How much do you know about the different coverage options?

Medicare’s open enrollment period runs through December 7. If you are enrolling in Medicare for the first time, you will discover that it is much more complex than an employer-sponsored group health plan. Here at Kendall Capital, we want to make sure our clients are well-informed of their options before they turn 65 and often recommend specialists who guide them through this intricate process. There are many variables to consider and much has to do with whether or not you and/or your spouse are still working full-time beyond age 65.

When you are enrolled in Medicare, you pay multiple premiums for multiple types of coverage (Parts A and B as well as the Part D prescription drug plan), and unlike a group health plan, there are no caps on out-of-pocket costs and a risk that you might have to pay a hospital insurance deductible more than once per year. Original Medicare also does not cover some costs that many seniors would like to cover, such as dental and vision care expenses.  

This is why so many retirees decide to buy Medigap policies or enroll in comprehensive Medicare Advantage (Part C) plans – they recognize the shortcomings of original Medicare. The downside of Part C plans is that you are restricted to the doctors in their networks. Original Medicare allows you to choose any doctor that accepts Medicare (though it is smart to have a Medigap policy as well).

You can freely switch from one Medicare Advantage plan to another in the open enrollment period; you can also enroll in one without having to go through underwriting. If you want to move from a Part C plan back into original Medicare, you may not be able to supplement Parts A and B with a Medigap plan right away because underwriting will be required.

Whether you are enrolling in Medicare for the first time or considering a change in coverage, it is vital to understand these matters. If you have questions, visit Medicare.gov or ssa.gov/medicare for more information.