Do Some Homework Before Enrolling in a Medicare Plan
Annual open enrollment for Medicare and Medicare Advantage plans is underway and continues through Dec. 7. The lengthy enrollment period allows Medicare-eligible individuals time to decide whether to stay with their existing plan or consider other options available for 2025.
It’s important to learn whether the plan you have now, or other plans you’re considering for 2025, will allow you to continue to use the physicians and hospitals you like and that are convenient to where you live.
Traditional Medicare
Traditional Medicare is a program where enrollees can choose almost any doctor or facility to use, but enrollees are required to cover deductibles, copays or percentages of the cost of care. Medicare Part A covers inpatient care, Part B covers outpatient care, and Part D is an option to cover prescription drugs. Some services, such as vision, dental and hearing aids, aren’t covered by traditional Medicare. Medicare Supplement Plans, also known as Medigap insurance, can be purchased to cover some of the costs and services not addressed by traditional Medicare.
Medicare Advantage Plans
Medicare Advantage plans (known as Medicare Part C) have been available since the late 1990s. Unlike traditional Medicare, which is administered by the federal government, Medicare Advantage plans are offered by private health insurance companies that are paid by the federal government to provide coverage for Medicare services. Some of those private companies offer zero-premium or low-premium plans or insurance not provided by traditional Medicare, such as coverage for vision, dental or hearing aids.
Educational Resources
With so many options available, choosing the right Medicare or Medicare Advantage plan for you can be challenging. Here are some tips that may help:
- Months before you turn 65, which is the typical age of eligibility, take time to learn about Medicare. Medicare.gov explains the basics of the health insurance program in easy-to-understand language, or you can speak to an adviser by phone. You also can learn about important deadlines for enrolling and compare health plans.
- Medicare.gov also provides basic information about Medicare Advantage and the different types of Medicare Advantage plans.
- Before enrolling in a Medicare Advantage plan, call the company providing the plan or check its website to determine if the physicians and hospitals you want to use are listed on the company’s provider network. If not and you enroll, you may have to change doctors, use a different hospital or drive a longer distance to have your health care covered by the plan.
- It’s smart to double-check. Before you enroll, call your preferred physicians or hospital to make sure that in 2025, they will accept the Medicare Advantage plan you are considering.
To see what Medicare Advantage plans BayCare Medical Group accepts for 2025, click here to reach the “Insurance Plans Accepted” page on BayCare.org. The fourth bullet has a link to “Insurance Plans Accepted by BayCare Medical Group.”