It’s open enrollment — the time when you can make changes to your Medicare coverage. From now until Dec. 6, you can enroll in a new Medicare prescription drug plan or switch from Original Medicare to a Medicare Advantage plan (and vice versa).
When you’re first selecting a Medicare plan, you may be faced with an overwhelming number of choices. One of the most challenging parts of understanding Medicare is how the different parts fit together.
In this blog post, you’ll read about the difference between Original Medicare (Parts A and B) and Medicare Advantage (Part C). You’ll learn what else to keep in mind as you are picking a plan.
Original Medicare (sometimes called Traditional Medicare) is insurance administered by the federal government. It consists of Part A, which covers hospital services, and Part B, which covers expenses like doctor’s appointments.
If you have Original Medicare, you can enroll in other plans for additional coverage. You can add a Part D plan to cover prescription drugs. You can also select a Medigap plan, which helps cover the costs of services under Parts A and B.
Tip: If you have a chronic disease like psoriasis or psoriatic arthritis, it’s generally a good idea to add a prescription drug plan and a Medigap plan to make sure that all your services are covered as fully as possible.
There is an initial enrollment period for Medigap. During this time, you cannot be denied coverage and will not be charged more due to pre-existing conditions. You can try to purchase a plan outside of your Medigap enrollment period, but companies can choose whether to sell you a plan and charge a higher rate. Some state insurance laws can impact your ability to buy a plan outside of your Medigap enrollment period.
Another option is to choose a Medicare Advantage plan (sometimes called Medicare Part C). Typically, you are automatically enrolled in Part A when you turn 65 and usually don’t have to pay a premium for it. With Medicare Advantage, you’ll still pay a premium for Medicare Part B, but all your benefits will be bundled under a single plan from a private insurance company.
Medicare Advantage plans are administered by private insurance companies that contract with the federal government.
Pros: Medicare Advantage plans are more popular than ever. For many, the option of having a single plan that covers all components of your health plan feels familiar and easy. Medicare Advantage is most similar to the benefits structure you may have received through an employer. While Medicare Advantage plans vary in terms of price and benefits, many offer additional coverage like vision and dental.
Cons: Keep in mind that if you have a Medicare Advantage plan, you’ll need to get a referral from your primary care provider to see a specialist, like a dermatologist or rheumatologist. If you have a Medicare Advantage plan, you may need to see health care providers that are in-network, which means that a more limited number of specialists may be available to you.
Choosing a plan
As you can see, there’s a lot to keep in mind when it comes to picking a plan. The right choice for you will depend on your whole health picture, the medications that you take on a regular basis and other factors.
The Medicare Plan Finder is an excellent resource to explore plan options in your area. You can use the plan finder to look at Original Medicare plan combinations, with supplemental coverage and a prescription drug plan. You can also compare your existing plan with other options. The plan finder will provide an estimate of your annual costs for each of your plan options, including premiums and drug costs.
Get support while shopping
Remember, NPF is here to help! Request a free Health Insurance Quick Guide to learn more about selecting a plan. Our Patient Navigators can answer your questions and connect you to in-person assistance to help you select a plan that offers the best coverage at the lowest possible price.
Driving discovery, creating community
For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.