Opinion

Ezratty: Medicare open enrollment marches on

Posted 11/20/20

Question: I will turn 65 in February. Because of COVID-19, I can’t seem to find anyone in person at the community centers. Any suggestions?

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Opinion

Ezratty: Medicare open enrollment marches on

Posted

Question: I will turn 65 in February. Because of COVID-19, I can’t seem to find anyone in person at the community centers. Any suggestions?

Answer: I wish I was able to meet with you in a center near you. However, we all need to keep safe, and so far COVID-19 cannot be transmitted by phone, so that will be our means of communication.

First, happy 65th birthday.

If you are receiving early Social Security retirement benefits, you will be automatically enrolled and will receive your Medicare card in the mail within several weeks. If you are not yet receiving Social Security benefits, please set up an account on the Social Security website. Maybe you have already done this. Click on the link stating “Apply for Medicare Benefits.” You will say “yes” when applying for Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), providing you do not have any other comparable medical insurance.

There are three times you can enroll in Medicare Part A and Part B for the first time. First, during the initial; enrollment period, which is the three months before, the month of and the three months after your 65th birthday.

The second way is if you delay Part B enrollment because you are covered by health insurance based on your own or your spouse’s health insurance. This is a special enrollment period. You can enroll in Medicare without penalty while covered by insurance based on current work, or for up to eight months after you lose your group health coverage or you (or your spouse) stops working. Medicare benefits will begin the month following enrollment.

The third way you can enroll for Medicare is during a general enrollment period, which is Jan. 1-March 31 each year. However, coverage does not begin until July 1. You might want to consider enrolling in a Part D prescription drug coverage. There may possibly be a late enrollment penalty for Medicare Part B and/or Part D. Remember, if you have group medical and/or drug coverage from your place of employment you do not need additional Medicare coverage. You will have to show proof of the coverage whenever you do apply for Medicare in the future. Without proof of comparable Medicare coverage, you will have “forever” penalties.

Once you have your Medicare card in your possession, verifying Medicare enrollment, you will begin to think of which path you prefer to receive your health care and covering your copays. One path is original Medicare, which pays 80% of hospital and health services, and you either pay cash for the remaining 20% copays or you enroll in a Medigap plan, also referred to as a supplemental plan. These plans are from private insurance companies and offer several levels of coverage. Monthly premiums are priced according to coverage, with complete copay reimbursements to partial reimbursements. You can use any doctor throughout the United States, do not need authorization or specific networks of doctors. However, you will need to enroll in a Medicare Part D prescription drug plan. There are no perks, such as dental, vision, fitness clubs, etc.

As an alternative to cover your 20% that Medicare does not pay is to enroll in a Medicare Advantage plan, which is a Health Maintenance Organization. In Maricopa County, most plans do not carry a monthly premium and have perks, such as no copay when visiting your primary care physician, and lots of other perks, such as vision, dental, hearing aids, fitness clubs and more.

If you need free assistance, call me at 623-866-4224.

Editor’s Note: Roberta Ezratty is a certified State Health Insurance Assistance counselor.

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