Ending the Medicare Sign-up Confusion

April 18, 2012

Signing up for Medicare can be confusing. As you approach that beloved age of 65, you will be inundated with materials from Medicare and insurance companies. Though the intent of these materials is to explain and simplify the process, it isn’t working.

Medicare A? Medicare B? Medicare C (Advantage Plans)? Medicare D (Pharmacy Coverage)? Medigap? What DOES it all mean?

First of all, when looking for help in answering these questions, find an independent advocate rather than a representative from one of the insurance companies. Insurance agents are selling insurance.

While Medicare is a government program, private insurance companies sell products to supplement traditional Medicare A/B coverage. The also sell Part D and Part C (Advantage Plans). And there are incentives for them to sell their products.

Following is a brief explanation of each type of Medicare.

Medicare A is coverage for hospitalization.

Medicare B is coverage for physician visits, lab tests and other outpatient services.

Medicare D is for prescription drug coverage. These plans are offered through insurance companies under a contract with the federal government’s Centers for Medicare and Medicaid Services (CMS) and have many details within them. It is important to carefully select your Part D coverage. If you do not select a Part D plan during your initial enrollment period, there can be penalties when signing up later. However, if you have few medications or certain discount plans at your pharmacy, it may not be necessary to enroll in a Part D plan right away.

Medigap coverage plans, also offered by insurance companies, are designed to supplement traditional Medicare A and B plans. There are several types of plans and several companies offering them.

Medicare C plans are also known as “Advantage Plans.” These plans are also offered by insurance companies under a contract with the federal government’s Centers for Medicare and Medicaid Services (CMS). These plans are managed care plans and offer certain perks and discounts. However, these plans require prior approval for most, if not all, services. While these plans often have cheaper premium costs, there are very distinct disadvantages as well. These plans need to be carefully considered prior to enrolling.

While many advocate these Medicare Advantage plans, I do not. I encourage the majority of people I speak with to enroll in traditional Medicare A and Medicare B with a Medigap plan and Medicare D (unless deemed unnecessary after review).

Enrollment in traditional Medicare A and B is offered via phone, mail, or online. Medicare D and Medigap plans can also be compared online.

Because Elder Advocates is not an insurance company, we can review your needs objectively and help you through your decision making and enrollment. Since we have extensive experience in this, it can usually be done within a few hours, taking the burden from you and your family.

Filed under: Decision Making,Insurance and Finance