Unbiased Analysis of Today's Healthcare Issues

Consumer Reports: Navigating the Medicare Maze

Written By: Jason Shafrin - Feb• 09•11

One of my favorite magazines is Consumer Reports.  I love getting a good deal and Consumer Reports unbiased research and decision to not accept any advertising dollars helps make sure I get my money’s worth on purchases big and small.

In the latest issue of this magazine (December 2010), Consumer Reports provides useful advice to Americans about to turn 65 onhow to navigate the maze that is Medicare.  The Washington Post reprints some of the article’s highlights.  Some of these include:

  • Sign up for Medicare before you turn 65.  The “initial enrollment period” for Medicare spans seven months: the three months before your 65th birthday, the month of your birthday, and the three months after that. But if you want your coverage to start on or before your 65th birthday, sign up in that first three-month period. Waiting longer will delay your coverage.
  • Don’t delay Medicare Part B signup after you stop working. There’s a monthly premium ($96.40 or $110.50 in 2010 for most people) for Part B, which covers most other medical expenses except prescription drugs. If you didn’t sign up for Part B when you should have, you will be hit with a harsh penalty: a permanent increase in your premium of 10 percent for every year that you could have signed up but didn’t.
  • Each Medicare Part D plans has different coverage rules.  Part D coverage is managed by private insurance companies.  Each Part D plans have a formulary, a list of covered drugs. But drug plans may change, with certain drugs dropping off the formulary or moving to another payment tier. You can change to a new plan if your old one made changes you don’t like.  Use the interactive formulary finder at www.medicare.gov to find out which plans in your area cover your drugs and in what payment tier.
  • When can I sign up for Medigap? In most locations you have the right to buy a Medigap plan without medical screening only at certain times, such as when you first sign up for Medicare or if your Medicare Advantage plan shuts down or you move out of its service area.
  • Medicare Advantage ≠ Medicare FFS.  Medicare Advantage plans are private plans that you can choose in place of original Medicare. The vast majority are HMOs that require you to get your care within a local provider network. A Medicare Advantage plan substitutes for Part A and Part B (and in most cases also Part D). You can’t buy a Medigap plan if you are on Medicare Advantage.

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  1. Ted Schmidt says:

    80% of all health care costs in this country are spent on persons over the age of 65. Failure to have adequate health insurance is the #1 cause of bankruptcy. Medicare does not cover all of your health care costs. Medicare is one of the most confusing forms of insurance known to man. Supplements, Medicare Advantage Plans, and Part D Rx plans only add to the confusion. Then when you add the annual changes, most persons turning 65 become totally confused. I am a independent insurance agent. If you have questions regarding Medicare, please contact me. Our goal is for you to understand your coverage, so that you can pick the coverage that is best for your circumstances.
    Ted Schmidt

  2. Becky says:

    I agree with you Ted, Medicare is extremely confusing… the entire health care system is confusing. There is a great book titled, “Uproot U.S. Healthcare:” To Reform Healthcare” written by Deane Waldman, MD MBA, who is a medical Dr. and has years of experience in the field of healthcare. He offers a lot of great suggestions to our current healthcare system. Every American should read this.

  3. Medicare is often thought of as a single word or program, it actually takes on many forms. Over the years, efforts to streamline the program and make it more efficient have resulted in a maze of plans and paperwork.Medicare is now made up of four parts — labeled A, B, C and D — two of which are run by hundreds of private insurance companies that contract with the government to provide service to seniors. Medicare, the federal health insurance program for those over age 64 and the disabled, can help pay many doctor and hospital bills, but it also comes with significant limitations.

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