Make Medi­care changes now

News-Herald (Perkasie, PA) - - OPINION -

Medi­care and sup­ple­men­tal health cov­er­age pro­vide a safety net for those age 65 and up, but in­sur­ance cov­er­age, at best, can be con­fus­ing.

For the nearly 117,000 Mont­gomery County res­i­dents who are 65 years or older now is the time to think about health care cov­er­age, as Oct. 15 was the first day and Dec. 7 the last day those with Medi­care can make changes to their health in­sur­ance plans.

Fol­low­ing are tips from one in­sur­ance car­rier for those us­ing Medi­care.

• Even i f y o u ’ r e h a p p y wit h y o u r c u r r e n t c o v - er­age, i t d o e s n ’ t h u r t t o c o mpare p l a n s . Most p l a n s make c h a n g e s e v e r y y e a r, s o i t ’s worth check­ing even if you care­fully con­sid­ered plans l a s t y e a r. I f y o u s t i l l l i k e what y o u h a v e , d o n o t h i n g a n d y o u ’ l l a u t o mat­i­cal l y b e r e - e n r o l l e d i n y o u r c u r r e n t p l a n.

• Orig­i­nal Medi­care EParts A and BF doesn’t cover ev­ery­thing. Take a look at your reg­u­lar monthly health care ex­penses and de­cide what plan cov­ers what you need at the best cost. Orig­i­nal Medi­care doesn’t cover ev­ery­thing and has no lim­its on outof-pocket ex­penses.

• Medi­care Ad­van­tage plans pro­vide ad­di­tional ben­e­fits. Medi­care Ad­van­tage plans EPart CF are an­other op­tion to orig­i­nal Medi­care. They pro­vide com­pre­hen­sive cov­er­age with fewer out-of-pocket costs than orig­i­nal Medi­care and of­ten in­clude cov­er­age for pre­scrip­tion drugs EPart DF. Medi­care Ad­van­tage plans also of­fer ad­di­tional ben­e­fits, such as hear­ing, den­tal, vi­sion ser­vices, help manag­ing chronic con­di­tions such as di­a­betes, and ad­di­tional sup­port af­ter a hos­pi­tal­iza­tion.

• Check that your net­work in­cludes doc­tors and hos­pi­tals you will need. Your health needs can change, so it’s best to think ahead to be sure you have easy ac­cess to qual­ity health care ser­vices.

• Make sure your plan cov­ers the med­i­ca­tions you take. If you’re buy­ing a Medi­care Pre­scrip­tion EPart DF plan, check if there’s cov­er­age for your drugs in the “donut hole.” This is where you are re­spon­si­ble for a cer­tain per­cent­age of charges af­ter reach­ing your pre­scrip­tion cov­er­age limit and be­fore you reach the yearly out-of-pocket max­i­mum spend­ing limit.

• If pos­si­ble, don’t wait un­til the last minute to en­roll. The ex­tra time helps your in­sur­ance com­pany ver­ify your el­i­gi­bil­ity, get you prop­erly set up in their sys­tem, or­der your ID card, and en­sure a smooth tran­si­tion from 2012 to 2013.

• It’s OK to change your mind. From Jan. 1 to Feb. 14, Medi­care ben­e­fi­cia­ries can can­cel their Medi­care Ad­van­tage plan and sign up for a Medi­care Sup­ple­ment, or re­turn to orig­i­nal Medi­care.

Where to go for help. A li­censed bro­ker can pro­vide you with all the in­for­ma­tion you need to make an in­formed de­ci­sion and even come to your home to ed­u­cate you. Also, many health plans of­fer community meet­ings about Medi­care. Check with an in­surer now to find out.

The of­fi­cial U.S. gov­ern­ment site for Medi­care, which in­cludes in­for­ma­tion on re­lated sup­ple­men­tal health plans is at www.medi­care.gov.

News-her­ald photo — DEBBY HIGH

SWEEPSTEAK WIN­NER ... Caro­line Court, cen­ter, re­ceives a $500 gift card to Lan­dis Food Mar­ket for win­ning first place in the Pen­nridge Community Cen­ter’s GrubSteak SweepSteak.

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