Medicare Annual Elections: November 15-December 31

Oct 4th, 2009 | By Sharon Shaw Elrod MSW EdD | Category: Social Security & Medicare

Each year Medicare recipients have the option to change their Medicare plan.  No questions asked!  Beginning November 15, and ending December 31, senior citizens covered by Medicare may elect to change their Medicare plan if it no longer meets their needs, if they find a better plan at a better price, or if they want to change from ‘original’ Medicare to a Medicare Advantage plan offered by a private insurance company. 

The place to begin is to be sure you understand the four parts of Medicare, which include the original Medicare plan and Medicare Advantage plans.

  • Part A:  This is the Original Medicare plan, which is basically hospital coverage, inpatient care in skilled nursing facilities, and critical access facilities (urgent care).  Most people do not pay a premium for this coverage. Part A covers inpatient care in skilled nursing facilities, critical access hospitals, and hospitals. Hospice and home health care are also covered by Part A.  You will automatically be enrolled in Part A unless you choose a Medicare Advantage Plan (Part C).  The federal government manages the Original Medicare Plan. It operates on a fee-for-service plan. Most people pay a deductible and then a co-pay or co-insurance.
  • Part B:  Part B is optional medical insurance that covers medically necessary services (outpatient care, doctor’s services, physical and occupational therapy and home health care) and supplies (wheel chairs, walkers, personal hygiene equipment, etc) provided by Medicare. Most seniors pay a premium to receive this coverage. 
  • Part C:  Part C is Part A and Part B combined in a policy offered by a private insurance company approved by Medicare.  These plans are called Medicare Advantage Plans.  The MA plans are still considered Medicare plans; they are an option offered in the private sector, and subsidized by the federal government.  This part also requires paying a premium by the participant.
  • Part D:  Part D is stand-alone prescription drug coverage insurance that usually requires an additional premium.  There are many different prescription drug plans and they must be read carefully to determine the drugs that are covered under the plan; all medically necessary drugs are covered. 

Once you understand the kinds of plans available, do an Internet search for ‘Medicare supplement plan’ ["Supplemental" simply means that you are purchasing a health care plan that supplements the basic plan (Part A) offered by Medicare] or Medicare Part B or C or D, depending on which kind of plan you want to consider; you will find a list of hundreds of companies offering supplemental plans in each of these three categories.  

Most major health insurance companies want your business, so they make it easy for the visitor to surf the website.  You will have a chance to compare the various offerings from that company and determine which one might best suit your needs with that company.   However, SCJ recommends that seniors look at health care insurance offered by several different companies, since they generally try to be competitive and, although you will find similarities in policies, you just may find one company that offers what you want at the best price.

Another option available to seniors interested in changing their Medicare coverage is to reply to the many direct mail ads you will receive over the next couple of months.  Talking with a representative on the telephone is advised in order to avoid misunderstanding what the policy covers.  If you begin to get the ‘hard sell’ from the customer service rep, be sure to remain in control and make your choice only when you have looked at everything you want to consider.  It’s your policy, it’s your money, and it’s your life.



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