It’s that time again. From October 15 through December 7 Medicare recipients can switch or supplement their healthcare plan. Any changes made will take effect on January 1 2015.
Original Medicare is comprised of parts A (hospitalization coverage) and B (physician coverage).
Original Medicare covers, on average, about 80 percent of an enrollee’s health costs, but there is no ceiling for out-of-pocket costs. Consequently almost ninety percent of Medicare recipients have opted for either a Medigap or a Medicare Advantage plan.
- Medigap supplements your Original Medicare benefits. The plans are sold by private companies and can help cover the copayments, coinsurance, and deductible costs associated with Medicare. Some policies provide extended benefits such as medical care when you travel outside the U.S.
- Medicare Advantage plans are sold by private companies who have contracted with the government. These plans cover your Part A and Part B benefits, and may also offer prescription drug coverage, dental and vision care and other benefits.
2015 Estimated Costs for Medicare Plans
According to the Centers for Medicare and Medicaid Services, premium payments for Original Medicare are expected to stay at $104.90 a month through 2015.
Recipients of Original Medicare also have to sign up, and pay for, a Part D prescription drug plan. The average monthly premium for Medicare Part D will be around $32 in 2015.
A Medicare Advantage plan from a private insurer (Part C) typically covers Parts A, B – and often D. Average monthly premiums for Advantage plans are estimated to rise to $33.90, a $2.94 increase, in 2015. Advantage plans are subsidized by the government, but the number of $0 premium plans has dropped by 19% this year. Medicare Advantage enrollees also have to pay the regular Medicare premium as well.
Medigap premiums vary widely, from 200-500+ a month.
Review Your Options
Medicare recipients receive an Annual Notice of Change from their insurance providers detailing any alternations in their plan for the coming year. You should have received this letter by September 30. If you haven’t, or have misplaced it, you can request that a copy be sent to you.
You should review the letter to make sure your costs or benefits won’t be significantly changed in 2015. If your health status has changed, you should check to ensure that your plan still meets your needs. If, for example, you are on a new drug regimen, make sure that your Part D plan covers the medicines you are taking. See if your plan’s preferred pharmacy will change (You may pay more at non-preferred pharmacies). If so, is the location still convenient for you? Can you get your prescriptions by mail?
You may wish to check with your healthcare providers directly to see if they will still be in the network for your Medicare Advantage plan. The online information may not be up to date. See if your plan offers coverage in any locations where you are likely to travel, or spend the colder months.
Medicare.gov offers a good breakdown, with reviews, of the various Medicare plans, which may help you choose the right coverage.
Medicare and Dental Health
Medicare’s dental care coverage is virtually nonexistent. So unless your dental issue is life-threatening, assume that Medicare won’t pay for it.
Medicare Advantage plans often provide dental insurance. Be aware that most plans have a maximum annual dental benefit of $1000-$1,500. Any costs after that will come out of your pocket. And dental insurance typically imposes waiting periods for any services beyond basic dental preventive care. Expect your copay to be about 50% of the cost of restorative treatments such as bridges or dentures.
Seniors may find that their needs are better met with a dental savings plan. An affordable alternative to dental insurance, a dental savings plan is like having a membership in a warehouse club. Members pay an annual fee to get access to reduced rates for dental services. You can choose a plan that includes restorative work such as dentures, crowns and bridges, as well as the preventative care you need to keep your smile beautifully healthy.
DentalPlans.com carries plans offered by the leading providers. To learn more, call one of our :DP AtYourService Customer Care Representatives at 1-800-238-5163.