Medicare insurance is health insurance that is provided by the federal government for people who are age 65 or older, certain younger people with disabilities, and people with end-stage renal disease.
Medicare plans are divided into four parts. Part A covers hospital insurance, Part B covers medical insurance, Part C is a subset of Parts A and B and allows private companies to provide subscribers with Medicare insurance, and Part D covers prescription drug insurance. Parts A and B are called “Basic” or “Original” Medicare, and Part C is called “Medicare Advantage.” There are also Medicare Supplement Insurance plans available, called “MediGap,” that help pay healthcare costs that Parts A and B don’t cover.
You can apply for Medicare coverage whenever you become eligible, regardless of the time of year. Once you are covered, you have the option of making changes to your plan once each year during a period called “open enrollment.”
Open enrollment runs Oct. 15 through Dec. 7 each year, and takes effect on Jan. 1 of the following year. Open enrollment is the only time you can make changes to your plan. You can change any or all parts of your plan (parts A–D). You can also add a plan or switch from one plan to another.
It is important to review your Medicare plan annually. “Every year, Medicare insurance companies make changes to premiums, co-pays and coverages that go into effect the next year,” said Cleveland Heights native Kathleen Carvin, an insurance broker with HealthMarkets Insurance Company. “It’s important to review the available options every year during open enrollment to make sure you have the coverage next year that you want, need and can afford.”
Although your current insurance company will send you a letter explaining the changes it is making to the plans it provides, it will not tell you about the changes that other providers are making. It’s best to review all the policy options with an expert, to make sure you have the best and most affordable coverage available. “Choosing the right Medicare supplement plan requires matching your personal healthcare needs to the range of options available to you,” said Carvin.
Reputable insurance agents will talk to you at length about your wants and needs before recommending a plan. Said Carvin, “I find out if the client has a preferred doctor and hospital. I explain the pros and cons of Basic Medicare and Medicare Advantage plans. I also ask what they like and don’t like about their current plan. Then I help them find a plan that covers their needs, at the lowest cost possible.”
When contacting an agent for advice it is important to understand the difference between insurance brokers and “captive agents.” Captive agents represent one particular insurance company, and sell policies only for that company. That insurance company may or may not have the best available policy for you. Insurance brokers represent many different insurance companies and sell a wider variety of policies.
The Cleveland Heights Senior Activity Center (SAC) is holding a free Medicare Open Enrollment Day on Tuesday, Nov. 17, 10 a.m. to 2:30 p.m. Counselors from the Ohio Senior Health Insurance Information Program (OSHIIP) will meet one-on-one to answer questions. OSHIIP volunteers are also available at the SAC every Wednesday morning. Call 216-691-7377 for an appointment.
You can contact Kathleen Carvin at 216-375-5902 or [email protected]. Helpful information on Medicare is available through the Centers for Medicare and Medicaid Service at 800-633-4227 or www.medicare.gov.