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The ABC's of Medicare for Seniors, Caregivers

By The Boomer FOXBusiness

This week is National Medicare Education Week. And with open enrollment just around the corner, there is no better time to review the ABC’s of Medicare.

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Understanding the basics of Medicare coverages is just as important for caregivers as it is for seniors. So whether you are enrolling in Medicare, or caring for a loved one who is, pay attention to this insight from Dr. Efrem Castillo, Chief Medical Officer at UnitedHealthcare Medicare & Retirement.

Boomer: What assistance is available to seniors during National Medicare Education Week?

Castillo: UnitedHealthcare established National Medicare Education Week in 2012 to help provide people with clear information about Medicare. During National Medicare Education Week, UnitedHealthcare will host free educational events throughout the country. To see the list of 2016 events and reserve a spot, visit NMEW.com.

We also offer a wide-range of digital resources for those who are unable to attend an event. This week, we hosted a live Facebook Q&A, and enrollment tips, plan-comparison worksheets and a glossary of Medicare terminology are always available on MedicareMadeClear.com.

Boomer: Do I need a broker to shop for coverage during open enrollment?

Castillo:  No. While you can get personalized support from a licensed agent, there are plenty of other resources available to make the shopping process easier and to help you feel confident about your Medicare enrollment decisions including:

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• Medicare.gov or 1-800-MEDICARE

• Doctors, pharmacists and other health care professionals

• Community support, including friends, family members and the State Health Insurance Assistance Program (SHIP) office

• MedicareMadeClear.com 

One of the pieces of advice I offer to beneficiaries every year is to get started on this process now. By doing so, you’ll have plenty of time to review your options before the Open Enrollment Period and find the best Medicare fit for you.

I suggest considering these three things when shopping for Medicare coverage:

Choice: When it comes to Medicare, one size definitely does not fit all. What works for your neighbor may not work for you. Take the time to learn and understand the benefits and costs of each plan so you can feel confident in your decision and your health care coverage.

Care: Care starts with a strong relationship with your primary care provider. If your plan has a network, make sure you’re comfortable with the doctors and hospitals in the network. Check to see if your plan will coordinate your care with the rest of your health care team.

Experience: Medicare can be complex and confusing. It’s important to find a plan that works best for you and supports you throughout your health care journey with plan benefits and resources that can help you live more and worry less.

Boomer:  If I change my coverages during open enrollment and find I am not happy, can I change back to my previous coverage or choose a new plan?

Castillo:  The Open Enrollment Period, which begins Oct. 15 and ends Dec. 7, is an important time of year because, for most Medicare beneficiaries, it’s their one opportunity all year to make changes to their coverage. It’s important that beneficiaries take advantage of this annual opportunity to review their current coverage, assess if it’s still meeting their needs, and explore their options to determine if it might make sense to change their coverage.

Most beneficiaries have to wait until the next Open Enrollment Period to choose a new plan or elect to go back to your previous plan. In some cases, you may be able to switch plans outside of the Open Enrollment Period. This includes changes in your life situation such as:

• You retire and leave a health plan through your employer

• You move out of your current health plan’s service area

If you have a Medicare supplement plan, you can drop your policy and apply for another at any time.

Boomer:  What plans are available that offer hearing, vision or dental services?

Castillo: Original Medicare (Parts A and B), sometimes called “traditional” Medicare, is the health insurance program offered by the federal government. Original Medicare covers inpatient care, such as hospital visits, and outpatient care, such as doctor’s visits and preventive care. However, original Medicare does not cover routine dental and vision care, such as dental exams, eye exams or eyeglasses.

Medicare Advantage plans, also known as Part C, include all the benefits of Original Medicare plus additional benefits and features, such as hearing, dental and vision coverage. If having coverage for these services is important to you, Medicare Advantage may be a good choice.

Boomer:  Are there any plans that offer a gym membership or wellness coverages?

Castillo:  Yes, some Medicare Advantage plans offer benefits such as prescription drug coverage, gym memberships, house call visits and access to 24/7 nurse phone lines.

I encourage you to use National Medicare Education Week to reflect on your health care needs and budget. Attend an event or look up Medicare information on MedicareMadeClear.com. Then do your homework and shop around to find the plan that is the best fit for you. 

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