8 Things Every Senior Needs to Know About Medicare

8 Things Every Senior Needs to Know About Medicare

Jeanette Gomez Medicare Leave a Comment


Medicare is a Federal government operated health insurance plan for people with disabilities and those who are age 65 and above. Some of the critical components of Medicare include Medicare Parts A and B, Medicare Advantage (Part C) and Drug Coverage (Part D). During the annual Medicare Enrollment period, beneficiaries of Medicare are given an opportunity to change their coverage. One of the biggest challenges faced by seniors during the enrollment period is lack of awareness. This disconnect causes hundreds of thousands of seniors to miss out on Medicare benefits every year. Here are 8 things every senior needs to know about Medicare Open Enrollment.Open Enrollment

Open Enrollment Date

The Medicare Open Enrollment period runs annually from October 15 to December 7 of each year. During this period, seniors can sign up for Medicare Part C (Medicare Advantage) or Medicare Part D (Medicare Prescription Drug Coverage). This is also the time to make changes to an existing plan. The changes include moving to a new coverage, changing the drug coverage benefit and opting out of enrollment.

Getting Medicare Part A and Part B (Original Medicare)

There are two ways to get Original Medicare. First, you can choose Original Medicare as a separate entity, and include a Medicare Prescription Drug Coverage or Part D option. Individuals who are collecting their Railroad Retirement Board (RBR) or Social Security automatically qualify to receive Hospital Insurance in Medicare Part A plan and Medical Insurance in Medicare Part B. Medicare Part B, however, comes with a premium. For this reason, you must decide whether you want to keep it. Alternatively, you can choose a Medicare Part C plan, which comes with Original Medicare plus other extra benefits, such as prescription drugs. The Medicare Part C works the same way as PPO or HMO, which means you can choose any doctor within the service network or outside the network for an extra charge.

You Can Choose to Do Nothing

If you do not wish to make any changes to your Medicare Plan during the Open Enrollment period, your current plan will rollover into the next year in its current form.  No action is required or necessary.  However doing nothing is not recommended.  If during the past year you have had a change in medications or have been diagnosed with a new medical condition; your current Medicare plan may no longer meet your needs.  Medicare plans also change and cost for each plan may go up or down.  Prescription drugs can be added or dropped to each plan as well.  Other plans may change benefits they once offered and stop coverage in certain locations.  It is recommended that because of the possible changes that can occur within each Medicare plan, that you check your current plan and see if a change in plan is necessary.

Medicare Cost is not Static

Medicare doesn’t cover all medical expenses. This may force seniors to incur some out of pocket cost for their care.  A few of the items that Medicare does not cover are:

• Long-term care
• Most dental careMedicare Cost is not Static
• Eye examinations related to prescribing glasses
• Dentures
• Cosmetic surgery
• Acupuncture
• Hearing aids and exams for fitting them
• Routine foot care

Importance of Timing

Individuals who turn 65 automatically become eligible for Original Medicare (Medicare Part A and B). During the enrollment period, you can:

• Change your plan from Original Medicare Plan to Medicare Advantage
• Alter your Medicare Advantage Plan back to the Original Medicare Plan
• Shift from Medicare Advantage plan to another Part C plan
• Move from Medicare Part C Plan with no drug prescription to a Medicare Part C with drug coverage
• Shift from Medicare Part C Plan with drug prescription to Medicare Part C plan without drug coverage
• Enroll on a Medicare Prescription Plan
• Shift your plan from one Medicare Prescription Plan to another
• Opt-out of your Medical Prescription drug coverage plan

Keep Track of Your PaymentsKeep Track Of Your Payments

Whenever you choose to add, change or drop a plan, always keep an eye on your payments. Some of the charges you need to monitor include; the premium amount; the total out of pocket expenses from the previous year and the changes in deductibles, prescription drug cost and co-pays.

Missed Deadlines

If you miss your deadline, you may be forced to wait until next year to make changes to your plan. Otherwise you may be forced to pay higher premiums and other penalties. However, there is a second enrollment window that starts from January 1 to February 16 (2016). During this second enrollment period, you can do the following:

• Switch your plan to Original Medicare, if you have a Medicare Advantage Plan.
• Switch to Original Medicare Plan and add drug coverage to an existing plan. Coverage begins from the first day of the month after enrollment; once the submissions have been received.

Seek Help

The process of enrolling or making changes to a Medicare plan can be very tasking. If you do not understand just how it all works, just ask for help. If you want instructions on how to sign up for any Medicare Plan, visit www.medicare.gov or call Medicare at 1-800-MEDICARE (1-800-633-4227).

About the Author

Jeanette Gomez


Jeanette Gomez, trusted advisor, transitioned to iSeniorSolutions when the company launched in 2014. Her career began working in the accounting department of a senior living facility back in 2007. From accounting, human resources, payroll and billing she has grown to have a deep understanding of the home health and senior living industry from the inside out. She has even provided years of executive administrative support to the owners and their many companies. Her current role as Digital Media Specialist now has her assisting and overseeing all digital media and data strategy.