Seniors in the rain
February 9, 2017 | by The Polyclinic


We’ve teamed up with Connexion Insurance Solutions to provide you answers to some of the frequently-asked-questions patients ask about Medicare. Each month we’ll publish an article or series of questions that are commonly asked about Medicare.

There is a lot of information available on Medicare – from trusted websites to direct mail and stories from friends and family. Building your knowledge of Medicare can help distinguish fact vs. myth. Today we provide some facts to bust a few myths around Medicare.

Myth: Original Medicare covers most services in full.

TRUTH

Original Medicare usually pays for only 80 percent of services received, generally leaving patients with 20 percent coinsurance. With no out-of-pocket maximums, those costs can be hard to budget for and accrue quickly.

Some people consider a Medigap, or supplemental, plan to fill in the gaps that Original Medicare leaves or choose a Medicare Advantage Plan (Medicare Part C) for more defined costs. Medicare Advantage can also provide additional coverage than Original Medicare while allowing patients to budget for expected costs.

Myth: Medicare Advantage is always more expensive than an Original Medicare plan.

TRUTH

When comparing Medicare plans, beneficiaries should consider all out-of-pocket costs to find the option that best fits their needs.

Original Medicare requires cost-sharing, doesn’t include prescription drugs, and has no out-of-pocket maximum.

Medicare Advantage plans can often cover more than Original Medicare, include additional benefits and lower copayments while having an out-of-pocket maximum.

Myth: Once you enroll in one Medicare plan, you cannot switch to a different plan.

TRUTH

Medicare beneficiaries can switch to a different plan during the Annual Enrollment Period from October 15 to December 7 each year.

There are also certain life changes or events that can qualify someone for a Special Enrollment Period and the chance to enroll or switch plans out of the normal time window, but generally, most have at least the one Annual Enrollment Period opportunity to make change.

-- Taylor Vidor, Connexion Medicare Producer

Reference: Medicare.gov




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