Houston Chronicle Sunday

YOUR HEALTH

Signing up for Medicare 2022 begine with knowing the facts

- By Valerie Sweeten FREELANCE WRITER

Medicare is only one word, but what it stands for and encompasse­s involves many parts, details and decisions that deliver beneficiar­ies excellence in care.

For those age 65 and older, the annual enrollment period for Medicare is Oct. 15 – Dec. 7, 2021.

Donnie Aga, MD, medical director of KelseyCare Advantage, said that during this time, Medicare-eligible individual­s can join, switch, or drop a plan. Coverage begins on Jan. 1, 2022 if the deadline is met correctly.

“If a Medicare Advantage Plan, Medicare drug plan, or Medicare cost plan with a five-star rating is available, individual­s can use the five-star Special Enrollment Period to switch from their current Medicare plan to one with a ‘fivestar’ quality rating,” Aga said.

Memorial Hermann recommende­d that individual­s who qualify for Medicare consult with a profession­al to guide them through the process to ensure they are choosing the best option for them.

Breaking down Medicare’s many components is crucial. Generally speaking:

Memorial Hermann stated that everyone needs to sign up for Part D coverage (prescripti­on drug coverage) when they turn 65 to avoid a penalty from the federal government. If the Medicare Advantage plan is selected, Part D is included in coverage. If they choose Original Medicare and purchase a supplement, they will need to purchase a Part D prescripti­on drug plan as well.

Not all Part D plans cover the same medication­s. Each plan has a “formulary” or list of drugs that are covered, Aga said.

“It is important to remember that Medicare Part D is not offered direct from Medicare,” Aga said. “Part D can only be received from private companies that contract with Medicare and offer either an individual prescripti­on drug plan (PDP) or through a Medicare Advantage plan that also includes prescripti­on drug coverage.”

One Houston woman recently qualified for Medicare and began the process of signing up.

“It was a breeze. I just went through the Social Security site, and that made it easy,” said Terry Swenson. “I filled out a few pages of forms with simplistic questions, for I would imagine the obvious reasons — needing to be fairly intuitive and not confusing so most just have to do it once.”

She had some suggestion­s to offer.

“It helps to have a cell number, so they text you a verificati­on code for security, which was easy. I got the paperwork through the mail quickly. Now I’m just waiting in my physical card. So as of Oct. 1, I start(ed) Medicare with my plans A, B, and C.”

Aga added that making a decision about your health care is something that shouldn’t be taken lightly. Consider the costs for prescripti­ons, the type of coverage, provider choice, quality of care, plans for travel, and out-of-pocket expenses, Aga said.

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