Getting an annual medical checkup helps set you up for a healthy year ahead. And it’s no different when it comes to Medicare. If you’re over 65 already, chances are you’ve already been through this Medicare routine before. If not, then welcome to this highly populated world of bewildering—but important—choices. Over 58 million people rely on some form of Medicare for their various healthcare coverage needs.1 And, since the Medicare limits, costs, and plan options change every year, you and the other millions of Medicare beneficiaries should review your Medicare choices while there’s still time for adjustments. The annual December 7 enrollment deadline is fast approaching.
Vital Signs: Plans ABC and D
Sticking with the checkup theme, let’s look briefly at each Part of Medicare—and some other factors—to see what you should check!2
Medicare Part A
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Think about the likelihood that you’ll need any of this type of care during the coming year. It’s never pleasant to think ahead like this, but it’s extremely important when considering plans.
Medicare Part B
Certain doctors’ services, outpatient care, medical supplies, and preventive services (including some vaccines) are covered under Medicare Plan B. Again, nobody expects you to be able to see the future, but consider your experiences during 2022 as a good indicator of what 2023 might require.
Medicare Part C
Medicare Advantage is really another name for Medicare Part C. This is the option to use a private insurance company for coverage instead of getting it under the government’s “Original Medicare” plans. This is perhaps the most challenging aspect of your annual Medicare checkup, as it can affect your choice and benefits under Plans A, B, and C. We’ll look at this in slightly more depth in a bit.
Medicare Part D
For many, aging means that prescription drugs become more and more part of our lives. Such is life! In any case, Part D of Medicare provides coverage for prescription drugs, along with some shots or vaccines not included under Part B. Of course, it’s easy to know which prescriptions you already take. The difficult part is guessing what changes or additions might be coming next year and then finding a plan that matches. After all, there were about 60 different Medicare plans with Plan D coverage in 2021.3
Help is but a SHIP Away
Even once you’ve done the necessary thinking about your 2023 medical needs, you’ll still face the daunting test of picking the right plans. And let’s not forget the most comprehensive plan in Medicare: Plan E (exasperation)! Yes, you can search for plans on Medicare’s site using its online plan finder,4 but chances are you’d rather talk with a person instead.
With the State Health Insurance Assistance Program (SHIP), you essentially have a hotline for Medicare-related help. Every state has its own SHIP program and, it seems, they all feel compelled to create a clever acronym for their own state’s SHIP. For instance, Florida’s is SHINE (Serving Health Insurance Needs of Elders). You can find your state’s SHIP by going to shiphelp.org and clicking on the “Find Local Medicare Help” button at the top of the page.5
But what if there’s a person you already know who can help you clear a path through the Medicare jungle?
Is Your Advisor a Medicare Expert?
The results from a recent Medicare survey by Sage Growth Partners6 reveal something quite puzzling. While a full third of the respondents have a financial advisor, only 2% of those with an advisor actually turn to them for help in selecting their Medicare plans. If your arrangement with your advisor is fee only, then this is essentially a complimentary service. But what does your advisor know about Medicare? Probably a lot!
So many investors who do use advisors are either heading toward retirement or there already, most advisors are quite well versed in the world of Medicare and Medicare Advantage plans. Not only that, but they should be up to date with any updates in both plan options and pricing. So, while short blogs like this one might be helpful to start understanding this year’s Medicare Advantage choices, don’t forget to ask your advisor for their guidance as well.
The Takeaway
Medicare itself began in 1965, so it’s had about 57 years to make itself easy to understand, with obvious choices to make for plans. Sorry to say that it has failed spectacularly in this respect and, of course, the 2023 Medicare plans have once again changed significantly (see our “Medicare Changes for 2023” for more info). Whether you’re new to Medicare or not, make sure to take the pulse of your medical needs during the open enrollment period before you pick your plan. And don’t forget to reach out for help if you need it. The deadline for choosing your Medicare coverage is Wednesday, December 7. Whatever you choose—with or without professional help—your coverage for 2023 begins January 1.
P.S. Medicare Scams and More
Scammers have calendars, too. For them, mid-October to December 7 of every year is open season for Medicare scams. They will call, email, and text in their quest to get your Medicare number and other personal information. A scammer with the right combination of your details can steal your identity, file fake claims as if they were you, or sign you up for a plan you’ve never even heard of. So, always be on guard, but especially during Medicare enrollment time.
Now, when we’re talking about scammers, we don’t mean private insurers. They are allowed to market Medicare Advantage plans and Part D drug plans, but there are rules. For example, an agent can’t insist that you sign up before the official December 7 deadline, they can’t threaten to take away your existing benefits—or offer any type of gifts for signing with them. Your financial advisor should be able to help you tell if any insurance company you’re thinking about is playing by the rules.
Sources:
1 https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2022-enrollment-update-and-key-trends/
2 https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare
3 https://www.kff.org/medicare/issue-brief/medicare-part-d-a-first-look-at-medicare-prescription-drug-plans-in-2021/
4 https://www.medicare.gov/plan-compare/#/?year=2023&lang=en
5 https://www.shiphelp.org/
6 https://sage-growth.ftlbcdn.net/wp-content/uploads/2022/07/0242_SGP_MediCare_MarketReport_FINAL.pdf
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