talk to a health care adviser or insurance professional. You’ll be thankful you did.
Farshad Asl is the regional director of the Los Angeles office for Bankers Life, the national life and health insurance brand that focuses on the retirement market. He can be reached at Farshad.Asl@BankersLife.com.