Senior Savvy
By Robert Goodman, MSW
Medicare 2022
Updated July 2021
The time has come to evaluate your Medicare coverage for 2022. From October 15 to December 7, you will have the option of joining or changing your Medicare Advantage Plan. You have several choices.
You can stay with original Medicare and/or buy a supplemental (Medigap) policy. If you want prescription drug coverage, you must also join with a Medicare Prescription Drug Plan (Part D).
You can choose to join a Medicare Advantage Plan Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage. You must take the drug coverage that comes with the Medicare Advantage Plan. Some plans offer additional benefits, such as vision and hearing screenings, disease management, and other services not covered under Original Medicare. Medicare Advantage Plans must offer emergency coverage outside of the plan’s service area (but not outside the U.S.).
A Health Maintenance Organization (HMO) plan is a health care plan in which you generally must get your care and services from doctors or hospitals in the plan’s network, and you may need a referral to see a specialist.
A Preferred Provider Organization (PPO) plan you can generally obtain health care from any doctor or hospital you want within their network. You have the flexibility to go to any doctors, specialists, or hospitals that aren’t in the network, but it will usually cost more. Monthly premiums and how much you pay for services vary depending on the plan.
Questions to ask Medicare Advantage Providers
- Is there a monthly premium and how much is it?
- What doctors can I see and how much it will cost me to see a doctor.
- What hospitals can I use and how much it will cost me to use a
hospital (either as inpatient or in an emergency).
- What happens if I am traveling and need to see a doctor?
- How much it will cost me for outpatient procedures.
- Is there a monthly drug premium and how much is it?
- How much it will cost me for your medicines over the course of a year.
- Are there any changes in my plan from last year?
For help in selecting a Medicare Advantage Plan go to the Medicare Plan helper at www.medicare.gov. The website has been revised and updated.
Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States. For information go to http://ssa.gov/prescriptionhelp.
The source for much of the information in this article is from www.Medicare.gov. You can find information on Medicare; look for a Medicare plan in your area, or compare Medicare Advantage Plans. Another good resource on Medicare policy and information is www.medicarerights.org.
Florida Navigator in cooperation with Temple Beth Shalom will be sponsoring a health fair and Medicare forum on Thursday, November 18 from 9:00 AM to 12 Noon where you can meet representatives of various Medicare advantage plans.