Time for Medicare patients to think about open enrollment options

by Lesley Politi on November 18, 2008

If you’re one of America’s more than 36 million seniors, it’s time to prepare and compare for your 2009 Medicare coverage.

Medicare is health insurance for most people 65 and older who do not have other sources of coverage. (The program also applies to younger people with certain disabilities and permanent kidney failure.)

It covers many services and supplies in hospitals, physician offices and other health care settings.

Now is the time to join, switch or drop Medicare. Open enrollment began Saturday.

Your deadline is Dec. 31, but make your decisions by early December — especially for those enrolling for the first time or making changes — to avoid conflicts with coverage in January.

You must make two major decisions. There are monthly premiums, co-payments and deductibles associated with both major choices.

•The first decision is to choose original Medicare or a private insurance (HMO or PPO) to cover hospital and doctor visits.

•The second concerns prescription drug coverage.

Savvy seniors might be able to find new prescription plans that save money.

“There are opportunities to go in and find different health plans under the approved Medicare Part D that would result in savings,” said James R. Langabeer II, an associate professor of management at the University of Texas School of Public Health in Houston. “Several plans this year did drop their overall cost. That’s what consumers have to look for.”

He also suggests asking your doctor whether generic alternatives to your name-brand drugs might work for you.

GETTING STARTED: Gather your Medicare card and a list of your current medications. Collect any mail you have received from Medicare, Social Security or your current drug plan.

VISIT MEDICARE ONLINE: www.medicare.gov

MAKE IT PERSONAL: Personalize your search for what’s best for you by visiting www.MyMedicare.gov, a site that allows you to decide based on your individual Medicare information. If you are new to Medicare, use the www.MyMedicare.gov password and instructions Medicare mailed to you.

NO INTERNET ACCESS?: Call 800-633-4227 (800-MEDICARE).

GET HELP: Enlist relatives and other trusted people for input as you decide. Remember: The right plan for one spouse may not be best for the other.

MORE HELP: Call 800-252-9240

CHOOSE A PLAN: Confirm that your medications are covered and that your doctor and other providers will accept the plan.

BE CAREFUL: Only deal with reputable people to protect yourself from theft and identity fraud.

THE FULL GUIDE: You should already have received the Medicare & You 2009 handbook in the mail. It is also available at www.medicare.gov/Publications/Pubs/pdf/10050.pdf.


Part A: Covers hospital services. Most people receive this automatically. You usually don’t pay a monthly premium if you or your spouse paid Medicare taxes while working.

Part B: Medical insurance for doctor visits, outpatient care and some preventive services. Most people will pay the standard premium, $96.40 a month in 2009. If you don’t sign up when you are first eligible, the premium may be higher. Cost varies for those in the Medicare Advantage Plan or with other health insurance. Part B enrollment rights can be affected if you have coverage through an employer or union and you or your spouse still work.

Supplemental insurance: Known as a Medigap policy and sold by private insurance companies; can help pay co-payments, co-insurance and deductibles not covered by Original Medicare.


Part C: Private insurance that includes Parts A & B. If you have this coverage, you don’t need a Medigap policy and cannot use it to pay for expenses under this plan.


Part D: Medicare Rx is a prescription drug benefit with a monthly fee. Those with Original Medicare must choose and join a Medicare prescription drug plan run by private companies and approved by Medicare. People with limited income and resources may qualify for help paying for medications.

Source: Centers for Medicare and Medicaid Services

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