Understanding Your Health Information

FAQ’s

Medicare Advantage plans (Part C) replace your original Medicare coverage (Part A, Part B), while Medicare supplement or Medigap plans (C, D, F, G, K, L, M, N) work alongside original Medicare to cover some of the costs that Medicare doesn’t pay for.

Why Compare Options?

When looking into all Medicare plans, it’s important to be aware of potential drawbacks to make informed decisions. Some options may advertise low premiums and extra benefits, but it’s essential to consider all the factors involved to make the best choice for your needs.  Inquire as to the following when exploring any Medicare plan:

Limited Provider Networks: Plans may have limited networks of doctors and hospitals. If your preferred healthcare providers are not in the network, you might encounter increased out-of-pocket expenses or be compelled to change doctors, which can disrupt your ongoing care.

Prior Authorizations: Plans may require prior authorization for procedures, tests, or medications, potentially delaying or denying recommended care.

Unexpected Costs: Although some Medicare plans may have lower monthly premiums, they could involve higher out-of-pocket expenses when you need medical care. Costs such as copayments, coinsurance, and deductibles can accumulate, especially for individuals with chronic conditions or those needing frequent medical attention.

Coverage Gaps: Some plans may not cover services that Original Medicare does, such as specialized care, certain types of therapy, or out-of-network care. This can leave you unexpectedly paying out-of-pocket for healthcare services.

Plan Changes: Plans have the flexibility to alter their benefits, provider networks, and costs on an annual basis. Your preferences and needs may vary yearly, necessitating regular reassessment and potential plan changes. Remember Medicare Open Enrollment is October 15th – December 7^th of each year.

Misinformation: Be cautious and ensure you have information that fully discloses limitations and/or exclusions. It’s crucial to carefully read and understand the details before signing up to avoid unexpected issues later. A good source to help provide information to make the best decision is your medical provider and pharmacist. They can likely provide you with your personal information about what services and drugs you need and if those are covered by a plan you are considering.

Conclusion

Note, before enrolling in a plan, it’s wise to thoroughly research and compare all available options, consult with your healthcare provider, and pharmacy to consider your long-term healthcare needs, and ensure that the plan you choose will serve your best interests without unexpected costs or limited access to care.  Weigh your information and plan options alongside traditional Medicare to make a fully informed decision.

The information provided for Medicare Plan enrollment is intended for general informational and educational purposes only. It does not constitute professional medical or insurance advice. Actual coverage may vary based on individual circumstances and specific plan details. It is recommended to consult with a licensed insurance agent or Medicare representative to discuss options and make informed decisions regarding healthcare coverage.

As You Age Your Health Changes – Shouldn’t Your Healthcare Coverage?

As you get older, your healthcare needs change and become more complex. It’s important that your Medicare coverage adapts to these changes so that you are fully protected and receive the best care possible. It’s essential to review annually and possibly update your Medicare coverage as you age.

1. Increased Healthcare Needs: The chances of developing chronic conditions, needing more frequent medical visits, or requiring specialized care increase. What may have been effective for you at age 65 might not be enough by the time you’re 75. Making sure your Medicare coverage adjusts to your changing health needs can help you avoid gaps in care and unexpected out-of-pocket costs.
2. Prescription Drug Coverage: In the future, you might need additional medications or new drugs. If your current plan doesn’t cover these medications entirely, you might end up paying more than you need to. Reviewing your Medicare Part D (Prescription Drug Plan) with your medical provider and/or pharmacist can help you better manage these expenses.
3. Access to Specialists: As your health changes, you may need to visit specialists more often. If your current Medicare plan has a restricted network or requires referrals, you could experience delays or increased costs.
4. Preventive Services: Medicare provides a range of preventive services that are particularly important as you get older. These include screenings for cardiovascular diseases, cancer, and diabetes. It’s essential to ensure that your plan adequately covers these services.
5. Long-Term Care: As you get older, you may require long-term care (swing bed or nursing home) or home healthcare. These benefits can significantly improve your quality of life and provide the comprehensive care you may need as you age. Determine if the plan you have or are considering, does or does not offer this type of coverage. 
6. Financial Considerations: Your financial situation might change as you get older, impacting your ability to afford healthcare. By consistently reviewing your Medicare coverage, you can discover plans that provide improved financial protection. This could include lower out-of-pocket maximums, extra cost-saving benefits, or premium assistance programs.
7. Changes in Medicare Plans: Medicare plans can change every year, which can impact benefits, costs, and network providers. Something that worked perfectly for you last year may not be the best choice this year. Reviewing your plan during the annual enrollment period will prevent any unexpected surprises and ensure that your coverage still meets your needs.

Conclusion

In conclusion, just as your health changes with age, your healthcare coverage should also evolve. By annually reassessing your Medicare options, you can ensure that your plan selection adapts to your needs, providing the best possible protection and peace of mind as you navigate the changes that come with aging.

The information provided for Medicare Plan enrollment is intended for general informational and educational purposes only. It does not constitute professional medical or insurance advice. Actual coverage may vary based on individual circumstances and specific plan details. It is recommended to consult with a licensed insurance agent or Medicare representative to discuss options and make informed decisions regarding healthcare coverage.

In short, having the right Medicare coverage is not just about insurance – it’s about guaranteeing comfort through comprehensive care, stability through reliable, consistent access to healthcare. By selecting a plan that meets these standards, you can approach the future with confidence, knowing that your healthcare needs are well taken care of, both now and in the future.

To compare plans and find a plan that best fits your needs visit www.medicare.gov

If you would like to talk it over call 1-800-633-4227 (Medicare) or contact the State Health Insurance Program at (228) 868-2311 or 1-800-444-8014 (Toll Free)

The information provided for Medicare Plan enrollment is intended for general informational and educational purposes only. It does not constitute professional medical or insurance advice. Actual coverage may vary based on individual circumstances and specific plan details. It is recommended to consult with a licensed insurance agent or Medicare representative to discuss options and make informed decisions regarding healthcare coverage.