Brenda Lyle – Florida Today

Q:  Is There One Medicare Plan for Everyone?

A:  Open enrollment for Medicare is right around the corner. This is the one time per year that Medicare recipients can make changes to their health and drug plans. If this is your first rodeo (and even if it’s not), here’s a Medicare open enrollment Q & A to help you navigate your selections.

What is open enrollment?

This is the annual election period, October 15th through December 7th every year. During this window, Medicare plan enrollees can reevaluate their coverage (whether it’s original Medicare with supplemental drug coverage, or Medicare Advantage) and make changes or purchase new policies if they choose. 

What is the difference between Medicare and Advantage Plans?

Medicare is the insurance an eligible recipient signs up for at age 65.  It consists of part “A” hospitalization coverage and is free for most recipients.  Part “B” is the coverage for doctor’s visits, lab tests, and other outpatient care. The premium is currently $170.10 per month for most people. These two parts of your Medicare package cover 80% of your health care insurance costs. If you have “traditional” Medicare, you utilize Part A, Part B and then you purchase a “medigap” or “supplement” plan and prescription drug coverage called Part “D.”  Availability for these supplement plans is based on your zip code and come with their own premiums. Those choosing high-end coverage could pay as much as $500 per month. Traditional Medicare does not cover vision or dental expenses.

On the other hand, Medicare Advantage Plans, sometimes called Part C or Medicare replacement, can be a lot less expensive up front.  They can have very low (or no) monthly premium and include vision and dental coverage AND your prescription drugs –all in one plan. They sometimes come with various extra “perks.” A lot of Medicare recipients find their low cost attractive, but the coverage will cost you more out of pocket when you utilize it.

What’s the right plan for me?

It is best to consult a Medicare agent or broker who sells multiple plans, to determine which combination of options is best for you. You’ll want to discuss your budget, health, prescription drugs and physician preferences to hit on the plan that’s best for you. One size definitely does NOT fit all. So your neighbor’s Medicare plan isn’t necessarily the one you need.

One Senior Place in Viera and Greater Orlando can help you evaluate your individual Medicare options.  Check the Events Calendar at OneSeniorPlace.com for a list of Medicare seminars throughout the open enrollment period.

One Senior Place is a marketplace for resources and provider of information, advice, care and on-site services for seniors and their families. Questions for this column are answered by professionals in nursing, social work, care management and in-home care. Send questions to AskOSP@OneSeniorPlace.com, call 321-751-6771 or visit One Senior Place, The Experts in Aging.

Brenda Lyle is a Certified Care Manager and Certified Dementia Practitioner with One Senior Place, Greater Orlando.