Medicare Made Easy

Medicare. It's a word that causes confusion and even a headache for many people approaching 65. The question is what do I do first, who do I call and where do I go? Those eligible for Medicare must be a U.S. citizen or legal resident for at least five consecutive years and 65 years old or older, unless there is a qualifying disability. When turning 65, Medicare provides for an initial enrollment period three months before the person's birthday, the month of the person's birthday and three months after the person's birthday. However, before a person can enroll in any Medicare plan, the person must have applied for and obtained a Medicare card with Part A and Part B, also known as Original Medicare. If a person already receives Social Security, the person automatically receives a card when turning 65. If they are not drawing Social Security, the person can go to a Social Security office to apply or visit medicare.gov.

The coverage options take us back to kindergarten, where we learned our ABC's.

Part A: covers inpatient hospital care plus additional services.

Part B: covers physician services and some preventive services.

Part C: Medicare Advantage. This is where a professional certified for Medicare plans is needed to guide you through the maze of plan options. Be sure to ask about value added benefits such as Silver Sneakers, hearing aids, Dental and Vision.

Part D: Prescription drug coverage. Medicare prescription drug coverage is received by either joining a Medicare prescription drug plan or through a Medicare Advantage Plan that includes drug coverage. Even if few or no drugs are used, it's important to purchase a plan because there is a penalty if you do not enroll when eligible. This penalty will last a lifetime and add to monthly costs. It is important to provide your professional a current list of your medications and ask them to determine which plan will include all your current drugs at the best price.

Medicare supplements are letter plans that fill gaps in Original Medicare A and B. The most popular plans are Plan F and G.

One of the most frequently asked questions is, “When I choose my initial plan, will I be stuck with that plan forever.” The answer is absolutely not.

During annual open enrollment, which occurs between Oct. 15 and Dec. 7, a different Medicare Advantage Plan or a Part D prescription drug plan can be selected. Since formularies change each year, it is recommended to review options with a professional that is certified for Medicare plans. There is typically no charge for an annual review of your benefits.

There are numerous Medicare plans to choose from, but as you are considering each type of plan, it is important you feel comfortable with the cost of the plan, cost of any copays and how you will receive the provided services.

Mary Duncan is vice president of Haas Healthcare Solutions in Chardon, Ohio. She can be reached at 440-286-1263.