Medicare Open Enrollment Made “Simple”

by Lin McNulty

This is one of those times when age has its advantages. In the hubbub of the recent Affordable Healthcare Act (ACA, also known as Obamacare), and how as individuals we may be affected, rest assured that if you are currently collecting Social Security and have Medicare, you don’t need to worry about the ACA. Put it out of your mind; there is no need to visit the Washington Exchange Benefits website or peruse the various plans available.

The only effect of the ACA on Medicare is that there are a few improvements in Medicare benefits, to include phasing out the “donut hole” by 2020, free preventative procedures to include mammograms, colonoscopies, immunizations, and a free yearly “wellness” visit. The donut hole describes the period after the initial coverage limit has been reached under Medicare Part D prescription-drug insurance and before the catastrophic-coverage threshold kicks in. When you are in the donut hole, insurance coverage of drug costs is sharply reduced.

Having said that, the Medicare system is still confusing. Pegi Groundwater and Michael Moss, however, are certified Statewide Insurance Benefits Advisors (SHIBA) and are more than prepared to answer your specific questions in a personal appointment (call 376-2561) to determine which option is best for you. And because rates can change from year to year for

In their presentation at the Library on Thursday afternoon, they emphasized that October 15 — December 7 is the time designated for Open Enrollment for those wishing to sign up or change coverage options.

Briefly, Medicare consists of:

1. Part A: hospital insurance (free if you qualify for Social Security benefits)
2. Part B: medical insurance that covers doctor visits, for which there is currently a premium of $104/monthly for most Medicare recipients.
3. Part C: Medicare Advantage, which includes Parts A, B, and frequently Part D
4. Part D: Prescription Drug Plan

Parts C or D must be purchased separately. In San Juan County, there are a number of carriers who offer Part D coverage but only Group Health and Regence offer Part C coverage. If you are currently healthy, you may find you have no need to purchase Part C or Part D coverage. There is, however a penalty of 1 percent per month for waiting to purchase Part D coverage until you find you need it. For example, if you wait until you are 68—three years after turning 65—you will pay an additional penalty equal to 36 percent of the premium amount for the rest of your life.

There are private companies which provide Medicare Supplement—also known as Medigap—plans. Again, each person needs to make an individual decision about when (or if) to begin additional coverage. That’s where our enthusiastic SHIBA volunteers can step in to help you with a personalized appointment (376-2561) to discuss options, and they look forward to helping you through the steps.