Seniors, do you like your Medicare plan?
If not, now is the time to make some changes. Open enrollment for Medicare began Oct. 15, giving enrollees the opportunity to shake things up if their plans aren’t working for them. The enrollment period lasts until Dec. 7.
Medicare is a government-supported health insurance system for people over 65, younger people with disabilities and those with end-stage renal disease (permanent kidney failure that requires dialysis or transplant). Most employees in the United States pay taxes into the system over the course of their careers, then they can enroll in a low-premium plan in retirement.
Medicare coverage is split into parts that cover various aspects of health care. Their minutiae can be difficult to decipher, which is why the Senior Center of Jackson Hole offers volunteer Medicare counselors twice a month.
“We’re trying to give them the information so they can make a good choice,” counselor Martha Birkett said.
Birkett’s official title is senior Medicare patrol counselor, and she was trained through the Wyoming State Health Insurance Information Program. She and June McCollister, the other counselor who volunteers at the Senior Center, help seniors navigate the system when they turn 65 or when they need to change their plan.
There are two main options for Medicare enrollees: “Original Medicare” is the colloquial name for Parts A and B; Medicare Advantage plans fall under Part C.
Part A is often referred to as “hospital insurance” and covers things like in-patient services, hospice care, lab tests and surgeries. In general, those who paid into the Medicare system over the course of their careers receive Part A coverage for free.
Part B is called “medical insurance” and covers outpatient services and some preventive care, among other things. It has a premium based on income (though most people pay around $135 per month), and it is automatically deducted from benefits like Social Security for those who receive them.
Medicare Advantage plans (Part C) are private insurance plans that are required to cover everything that Medicare does but may include things that Medicare doesn’t, like vision or dental coverage. Those interested in a Medicare Advantage plan must enroll in Parts A and B and pay the Part B premium.
“We try to steer people clear of that in Wyoming,” Birkett said. “We don’t have good Part Cs because we are a small state and spread out.”
Anyone confused by the compartmentalized Medicaid system — which also includes Medigap plans that pay the difference between what Medicare covers and hospitals charge, and Part D (drug coverage) — can seek help from counselors at the bimonthly meetings at the Senior Center.
“Those are good place to start,” said Hannah Sell, activities and volunteer coordinator at the Senior Center. “They’ll have additional meetings if people need more information.”
In the open enrollment period, Medicare enrollees can change from original Medicare to a Medicare Advantage plan, or vice versa, or they can change their Part D coverage with “no questions asked,” Birkett said.
Sometimes, changes to a plan made outside an open enrollment period can incur penalties, as can signing up for any type of Medicare coverage outside the initial open enrollment period around a person’s 65th birthday or her retirement. Those who missed their initial enrollment period will have to wait until Jan. 1 to enroll and may face late-sign-up penalties.