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Senior Citizen's Guide to North Jersey

When it Comes to Medicare, Choices Abound

It‘s said that the more things change, the more they stay the same. Anyone who follows health care policy knows that programs and plans are almost always in a state of flux. Change can be complicated but with the right guidance and information in your hands, it can also be good. And if you have Medicare or are Medicare-eligible, now is the time to take a good look at medical coverage that is right for you and within your budget.

Medicare’s annual enrollment period is here. It commenced on October 15 and runs until December 7, so seniors are carefully weighing options and information during this very important window of opportunity to make a change. Seniors and others on Medicare have the option to change their health plan or move from traditional Medicare to a Medicare Advantage plan. They can also choose to move back to traditional Medicare. The coverage under this new enrollment period becomes effective on January 1, 2012.

Medicare is the federally supported health coverage plan that assists seniors 65 and older and the disabled pay for care. The program features two principal components -- One for hospital coverage (Part A) and the other for medical coverage (Part B), and two other parts that offer flexibility and prescription drugs -- Part C and Part D.

Part C represents Medicare Advantage (MA). This part combines both hospital (A) and medical (B) coverage, and can incorporate Part D, which is a prescription plan. One of the main advantages to the MA plan over the standard Medicare Program is that Medicare Advantage Prescription Drug plans (MAPDs) already include a prescription benefit whereas Medicare beneficiaries are required to subscribe to a separate, stand-alone Part D plan and, in many cases, pay a separate premium. This premium would be required only when enrolling in Part D.

So, there are many different products for seniors to think about before making a decision, as well as new features to those products.

If you’re reading this article, you may feel comfortable with your coverage and content to make no changes. You have that option. You don’t have to do anything if you want to stay right where you are with your coverage.

That said, it still would make sense to take a look at your options and to make sure that the coverage you enjoy now is still available and in effect for next year. For example, take a look to make sure your physicians and prescription drugs are still in your plan. Is the formulary still right for you? Does the network of physicians and specialists meet your needs? As you review all the options, are you aware of how drug quality limits, name brand drugs, and the “donut hole” can influence your out of pocket costs?

Many of the Medicare changes for next year are the result of the new federal healthcare reform law, the Affordable Care Act (ACA). The good news is that the new law has made many preventative services and procedures free of charge. Under the new law, some drug options are more affordable, too. These changes are part of the benefit options in Medicare Advantage plans.

The variety of Medicare options present many choices that should be compared side by side to ensure that your decisions make the most sense for your budget.

The official Medicare web site offers a comprehensive, step by step resource of information to help you weigh options and find answers to many of your health coverage questions:

We extend wishes of good luck and good health to all during this enrollment period and throughout the year!

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