Social Security. Medicare. Part A. Part B and the rest of the senior health care alphabet soup. Choosing the right coverage can be daunting.
That’s what Kathleen Bennett is here to help with. The insurance agent held an open house Wednesday, Oct. 23, at Hillock Insurance at 616 W. North St. in Enterprise to help people understand and be able to enroll in Medicare and related programs.
“I know this can be very complicated and confusing, so come see me if you are thinking of enrolling in a Medicare plan,” she said. “There’s no cost to answer questions.” Bennett said she also can help people already enrolled in Medicare and its supplements change plans or sign up for something new.
There are three main things that people nearing eligibility for Medicare should know, Bennett said.
The first is that that they have a seven-month window surrounding their 65th birthday—three months before their birth month, their birth month, and three months after their birth month — in which to enroll in Medicare Parts A and B. So if you were born on, say, September 10, you would have all of September, all of the three months before your birthday (June, July, and August) plus all of the three months after your birthday (October, November, and December) to enroll in Medicare’s basic programs, A and B. Part A covers 80 percent of hospitalization. B covers 80 percent of physician, outpatient care, and other, related expenses.
Second, it’s important to understand the difference between Medicare A and B and the additional plans of Medicare Advantage (Part C), Medicare supplement plans, and Part D, which covers prescription drugs.
And third, it’s important to choose the best plan for your individual situation.
The deadline for enrollment in Parts C, Supplementary plans, and part D is December 7.
Medicare Advantage, aka Medicare C, is a program administered by Moda—a health-care insurance company that started out as the Oregon Dental Service (ODS) in 1955. Today they are eastern Oregon’s only provider of Medicare Advantage. Medicare Advantage is relatively new. It is an “all in one” alternative to Original Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These “bundled” plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).
If Medicare Advantage through Moda doesn’t work for you, there are supplement Plans F, G, K and N, also known as “Medigap insurance” These plans are defined by Medicare. They are offered by many private health insurance providers, including Blue Cross, Farmers, United Health Care and others. Because Medicare defines the coverage, any “Plan G” policy, for example, provides the same coverage as any other “Plan G policy” regardless of the company you purchase the plan from. To enroll in Medigap coverage, you must be enrolled in Medicare parts A and B. But, importantly, these supplemental plans do not provide coverage for prescription drugs.
If you choose Medigap coverage (above), you may also wish to have prescription drug coverage. This is provided by Medicare Plan D, which has several standard options defined by Medicare. Like the Medigap coverage, it is purchased from private insurance companies.
There are many different options for medical insurance to supplement the basic Medicare parts A and B. “It’s helpful to have someone guide you through those choices. It’s not a one-size fits-all,” Bennett said. “I’m here to help Wallowa County residents make the best choices for their individual situations.”