FORT MILL — The Medicare open enrollment period begins Monday. Most senior citizens depend on the program for their health insurance coverage and, for some, the choices and requirements can be confusing.
Eric Padelford, a Fort Mill-based General Agent and Medicare Specialist, says one of the primary things seniors should be aware of is, if they are happy with their current coverage, they do not need to take any action between Monday and Dec. 7, when open enrollment ends.
For everyone else, there are things they need to be aware of. Padelford, who has an MBA and more than 25 years commercial experience, has been licensed in health and life insurance products since 1969 and is recertified annually to represent Medicare insurance plans, provided some answers to common questions seniors may have:
• Who needs to be aware of this and why?
All current Medicare beneficiaries should be aware of the open enrollment period because this is the time this year when people can elect to change their Medicare Supplemental, Part D Prescription benefits and, Medicare Part C Plans (Known as Medicare Advantage).
If the beneficiary is not happy with their current coverage or if the plan has become more expensive or benefits have been reduced, it is the right time to consult a Medicare benefits specialist to consider all approved plans that are available.
• Is this something someone who is not currently Medicare eligible be in the next 12 months needs to be aware of?
People who will become eligible for Medicare during the next 12 months (usually people turning 65) can sign up for Medicare and Medicare related insurance products during the 90 days before and 90 days after they turn 65. They do not need to be concerned about the AEP (Annual Enrollment Period).
• Are Original Medicare Parts A an B adequate coverage?
Probably not, because of the Part A Deductible and the Part B 20 percent coinsurance exposure.
Original Medicare can leave the beneficiary with Hospital and Outpatient charges that can often run into thousands of dollars.
• What if I have pre-existing conditions? Can I change plans?
That depends upon the condition and the type of plan that you are enrolled in. It is best to call a Medicare Specialist and inquire about your options.
• How do I know what plan is right for me?
A Medicare Specialist will do a side by side objective comparison of all available coverage options in which cost, benefits, and out of pocket maximums are fully discussed and compared.
• What other types of professionals can recipients seek out?
Any Certified Medicare Specialist can be a very useful source of information. The major Insurance Carriers including Humana, United Health Care, Aetna, Blue Cross/Blue Shield, also can offer valuable (but usually company specific) advise and information.
• Are there any major changes related to the Affordable Care Act?
The Affordable Care Act deals directly with the under age 65 Health Care marketplace.
While some changes in government funding of Medicare have resulted, Medicare is generally impacted by different laws and regulations.
• In addition to calling you and other professionals, are there any other reliable sources – online or via government or other not for profit entities – people can turn to for information?
An excellent source of accurate and useful information is Medicare.gov. There you can compare all approved Medicare insurance options and explore a range of Medicare related topics.
• Is there anything else seniors should know?
Daytime TV is flooded with ads for Medicare products this time of year.
While they are generally accurate and useful, keep in mind that if you are happy with your current insurance and their rates have remained affordable, you need not do anything to retain your current coverage if it remains available.
Contact Eric Padelford at 704-651-7465. For more information, go to seaffordablehealth.com.