Annual Enrollment Period and Medicare
It’s almost the Annual Enrollment Period (AEP) for Medicare Advantage plans. AEP is when Medicare beneficiaries are able to switch health plans. The time period typically lasts from October 15 to December 7. During this time, Medicare beneficiaries can explore which plans meet their health needs and fit within a budget. Below is some helpful information about Medicare and the different Medicare insurance products.
Medicare and Its Parts
According to Medicare.gov, Medicare is “ (a) program of health insurance designed to assist the nation’s elderly to meet hospital, medical, and other health costs.” It’s only available to (most) individuals within the United States who are 65 years or older. A person who has received Social Security Disability Insurance for 24 months or more can also receive Medicare benefits. The program consists of four sub-programs known as “Parts”.
Part A helps pay for hospital and other facility costs like a rehabilitation hospital. Part A also covers hospice and, under certain approvals, home health care needs. Part B helps pay for medical costs that occur outside of a hospital or other institution. Doctor appointments, outpatient procedures, and flu shots, for example, fall under Part B.
Parts A and B combined are known as Original Medicare (OM). Beneficiaries must pay deductibles, premiums, and coinsurance when they have Original Medicare. Original Medicare has its downsides as there is no ceiling for out-of-pocket expenses.
What Are Medicare Advantage Plans
Medicare Advantage (MA) plans offer the same coverage offered by Original Medicare plus more. These plans fall under Part C. A Medicare recipient cannot enroll in both OM and an MA plan. Health insurance agents can help sell Medicare Advantage (MA) plans. However, agents do not sell OM.
Private companies design and manage MA products. When a Medicare-eligible person enrolls into a MA plan, they become a “member”. Companies embed benefits like prescription drug coverage, gym membership, and dental coverage into MA plans to offer more than OM. MA plans can have monthly premiums, deductibles, and other out-of-pocket expenses. However, all MA plans protect their members with a Maximum Out-of-Pocket feature. When a person pays $6,700, for example, in out-of-pocket expenses for healthcare services, the insurance company will pick up the rest of the tab.
