Tuesday, October 09, 2012

A look at Medicare health plans in Connecticut

The annual open enrollment period for individuals enrolled in Medicare, who want to make a change in their Medicare health plan, starts October 15, 2012. This period lasts until December 7, 2012 and any changes made will be effective January 1, 2013.

MediCARE only pays a physician or other outpatient provider 80% of your treatment expenses! Unlike employer benefit plans there is no limit on your 20% cost sharing! Thus, a great way to protect yourself from the big risk of unpaid expenses is to buy one of two types of Medicare health plans:

Every private company offering a Medicare Supplement in Connecticut provides the same coverage for each plan. Supplement A has the least amount of coverage, Plan B includes more, etc. There can however be considerable variation in the monthly premium. The Connecticut Department of Insurance has a chart, which shows the monthly premiums for each each companies plans. The cost of Plan F, which has full coverage, can vary from $214 a month up to $452.

Medicare Supplement plans, often called MediGap plans are very popular for individuals who need the flexibility to receive medical treatment in different states. A recent survey found 9 out of 10 individuals, who were enrolled, reported they were happy with their coverage.

MediCARE's Part A or Part B, nor a Supplement, does not pay for normal outpatient prescription medications. Thus, to have coverage for part of the medication costs you may have, its important to add a Medicare Prescription Drug Plan (Part D). Enrolling when you first sign up for Medicare is important since a penalty will be applied if a person does not have what is called credible prescription coverage.

Medicare Advantage in Connecticut plans are the second type of Medicare Health plan and they are considered MediCARE Part C. Private medical insurance companies offering Medicare Advantage (MA) plans have a yearly contract with MediCARE; receive a fixed monthly payment for each person who enrolls; provide at least the same benefits as in original MediCARE, but often add additional coverage such as more extensive preventive care; have co-pays for physician visits, emergency room visit, or for a certain number of days when in the hospital; and, depending on the plan, usually charge a monthly premium.

Individuals enrolled in a MA plan receive their medical treatment through the companies network of providers and most include coverage for Part D prescription expenses. The cost sharing a person has on their treatment expenses, such as for co-pays, is limited by the plan's annual maximum out of pocket (MOP.

MA plans are usually more economical than buying a MediGap plan plus a Part D plan. Thus, they are of interest to many individuals.

Another way to lower the monthly cost of a Medicare Health plan is to select the Supplement, which includes an option to add a deductible of about $2,000. This plan together with a Part D plan would result in a monthly cost, which is lower than some MA plans and also have a lower MOP.

Surveys of people close to 65 tell us more than 50% are confused about Medicare and only about 10% understand Medicare's Part C!

Interested in eliminating the confusion and increasing your understanding? Call (860) 739-0005 - today. We can meet for a no cost conversation about MediCARE. We can also discuss the value Medicare Supplements in Connecticut or Medicare Advantage Plans in Connecticut can provide.

John C Parker, RHU, LTCP
Niantic, CT

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