Golden Opportunities

Medicare used to be simple: One program for everyone. Not anymore. Now there are so many different health insurance options, I don't know if anyone understands all of them. Well...there's at least one person who does, and she's going to help us all understand the new Medicare programs. Her name is Carolyn Abraham, director of Medicare and marketing at Kaiser Permanente.

Question:Now is an important time for people in Medicare?

Answer: Yes. November 15 - December 31 is the annual election period when those enrolled in individual Medicare plans have the opportunity to review their options and perhaps change the plan they have.

Question:There are so many confusing Medicare options. Where do we start?

Answer: A good place to start is to get a basic understanding of the various types of plans offered. There are generally four types: Original Medicare, Medicare Advantage Plans, Medigap plans, and stand-alone drug plans.

Question:Let's start with original Medicare. Tell us about that.

Answer: This is a fee-for-service plan that covers many health care services and certain drugs. You can go to any doctor or hospital that accepts Medicare. When you get your health care, you use your red, white, and blue Medicare card.
The Original Medicare Plan pays for many health care services and supplies, but it doesn't pay all of your health care costs. There are costs that you must pay, like coinsurance, co-payments, and deductibles. These costs are called "gaps" in Medicare coverage. You might want to consider buying a Medigap policy to cover these gaps in Medicare coverage. You can also add prescription drug coverage by joining a Medicare Prescription Drug Plan.

Question:What are Medigap plans?

Answer: These are private insurance plans designed to fill the gaps in original Medicare. The plan may cover coinsurance, copayments and/or deductibles.

Question:What are Medicare Advantage Plans?

Answer: Medicare Advantage plans are purchased instead of traditional Medicare. They include HMOs, Preferred Provider Organizations (PPOs), Private Fee for Service [define], and MSA Medical Savings Accounts. These plans offer one rate, regardless of age.
These plans may cover more services and have lower out-of-pocket costs than the Original Medicare Plan. Some plans cover prescription drugs. In some plans, like HMOs, you may only be able to see certain doctors or go to certain hospitals to get covered services.

Question:What are stand alone drug plans?

Answer: With these stand-alone plans, you pay a premium that lets you add prescription drug coverage to the Original Medicare Plan, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans and Medicare Medical Savings Account Plans.

So now you understand all there is to know about the Medicare choices, right? Right! Don't worry, we'll get Carolyn back to help us sort out the pro's and con's of each. In the meantime, give Kaiser Permanente a call to learn more about their Medicare Advantage plan. Also, if you call them and mention Golden Opportunities, you can receive a free copy of the Healthwise for Life Handbook. The number's next. My thanks to Carolyn Abraham.