The window is available each year: 15 Oct – 7 Dec. For all Medicare eligible patients, please examine your plan during the enrollment period; perform a checkup & see if you want to change or continue with your current plan. Why is this important? Coverage benefits and premium prices are OFTEN altered from year to year, and while monthly premiums are important, some plans will low ball the premiums to lure you in yet stick you with higher overall costs on copays and deductibles.
Basic Terminology: Great Primer on (https://www.cnbc.com/2017/10/10/if-you-miss-this-medicare-deadline-it-could-hurt-your-health.html )
Medicare offers a listing @ https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/your-medicare-coverage-choices.html
US News and World Report lists local Treasure Valley plans by highest to lowest rated @ https://health.usnews.com/medicare/search?county=16001&type=cd&zip=83646&sort=rating
1) monthly premiums (amount spent every month even when services are not needed)
2) deductible (amount you pay before the insurance company begins to pay anything)
3) max out of pocket (most you will pay for A+B services; does NOT include part D prescription costs)
Although some assistance is provided by the insurance payer for “preferred” medications, as defined by the payer, a coverage gap (donut hole) commonly will apply. For example, you will often see the following qualifier:
“In 2020, once you and your plan provider have spent $4020 on covered drugs, (combined amount plus your deductible) you will be in the coverage gap. (AKA “donut hole”). You will be required to pay 25% for brand-name drugs and 25% on generic drugs unless your plan offers additional coverage. (VERY uncommon)”
These high copay amounts will apply through the donut hole time until the max out of pocket is reached.
If you KNOW you will need substantial medical coverage in the upcoming year, it may be wiser to pick a plan that may have a higher premium, but has a lower max out of pocket.
Another consideration is how restrictive each plan is regarding prior authorizations and limits on which services/medications are readily accessible. Ask your physician for which payers cause them the greatest grief and difficulty in having services approved to help you.
Original Medicare A+B is going to be more expensive. Medicare Advantage is going to be less and typically covers more; some plans have vision, dental and hearing coverage. A few even have zero-dollar premiums.
However, you need to look at your health care needs and lifestyle preferences to decide. If you travel frequently or you’re a snowbird, Medicare Advantage plans often won’t cover you when you’re out of your geographic area due to narrow networks with greater restrictions.
You cannot get something for nothing; lower costs with Medicare Advantage may give less flexibility on which doctors and hospitals you can use.
More on Medicare & other insurance costs: https://www.carefulcents.com/the-average-cost-of-health-insurance/
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