Medicare - Elder & Estate Planning Attorneys

10 Essential Tips to Maximize Your Benefits for Medicare Open Enrollment in Florida

Did you know Medicare’s Annual Open Enrollment Period is a crucial time for Florida seniors to review and adjust their health coverage? This critical time period runs from October 15th to December 7th each year, and allows beneficiaries to make important changes to their Medicare Advantage and Part D prescription drug plans.

Whether you are looking to lower costs, improve coverage, or adjust to new health needs, navigating Medicare in Florida can feel overwhelming. With the right approach, however, as well as a clear understanding of your options, you can maximize your benefits and find the best plan for you. Let us share our ten essential tips to guide our Florida seniors and their loved ones through Medicare Open Enrollment, helping you make informed decisions about your health coverage.

1. Review your current plan. Before making any changes, take time to assess how well your current Medicare plan has served you over the past year. Are your doctors and specialists still covered? Have your prescription drug costs increased? Reviewing your current plan helps identify gaps or areas where your coverage may fall short, allowing you to make a more informed choice during Open Enrollment.

2. Consider changes in health needs. Your health needs may have changed over the past year. New medications, treatments, or health conditions could mean your current plan is no longer the best fit. It is essential to evaluate how these changes impact your Medicare coverage and whether you need a plan that offers better access to the services and medications you require.

3. Compare Medicare Advantage vs. Original Medicare. Many Florida seniors choose between Medicare Advantage (Part C) and Original Medicare (Parts A and B). Medicare Advantage plans often bundle additional benefits like vision, dental, and hearing, but they may limit your choice of providers. Start by comparing the flexibility and coverage of these options carefully to determine which plan meets your needs and lifestyle.

4. Check prescription Drug Coverage. Prescription drug costs can be a significant portion of your healthcare expenses. During Open Enrollment, take the time to review your Part D plan or the drug coverage offered by Medicare Advantage. Make sure the plan you choose covers your medications at a price you can afford, and consider any changes to formularies, also known as the list of covered drugs, for the coming year.

5. Review provider networks. If you have specific doctors or specialists you want to continue seeing, ensure that they remain within your plan’s network. This is particularly important if you are considering switching to a Medicare Advantage plan, which often restricts coverage to a network of providers. Going out of network can lead to higher out-of-pocket costs, so it is essential to confirm that your healthcare providers are covered.

6. Evaluate out-of-pocket costs. Beyond monthly premiums, take a close look at your plan’s deductibles, co-pays, and out-of-pocket maximums. Understanding these costs is crucial in determining whether a plan is affordable over the long term. There is no question that you want to compare these costs across different plans to ensure you select the one that offers the best overall value for your healthcare needs.

7. Take advantage of free resources. Florida seniors can access free counseling services through the Florida State Health Insurance Assistance Program (SHIP). SHIP can provide personalized guidance to help you compare plans and understand your options during Open Enrollment. Whether you have questions about coverage or need help navigating the Medicare system, SHIP counselors can be an invaluable resource.

8. Look for extra benefits. Many Medicare Advantage plans in Florida offer additional benefits such as fitness programs, transportation to medical appointments, and meal delivery services. These extra perks can provide significant value, especially if you have specific health needs that require additional support. You want to, however, make sure to weigh these benefits when considering your plan options.

9. Watch out for scams. Unfortunately, scams targeting Medicare beneficiaries can spike during Open Enrollment. You want to be cautious of unsolicited phone calls, emails, or people asking for your Medicare number. Always work directly with trusted resources such as the Medicare.gov website or a SHIP counselor to avoid fraud and protect your personal information.

10. Do not wait until the last minute. Medicare Open Enrollment runs until December 7th, but waiting until the last minute can limit your ability to thoroughly review your options and make the best choice. Start comparing plans early, so you have enough time to evaluate all aspects of your coverage and get help if needed. When you make your decisions, doing so early also ensures a smooth transition if you decide to switch plans.

We know this article raises more questions than it answers. Medicare Open Enrollment is the perfect time for Florida seniors to reassess their health care needs and make necessary adjustments to their coverage. By following these ten tips and seeking professional guidance where needed, you can maximize your benefits and ensure you have the right plan in place for the coming year. Elder and Estate Planning Attorneys, PA, is a law office small enough to provide personal service but large enough to provide service in Jupiter, as well as Palm Beach, Martin, St. Lucie, and Indian River Counties in Florida. Our law firm will guide you through legal challenges involving elder law, estate planning, trusts, veterans benefits, real estate, and more. We encourage you to contact us and schedule a meeting with our attorneys.

Medicaid Planning for Florida Seniors

Did you know that, according to the US Dept. of Health and Human Services, a person turning 65 today has almost a 70% chance of needing some type of long-term care services, including assisted living or a nursing home? The median cost of a private room in a nursing home is over $100,000 annually, according to the Florida Health Care Association. Medicaid planning involves legally and ethically protecting assets for those who do not already qualify for Medicaid, and for those who qualify but may be expecting an influx of money, such as an inheritance or a personal injury settlement, so that individuals can make their money last longer and lead to the highest possible quality of life.

The laws governing Medicaid can be complex. For 2021, the income cap to qualify for Medicaid in Florida is $2382.00, per month. If your monthly income, from all sources, exceeds the limit for this year, you will not qualify for Medicaid. You may, however, consider creating either a Miller Trust, a Qualified Income Trust (QIT), or a Supplemental Needs Trust. A Miller Trust is an irrevocable trust that accepts any monthly income over the income cap or slightly more, even though the Trust still uses that money to pay for your long-term care, minus a small personal allowance. These types of trusts may be structured so that certain assets and income sources are removed from the Medicaid calculation, allowing a person to then qualify to receive Medicaid benefits to cover the cost of long-term care.

Medicaid planning may require a thorough examination of your total asset portfolio. Our office can help you protect your home and other assets. This can be especially important if one spouse needs care and the other can live independently. Do you have questions? Please contact our law practice to learn more. We are here for you. Elder and Estate Planning Attorneys PA is a law office small enough to provide personal service but large enough to provide service in Palm Beach, Martin, St. Lucie and Indian River Counties.

Medicare Part D – What You Need To Know

If you’ve reached the point in your life that you’re insured by Medicare, you’re not alone. Tens of millions of American seniors also rely on Medicare to help pay for their healthcare needs, such as hospital care and outpatient medical services. But you may still be wondering if your prescription drugs will be covered. As of 2017, more than 42,000,000 Medicare beneficiaries had prescription drug coverage through Medicare part D, which is optional.

Anne’ Desormier-Cartwright of Elder and Estate Planning Attorneys PA, offer some insight. 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. But you may need to purchase a stand-alone drug plan if your specific Medicare Advantage Plan doesn’t include prescription drugs.

Medicare part D, pays for outpatient drug expenses. Each approved part D plan covers different drugs and co-pays for brand name and generic covered drugs. One way to get the Medicare part D enrollment process started, is to call 1-800-MEDICARE to locate prescription drug plans in your area.

There are other ways. To find out more, an elder law attorney can help with this matter and more. Elder and Estate Planning Attorneys, PA, is a law office small enough to provide personal service, but large enough to handle all of your estate and planning needs. Do not wait to contact their office for support.

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 MedicareResources.org 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.

Tag: Medicare