It’s that time again! It’s open enrollment for Medicare, which falls between October 15, 2018 – December 7, 2018. It’s the time of year mailboxes are flooded with promises from all sorts of different companies about how much money they will save you. There are advertisements everywhere for all kinds of products, and the different options within Medicare itself can be confusing too. Here are a few things to know and some resources that might help clear up the confusion!
What exactly is Medicare and what does it pay for?
Medicare is the federal health insurance program for:
- People who are 65 or older
- Certain younger people with disabilities
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
The different parts of Medicare help cover specific services:
Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, short-term care in a skilled nursing facility, hospice care, and some home health care.
Medicare Part B (Medical Insurance)
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.
Medicare Part D (prescription drug coverage)
Part D adds prescription drug coverage to:
- Original Medicare
- Some Medicare Cost Plans
- Some Medicare Private-Fee-for-Service Plans
- Medicare Medical Savings Account Plans
These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.
What are Medicare Advantage Plans?
Medicare Advantage Plans can be a confusing, and sales people with the companies who sell them can be pretty aggressive in their sales tactics. The Medicare website provides lots of information about these plans and can help educate you about them before you sign up. Medicare describes these plans as “Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These "bundled" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).” Additional information about them can be found at the following link: https://bit.ly/2DryVBW
Does Medicare cover the costs of memory care?
Unfortunately, no, Medicare does not pay for long-term care like assisted living, private duty home care, or long-term care in a nursing home. Medicare is a health insurance program designed to help cover the costs of skilled medical care such as hospitalization and other inpatient care for acute medical needs, physician services, skilled therapies, skilled nursing, medical supplies, hospice care, and prescription drugs.
If I have questions about my options under Medicare and/or supplemental plans, is there an unbiased source of help?
Yes!! Each state offers a Senior Health Insurance Program (SHIP) that provides accurate and objective counseling, assistance, and advocacy relating to Medicare, Medicaid, Medicare supplements, Medicare Advantage, long-term care, and other related health coverage plans for Medicare beneficiaries, their representatives, or persons soon to be eligible for Medicare.
In Oklahoma, you can contact:
Senior Health Insurance Counseling Program
Phone: (405) 521-6628
Toll Free:(800) 763-2828 (in state only)
Website: SHIP.OID.OK.GOV
The 2018 Medicare Supplemental Insurance Buying Guide is also a great resource and can be found at the following link: https://www.ok.gov/oid/documents/031618_shoppersguide2018-web.pdf
In Texas, you can contact:
The Area Agency on Aging (AAA) program that serves your county has a Benefits Counselor available to answer questions about Medicare. The website which lists all AAAs in the state can be found at the following link:
In Dallas County:
Area Agency on Aging of Dallas County in partnership with Community Council of Greater Dallas
Phone: (214) 871-5065
Website: https://www.ccadvance.org/help-for-seniors-and-caregivers/
In Rockwall County:
North Central Texas Area Agency on Aging
Toll-Free Phone: (800) 272-3921
Website: https://www.nctcog.org/aging-services/older-adults/direct-services
The Medicare website is full of helpful information. It can be found at the following link: www.medicare.gov