Category: Medicare

Medicare Open Enrollment 2020: What You Need to Know

Are you ready for Medicare Open Enrollment? Every year, Medicare health and drug plans make changes to costs, coverage, providers, and pharmacies in their networks. Have you considered that, between coverage changes and health condition changes, it may be wise to revisit health plans during the open enrollment period annually? This year, Medicare’s annual open enrollment period begins October 15th and ends December 7th.

For those already on Medicare, you should have received an “annual notice of change” from your Medicare plan in September. This letter explains all the changes coming in the new year, including coverage and costs such as premiums, deductibles, and copays. Review your medical expenses over the last six months, including a list of the doctors you see regularly and the medications you need.

Medicare beneficiaries without some sort of Medicare Supplement Insurance (Medigap) may face Medicare cost-sharing if they have health problems. Original Medicare pays for much, but not all of the cost for covered health care services and supplies. A Medigap policy can help pay some of the remaining health care costs, such as copayments, coinsurance, and deductibles.

If you are not able to purchase a Medigap policy, a Medicare Medical Savings Account (MSA) might be a good option. MSAs combine high-deductible insurance plans with a medical savings account that you can use to pay for your health care costs.

Medicare Advantage plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all of your Part A and Part B benefits. Most Medicare Advantage plans also offer prescription drug coverage. Before switching to a Medicare Advantage plan, be sure to examine it closely to see if it makes sense. While many have $0 premiums, the out-of-pocket costs can be high, or your hospital or your doctor may not be in-network.

The Medicare Plan Finder on is an online tool from the government to help you select a plan. After you enter your zip code and details about your medications and whether you receive them by mail, you can compare plans available in your area. You can also try the State Health Insurance Assistance Programs, which offer free local counseling to enrollees, or call 1-800-MEDICARE. 

For help evaluating your Medicare coverage options and which plan may work best for you, contact our office today to schedule a meeting time.


What Is Medicare Part D and What Options Apply?

Tens of millions of American seniors rely on Medicare to help pay for their health care needs.

As long as someone is age 65 or older, a U.S. citizen or permanent resident living in the country for at least five straight years, and either they or their spouse paid Medicare taxes during their working years, they’re eligible for Medicare. The program offers government-funded health care coverage in a variety of areas, such as hospital care and outpatient medical services.

Another area of coverage is for prescription drugs. This is what’s known as Medicare Part D.

For most of its history, the Medicare program did not offer a prescription drug benefit. But that changed in 2006, when a bipartisan Congress added the coverage.

By 2017, more than 42 million Medicare beneficiaries had prescription drug coverage through Medicare Part D, which is optional. About 60 percent had a stand-alone prescription drug plan in conjunction with Original Medicare, also known as Medicare Part A (hospital insurance) and Part B (outpatient medical services). The other 40 percent had a Medicare Advantage prescription drug plan.

Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare as it allows program beneficiaries to receive their Medicare benefits through a private health insurance plan. Most Medicare Advantage plans include prescription drug coverage, although you may need to purchase a stand-alone drug plan if your specific Medicare Advantage plan doesn’t include prescription drugs.

For those enrolled in Original Medicare, the only source of prescription drug plans is through private insurance companies because Medicare A and B do not cover outpatient, or outside of a hospital, prescriptions. Medicare Part D, however, does pay for outpatient drug expenses. Each approved Part D plan covers different drugs and copays for covered drugs, which include both brand-name and generic products. It does not cover over-the-counter medications like cough syrups or antacids, prescription drugs like Viagra, or cosmetic treatments like hair growth elixirs or weight loss pills.

Here are several ways to get the Medicare Part D enrollment process started:

Call 1-800-MEDICARE to locate prescription drug plans in your area.
Log on to Medicare’s Prescription Drug Plan Enrollment Center.
Fill out the paperwork sent by mail from Medicare.
Call the private insurer with the specific prescription drug plan you want to join.
Call at 1-855-593-5633 and talk with a licensed agent.

Does this article raise more questions than it answers. We know that dealing with any elder law issue can be difficult. Do not wait to contact our office for support.