7 Methods to Avoid Medicare Insurance Traps As Well As Costly Blunders
Limbach, J. - ConsumerAffairs.com - 11/4/2010
If you're going to turn 65, you'll be a part of the initial wave of baby boomers registering for Medicare insurance. Customer Reports Health recommends signing up as early as 3 months ahead of your birthday. Neglecting to do thiscould potentially set you backthousands of dollars down the road. That is one of 7 tricks for navigating the Medicare maze.
"If you don't stay on top of the process when you first sign up, you are able to fumble in to choices that could lock you out of certain kinds of coverage, costing you thousands in additional rates and out-of-pocket expenses," said Nancy Metcalf, senior program editor, Consumer Reports Health.
"Medicare insurance is filled with traps so it's really worth your time to dig into the facts from the system and ensure you ultimately choose wisely based on your individual needs."
Listed below are seven tips for navigating the Medicare labyrinth:
DO enroll in Medicare well before you turn 65.
Whether or not you're still working and have health benefits, you have to register for Medicare Part A, which covers any hospital costs. The first registration period spans the 3 months just before, the actual month of, as well as the 90 days following your 65th birthday.
If you sign up within the first three months, your Medicare coverage starts at the beginning of your birthday month. If you sign up during your birthday month, subsequently coverage starts in the beginning of the next 30 days. If you hold off until the last 3 months, you'll face increasingly lengthy delays in the beginning of your coverage.
Do not delay Medicare Part B signup after you leave the workplace.
While Medicare Part A costs nothing to anyone who has paid Medicare taxes for over a decade (or is married to somebody that has), Medicare Part B includes a month to month premium ($96.40 or $110.50). Part B covers almost every other medical expenses, aside from prescription drugs.
If you don't sign up for Medicare Part B when you or your partner stops working, then you'll fall into what is potentially Medicare's largest trap and you'll be hit with a permanent increase in your own premium of 10 percent for each year that you could of registered but did not. There are several unique rules for particular groups, detailed at www.ConsumerReportsHealth.org.
DO understand that Part D, the prescription-drug benefit, has different regulations.
Part D is shipped solely through personal plans with an average premium of around $41 a month in 2011. Just as with Part B, you will pay for a premium penalty for late enrollment, but for Part D, it is 1 percent additional for each month that you could have signed up but didn't.
Should you have low drug bills today and believe Part D is unnecessary, consider that calculation and consider your immediate savings against the penalty down the line in case you need costly prescription drugs. Utilize Consumer Reviews' Best Buy Medicines, which provides drug rankings for over thirty five common medical conditions, to judge the cost of drugs.
The actual free program provides ratings based on price, safety as well as efficacy, detailing the costs related to different dosages for many accessible medications in every category.
DON'T mistake original Medicare and Medicare Advantage.
There's original government-run Medicare that includes substantial insurance deductibles and co-insurance (for instance, an $1,100 deductible for any hospital visit and 20 percent of outpatient physician appointments). People who don't have a second retiree strategy from their company usually buy a separate personal Medigap policy to assist with those insurance deductibles and coinsurance.
About 25 percent of Medicare customers opt for the more recent Medicare Advantage programs. They are private policies -- mostly HMOs -- which take the place of original Medicare plus Medigap, and often the Part D medication program too.
While you'll likely pay cheaper monthly premiums, bear in mind that you will not have Medigap to pay any deductibles and co-pays, which could vary from plan to plan. Thus, one of several disadvantages of an Benefit plan is potentially higher out-of-pocket expenses if you get severely ill.
DO discover how your own retiree program works with Medicare.
Retiree plans take several forms such as stand-alone plans and programs similar to active-employee plans. Either kind will pay secondary to Medicare. Declining your retiree coverage as well as registering for a Medicare Advantage plan on your own can become a major pitfall. Most importantly your own company may not let you re-enroll if you abandon your retiree plan, thus prior to signing up for anything, find out exactly how your retiree plan works together Medicare.
Do not unintentionally lock yourself out from Medigap coverage.
Purchasing a Medigap plan could be tricky, particularly if you have developed a pre-existing problem. State laws vary, however in nearly all places you possess the right to purchase a Medigap program without medical screening only at certain times, for instance when you initially subscribe to Medicare Part B, when you lose your Medicare Advantage coverage because a plan shuts down or if you leave its service region, or when you lose your retiree coverage.
Discover the policies of Medigap where you live by investigating together with your State Medical health insurance Counseling and Support Program (go to www.shiptalk.org to find your state's program).
DO recheck your Plan D formulary annually.
Every Part D plans possess a formulary, a summary of covered drugs. Bear in mind that the formulary can change from year to year, which means that your medicine might fall off the formulary or proceed to an increasingly expensive payment tier. Plans can also put new restrictions on drugs, such as requiring your doctor to get authorization from the insurance provider prior to prescribing them. You may change to a new plan yearly if your plan makes adjustments that do not work for you.
Make use of the interactive formulary finder at Medicare.gov and stay on the top of best medication choices for your condition by using drug studies published for free at www.ConsumerReportsHealth.org (click on the Prescription Drug tab).
Ranking of leading Medicare Advantage HMOs
In addition to the do's as well as do nots typed out inside the document, free ratings of 183 Medicare Advantage HMOs can be found online at www.ConsumerReportsHealth.org. The Rankings are produced by the non-profit National Committee for Quality Assurance (NCQA), the main U.S. group which sets measurement requirements for health insurance, accredits programs, measures the quality of treatment they accomplish, and publicly reports the findings.
Subscribers can access more detailed details such as exactly how well plans conduct based on consumer fulfillment, providing preventive services, and treating well-known ailments. Rankings and much more detailed info on 104 Medicaid plans will be made available free of charge.
More is obtainable in the December issue of Customer Reports and online at www.ConsumerReportsHealth.org.