Medicare may be one of those life necessities individuals put off until they must deal with it, but once signed up it should be reviewed annually, according to experts in the field.
The opportunity to make changes is available now through Dec. 7, and any changes made are effective Jan. 1, 2024.
Three months prior to a person’s 65th birthday is when eligibility begins, and he or she has until three months after the milestone birthday to make all the initial decisions. After that, the annual enrollment period (mid-October to early December each year) is the time for reviews.
Jordan Puskos, business manager for GuideStone Financial Resource’s life and health team, emphasized how the Medicare journey is different for everyone.
“Start having the Medicare conversations about six months before your 65th birthday,” she said, noting friends who have already signed up are helpful resources as well as small groups at church.
‘Do your research’
“The main thing is to do your research and medicare.gov is a great starting point for anyone who is starting that journey,” she said. “It’s important to engage with qualified professionals and to realize every situation is different.”
In fact, a service churches can provide their members — and be an outreach to the community as well — is to bring in a professional to share about the various aspects of Medicare and answer questions.
Brokers are typically paid on the back end by the carrier if the plan they represent is selected, but there is no obligation to go with the brokers’ firm. Also, brokers are not allowed to charge fees for their presentations or for answering questions related to Medicare.
“Find someone you know and trust who can explain what all the plans mean,” Puskos said.
“Everybody is going to enroll in A and B and have the option of supplemental or advantage, but how do you know which to select? You have to deep dive into what are your needs, your medical history, your family’s medical history, your prescription history, what you will need robust prescription coverage for, your area and hospital networks,” she explained. “There is no right or wrong answer. It’s just what is best for me.
“One of the most common confusions is people think all of it is free,” she added. “While that is true for part A (hospital coverage), you will owe a premium for part B (doctor services) and if you have a supplemental then there will be an additional premium. Part D (prescription coverage) also has a premium.
“It is government subsidized, but it’s not free,” Puskos explained. “(And the various options create) very different arrangements.
“There also are exceptions if you are older than 65 and still working.”
Rebekah Elgin-Council, chief marketing officer for Blue Cross and Blue Shield of Alabama, recently promoted BCBS’ Medicare Advantage plans in a news release, noting “a zero-dollar premium in all 67 Alabama counties.”
Elgin-Council also shared tips for the Medicare enrollment process:
- Consider all your options by comparing benefits, cost and services of each plan.
- Make sure your doctors are covered in the provider network.
- Confirm your prescriptions are covered in the formulary.
- Know the lingo, including deductible, copay and premium.
- Look at enhanced benefits including dental, vision, hearing, fitness and travel programs.
- Consider your health care needs and any upcoming surgeries or doctor appointments in 2024.
Puskos said Medicare enrollees will receive an Annual Notice of Change letter each September leading into the fall open enrollment period to make changes.
“At a minimum, review the letter … and if on an Advantage plan, it’s important to look at the plan because things can fall in and out of the network,” she said. “Also, your medical status could have changed.”
Puskos and her team at GuideStone are available for more information.
Counseling and assistance
The Alabama State Health Insurance Assistance Program (SHIP) also offers “personalized, unbiased counseling and assistance to Medicare recipients and their families,” according to the SHIP website.
“The statewide program … can help with questions or concerns about Medicare coverage, benefits, premiums and coinsurance (see sidebar for contact information).
“SHIP also … can assist with complaints and appeals with regard to coverage.”
Time to sign up for Medicare?
Medicare.gov
- 800-MEDICARE (800-633-4227)
- TTY users can call 877-486-2048
Blue Cross and Blue Shield of Alabama
- bcbsalmedicare.com
- 888-372-3909
United Way Area Agency on Aging
- uwaaa.org/ship
- 800-AGE-LINE (800-243-5463)
GuideStone Financial Resources
- help.guidestone.org/30242-medicare
- jordan.puskos@guidestone.org
Medicare brokers
Qualified professionals representing a variety of brokerage firms also can provide helpful information, and a conversation does not obligate you to purchase the plans they represent.
Source: The Alabama Baptist
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