Annual enrollment for over-65 health plan

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By Bev Carlson, APR, PAHM

The annual enrollment period for the U.S. government’s over-65 health plan is Nov. 15 to Dec. 31. During this annual enrollment season, people with Medicare can join, switch or drop Medicare prescription drug and Medicare Advantage plans. Changes take effect Jan. 1, 2010, and there will not be another opportunity to change drug plans until November 2010.

There are many resources available for those who are going through the process of navigating Medicare and supplemental coverage. Among them, a local insurance agent with Medicare expertise can help, as well as someone you trust who has been through the process. But remember that each person’s needs are different.

There are also several helpful public resources. The Nebraska Senior Health Insurance Information Program at (800) 234-7119 is a state program that offers free counseling. Those who are eligible for Medicare can also contact the government program directly at http://www.medicare.gov.

Here are a few tips on navigating Medicare Open Enrollment:

Making sound Medicare decisions

What is a Medigap policy? Also called “Medicare Supplement Insurance,” a Medigap policy is health insurance sold by private insurance companies to fill gaps in Original Medicare coverage. Medigap policies help pay your share (coinsurance, copayments or deductibles) of the costs of Medicare-covered services.

When should I shop for Medicare supplement insurance? The best time to buy a Medigap policy is during your Medigap open-enrollment period, when you have the right to buy any Medigap policy offered in your state. However, even if you are no longer in your Medigap open-enrollment period, there are several situations in which you may still have a guaranteed right to buy a Medigap policy.

Buying a Medigap policy is an important decision. Only you can decide if a Medigap policy is the way for you to supplement Original Medicare coverage and which Medigap policy to choose. Shop carefully. Compare available Medigap policies to see which one meets your needs.

If you decide to switch Medigap policies, don’t cancel your first Medigap policy until you have decided to keep the second Medigap policy. On the application for the new Medigap policy, you will have to promise that you will cancel your first Medigap policy.

How do I get prescription drug coverage? Medicare offers prescription drug coverage (Part D) for everyone with Medicare. If you have a Medigap policy with prescription drug coverage, you chose not to join a Medicare Prescription Drug Plan when you were first eligible. However, you can still join a Medicare Prescription Drug Plan. It’s a good idea to review your coverage each fall, because you can join a Medicare Prescription Drug Plan between November 15—December 31 each year.

What Medicare Supplemental Policies don’t cover. Medigap policies don’t cover:

*Long-term care (such as care in a nursing home)

*Vision or dental care

*Hearing aids

*Eyeglasses

*Private-duty nursing.

Annual Enrollment Period. If you are currently a Medicare beneficiary, you can make one “election” during the Annual Enrollment Period between Nov. 15 and Dec. 31 of each year. This includes enrolling in or changing to a prescription drug plan, a Medicare Advantage plan or a Medicare Advantage plan with prescription drugs or other Medicare health plan for an effective date of Jan. 1 of the following year.

 

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