Okay, enough for now of this dying stuff of the past few days. Let's get on with the particulars of living – in today's case, Medicare.
On Monday this week, the annual Medicare open enrollment period began. It runs until 7 December which isn't very long if, like me, you procrastinate over such tedious work. But it's important so pay attention. I'll make this a easy and clear as possible.
Let's start with this (deceptively) simple overview of the process:
Here are the things you can do during this fall enrollment period:
• If you now have traditional Medicare (Part A for hospital coverage; Part B for outpatient coverage), you can switch to an Advantage plan (Part C) if you wish
• If you now have an Advantage plan, you can switch to traditional Medicare
• If you dislike your current Advantage plan, you can switch to a different Advantage plan
• If you have a Part D prescription drug plan, you can choose another or you can purchase one if you did not do so when you were first eligible
Remember, traditional Medicare (Parts A and B) is offered by the federal government. Advantage plans and Part D (prescription drug coverage) are commercial products although they must meet certain requirements of the government.
Here are the 2019 premium and deductible changes for traditional Medicare :
Ninety-nine percent of traditional Medicare beneficiaries pay no Part A (hospital) premium. The deductible, when you are admitted to a hospital, will be $1,364 for 2019, up from $1,340 this year.
The new Part B (outpatient) premium, deducted from your Social Security benefit each month, will be $135.50 in 2019, up from $134 this year. The deductible will increase to $185 from 2018's $183.
There is more detailed information on Part A and Part B premiums and deductibles here.
The grandmother of all Medicare information sources during fall enrollment is the Medicare and You 2019 book.
In the past, it was snail-mailed to every Medicare beneficiary in the U.S. Some people still get it that way. If you receive yours electronically or if you have misplaced it, you can download a copy online here. [pdf]
For Advantage plans (combined Parts A and B in one package with, most of the time, Part D), and for stand-alone Part D plans to go with traditional Medicare, there are differences from state to state. You can find information for each individual state here [pdf].
A NOTE ON SOME DIFFERENCES BETWEEN TRADITIONAL MEDICARE AND ADVANTAGE PLANS
Advantage plans sometimes have no monthly premiums and usually offer additional services such as coverage for vision, hearing and dental along with reduced gym membership fees and such which make them attractive.
However, each one also requires that you use their roster of physicians, hospitals and other service providers. Also, just this week, The New York Times reported on some Advantage plans that have been improperly denying claims.
Traditional Medicare leaves some gaps in coverage which beneficiaries fill in by purchasing supplemental (“Medigap”) and (Part D) policies but there are no plans with vision or dental or hearing coverage.
Generally, between the two Medicare possibilities, traditional Medicare delivers the widest choice of hospitals and doctors and with supplemental and prescription drug plans added in can result in much lower out-of-pocket costs particularly for people with serious health conditions.
That certainly is true for me over the past 16 months of heavy use and I'm now quite grateful I stayed with traditional Medicare. But needs, obviously, differ from person to person.
CHOOSING YOUR 2019 PLAN
Year after year, Medicare has been improving their Plan Finder pages - there can be more than two dozen plans depending on the state. You will find the beginning page here where you can follow it through the steps either for Plan D or Advantage plans or both.
I could take you through every step here, but as it turns out, Portland, Oregon's local newspaper, The Oregonian, has just published an easy-to-follow instruction video. Here it is.
(Note that the online pages may look somewhat different from those in the video, but the information is the same.)
Because this was produced in Oregon, the telephone help line number at the end of the video is for Oregon residents only. You can search for help where you live by Googling something similar to “choosing a part D plan in [state]”.
Or, you can telephone Medicare (1.800.MEDICARE) where a representative will help you through the entire process however long it takes.
Or, you can find personal help in your state through the nationwide State Health Insurance Assistance Program (SHIP) at this website. I've known several SHIP helpers and they are smart, well-trained and extremely knowledgeable people.
JUST DO IT
Okay. You have six weeks to get this done. With Part D, it is important to work your way through the minutiae of formularies, tiers, deductibles, etc. to find the best plan for you.
It's tedious, but doing it last year over two days in short bursts, I saved a lot of money on the Part D premium, deductible and copays. My drugs still cost me a small fortune and dumped me into the infamous donut hole for awhile this past year. But if I'd kept my previous policy the drugs would have cost a lot more.
THE DONUT HOLE
There are good changes to the Part D donut hole in 2019. It is complicated to explain and I've already carried on too long. There is a explanation at Kaiser Family Foundation.