Medicare Open Enrollment: Understanding and Taking Charge of the Options - Spokane, North Idaho News & Weather KHQ.com

Medicare Open Enrollment: Understanding and Taking Charge of the Options

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(ARA) - For retirees, there are many different activities that can occupy the free time they have now that they are out of the working world. Some of the top choices might include spending extra time with family (especially the grandkids), taking that dream vacation, volunteering in their local community or improving their skills in a favorite hobby.

However, from November 15th to December 31st, retirees ages 65 and older should take the time to do something that is probably not on the top of anybody's list of favorite things to do -- sort through their Medicare health benefits options. During this annual Open Enrollment period, the nearly 40 million individuals who are eligible for Medicare can select their health coverage for the upcoming year.

Even though it might not be the most enjoyable task, it is an extremely important one. Unfortunately, with age usually comes an increased need for health care services, so it is important to choose a plan that will meet both current and future health care needs.

The good news is that there are many resources that can help retirees sort through their plan options, including those offered by the Centers for Medicare and Medicaid services (www.medicare.gov), senior centers and community organizations, and health insurers that offer Medicare Advantage plans.

"In many cases, individuals have received their health benefits from their employer throughout their careers, so they are not used to shopping for a health plan," says Frank McCauley, the head of the Consumer Segment for Aetna, which develops and markets products for retirees. "Because they are new to the process, and there are many options to consider, it is essential that they have access to information that helps them make the best decision for their specific situation."

Making the Most of Medicare

Since most people have paid federal Medicare tax throughout their careers, they are somewhat familiar with the government program. However, they might not be aware of the different aspects of the program, or the fact that private insurers offer Medicare plans that offer benefits above and beyond Original Medicare. The various parts of the Medicare "alphabet" include:

* Part A helps pay for inpatient hospital care, skilled nursing facilities, hospice care and some home health care. Because people usually pay for Part A coverage through a federal Medicare tax while working, most don't pay a deductible or monthly premium after age 65.
* Part B helps cover doctors' services, outpatient hospital care, physical and occupational therapy. This is optional and usually requires a monthly premium.
* Part C includes Medicare Advantage plans (such as Health Maintenance Organizations and Preferred Provider Organizations) and provides Parts A and B benefits to enrollees, as well as prescription drug benefits in some cases. With these plans, Medicare contracts with private insurers to provide this coverage.
* Part D provides coverage specifically for prescription drug benefits. Like Part C, Medicare contracts with private insurers to provide this coverage.

According to McCauley, Medicare Advantage plans can offer enhanced coverage options for consumers.

"These plans typically offer better benefits than the original Medicare plan, and you can also combine prescription drug coverage with these plans, which is significant for many retirees," McCauley says. "They are really 'all-in-one' plans, so you pay one monthly plan premium for a complete benefits package. It can make life a lot simpler."

In addition, many insurers offer valuable "extras" at no extra cost, such as annual routine hearing and vision exams, allowances for eyewear and hearing aids, and even certain discounts on things like nutrition counselors or gym memberships.

McCauley noted that many insurers also offer disease management or case management programs for their members, which can be particularly beneficial for individuals who have chronic conditions. These programs provide targeted outreach to individuals based on their specific health needs and can help to enhance the access to care an individual receives and, ultimately, their quality of life.

Starting the Search

Instead of immediately choosing a plan, McCauley said it is important to make this important decision in a step-by-step process:

* Learn the basics -- Find some general background information that will allow you to feel comfortable discussing the fundamental elements of Medicare. One helpful resource is www.planforyourhealth.com, which includes a brief breakdown of the different health care options after retirement, a list of 10 tips for a healthy retirement and information on other relevant issues such as long-term care.

* Know who you are -- After absorbing this initial information, determine what types of plan features are most important on a personal basis. If you have a strong relationship with a doctor, does he or she accept the insurers that you are looking at? What types of prescription drugs do you need, and how are they covered by the different plans? These are just a couple of examples of the questions that should be answered before moving forward.

* Research plan designs -- At this stage, you know the essentials and the most important things to you personally, so find the plan the best meets your needs. For more specific details on Aetna Medicare plans, individuals can call (800) 529-5586 or visit www.aetnamedicare.com, where there are descriptions of plan options, resources to locate doctors and pharmacies, and frequently asked questions on Aetna Medicare plans.

* Enroll in a plan -- Now that you're armed with knowledge and comfortable with your options it's time to enroll. Keep in mind, however, that you only have until December 31st to choose your Medicare plan for the upcoming year.

Courtesy of ARAcontent
Content provided by Aetna

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