Medicare: 3 More Things You Need to Know

Medicare is open for enrollment until December 7, so if you haven’t signed up, there is still time! More than 40 million Americans are already enrolled in the Medicare program. If the reason you haven’t signed up yet is because of some concerns you may have about the enrollment process, Crosspointe Insurance can help you make some sense of all the Medicare information that’s on the web. For an overview of the Medicare program, check out the 3 Things You Need to Know about Medicare Enrollment.

Enrolling in Medicare

When it comes to Medicare enrollment, you have two options. You can decide whether you want to enroll in the original Medicare program, or if you want a Medicare Advantage Plan. Original Medicare includes hospital insurance, and you can pay a monthly premium for medical insurance.

The Medicare Advantage Plan is more like a Health Maintenance Organization (HMO)[1], or a Preferred Provider Organization (PPO)[2], in that you are essentially enrolling in Medicare Part C, hospital and medical insurance. You’ll pay a monthly premium for the Advantage Plan, and copayments for covered medical services. The costs, extra coverage and rules for Part C vary by the plan you purchase.dreamstime_13141159

After choosing between the Original Medicare program or the Medicare Advantage Plan, you’ll need to decide if you want prescription drug coverage (Part D). If you are enrolled in the original Medicare, you must join a Medicare Prescription Drug Plan and pay a monthly rate. If you have a Medicare Advantage Plan, prescription drugs are included in your plan, most of the time. Please note that if you do not choose a drug plan while you’re eligible to enroll in Medicare programs, and do not have other creditable prescription drug coverage, you may pay a late enrolment penalty if you choose to join later. It is important to know when you are eligible.

After determining where you are getting your drug coverage (should you choose to enroll with that), you can decide if you want supplemental coverage with your Original Medicare Plan. Please note that if a Medicare Advantage Plan is not offered in your area, you will have to choose the Original Medicare program.

  • Convenience

When choosing coverage, it’s important to note the convenience of your plan. Some convenience questions you should ask are: Where are the doctor’s offices? What are their hours? Do they use electronic health records? What pharmacies can I use? Will my other healthcare providers accept my type of coverage? Is the pharmacy I use preferred? Can I get my prescriptions by mail?

  • Cost

Another thing that is very important for everyone enrolling in Medicare is the cost of your plan. Some questions to be considered are: Do I need to purchase an additional Medicare drug plan? What are my yearly deductibles? Will I need to pay out-of-pocket? Is there a yearly limit on what I can pay out-of-pocket?

  • Coverage

Finally, determine how well you will be covered by this plan and determine whether you will need additional coverage. Questions you should ask yourself are: Some how well does the plan cover the services I need? Am I satisfied by my medical care? Will I have coverage in another state or country? Are there coverage rules that apply to my prescription?

Looking for more of the Medicare basics? If you just want the basics on Medicare enrollment, check out another one of our blog posts that gives an overview of the Medicare program.

While Medicare can be confusing, Crosspointe’s expert advisors can help you navigate the enrollment process. We can make the process a lot easier and find the perfect plan for you, all for no additional cost. Give us a call at 888.788.1565 or submit a request for a quote online.

[1] An HMO is an organization that provides or arranges managed care for health insurance on a pre-paid basis.
[2] A PPO is a managed care organization of medical doctors, hospitals, or other health providers who have agreed with an insurance carrier to provide health care at a reduced rate for those on the plan.