Medicare 101

Some of you may have already gone through this process and the rest of you will....sooner or later. My husband will be 65 in October and for the past few months he's been inundated with offers from a multitude of insurance companies explaining their Part B benefits and wanting you to fill out a little card for someone to either call or drop by. One company was even holding a seminar with snacks and beverages offered. My husband fell for that one...almost. He signed up but didn't go. Although the person in charge will explain very well how Medicare works and the difference between the companies and their plans, they will eventually try and get you to sign up with them. The trouble with that is that you've got to do the same for every company out there.

My husband was lucky enough to meet a man last year at Walmart who was giving out info and advice for those who were ready to join or switch their current company. He is a Medicare Specialist and works for a local company who is on contract with many insurance companies, so he has no interest in one particular company. His interest lies in the consumer. I highly suggest that when your time comes you find a person like that. I guess in essence he is an insurance broker.

He did a great job explaining that everyone will automatically be on part A and B, that's hospital and medical for the same price of $115.40. If you have other medical insurance you may not need part B for awhile but you also may pay an enrollment penalty when you do join. Then it starts to get interesting and confusing. Part C is the Medicare Advantage Plan and Part D is the prescription drug program. If you do not sign up for Part D when you're supposed to, you will be penalized for the rest of your life. Seriously.

The original Medicare Supplement (Part B) helps you pay for some of the costs that Medicare doesn't pay with any doctor or hospital visits. You will pay a monthly premium for Part B and if you want drug coverage you must choose a Drug Plan. And then you can also buy a Medigap policy to fill gaps in coverage. All of these separate plans add up.

The Medicare Advantage Plan also called part C, includes Part A and B. This plan has only been around since 2006 and can be confusing to those that have been with the Original one for years. The premiums are usually cheaper because you're not paying extra for a medical plan or drug plan.

The plan you choose depends on what medicines you are currently taking and your general health. My husband is only taking one, for high bp. And it makes a difference on who you see as a doctor and if they are a carrier of a certain plan. So there are many factors to look at when choosing a particular plan. that's why it's very beneficial to find someone who can explain all of the insurance companies and not favor a particular one. You can also switch from the Advantage Plan to Original Medicare or Visa Versa but only at certain times of the year if your circumstances change.

If you take the Advantage Plan route you may have to switch doctors if you have a particular benefit package you love but your current doctor is not enrolled in it. We got lucky with our doctor being a part of one company that does not charge a premium. Since he is generally healthy and only takes one medication we chose the Advantage Plan. He will soon have pretty decent medical coverage for 115 bucks a month. Sometimes it pays to be married to an old dude. Now I just hope I don't have to wait 12 more years before I can find some good coverage too.

Please don't take me at my word for all of this, my memory is already starting to fade about what he told us. But I feel confident that we made the best choice for his particular circumstances. All-in-all it wasn't as hard or confusing as I thought it would be. Signing up for his Social Security seemed harder.


Thank God for the dear old National Health Service here in the UK. Thanks also for your comments on my blog.
Grumpy said…
I signed up for SS online in about 10 minutes; my head is spinning regarding Medicare.

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