The Medicare Open Enrollment period is here. Now is the time for seniors to consider their health care needs and make decisions on their coverage. Read on to learn what to keep in mind and who can help with the decision making process.

When is Medicare Open Enrollment?

The annual enrollment period, also known as AEP, occurs annually from Oct. 15 to Dec. 7. During this time, people 65 and older can:

  • Switch from Original Medicare to a Medicare Advantage plan or vice versa
  • Change from one Medicare Advantage plan to another
  • Move from one Medicare Part D plan to another

What’s the difference between Original Medicare and Medicare Advantage?

The first step to understanding the differences between Original Medicare and Medicare Advantage is knowing the different plan parts:

  • Part A = hospital insurance, which helps cover the cost of a stay in a hospital, skilled nursing facility or hospice care
  • Part B = medical insurance, which helps cover the cost for doctor services, outpatient care, durable medical equipment and other medical services
  • Part C = Medicare Advantage, which includes Part A and B benefits through one plan
  • Part D = prescription drug coverage, which helps cover the cost of outpatient prescription drugs

Original Medicare plans consist of Part A and Part B coverage. On the other hand, Medicare Advantage – also known as Part C – is provided through a private insurance company and combines hospital and medical insurance benefits and typically also has other benefits, including drug coverage, dental and/or vision coverage.

The key differences between these two types of plans often come down to cost and in-network health care providers.

  • Cost: Original Medicare does not have a limit on out-of-pocket spending. To help control costs, many members purchase supplemental coverage, including Part D drug coverage and sometimes a Medicare Supplement policy, also called Medigap. Medicare Advantage plans tend to have lower monthly costs than Medicare Supplement plans and also limit total out-of-pocket expenses with out-of-pocket maximums.
  • Network coverage: With Original Medicare, members can visit any doctor or hospital that takes Medicare anywhere in the U.S., whether they have only Original Medicare or a Medicare Supplement plan. Medicare Advantage members, on the other hand, need to use doctors in their specific plan’s network.

How can seniors determine which plan is right for them?

Nicole Creamer, Blue Cross and Blue Shield of Nebraska’s (BCBSNE) senior director of individual and Medicare sales, said seniors should consider a variety of factors, including their:

  • Current and future health care needs
  • Budget and what they feel comfortable spending on their plan
  • Desire to stay with their current doctor or pharmacy

“A Medicare Advantage plan can provide additional benefits for those who are looking for benefits such as dental, over-the-counter allowances or gym memberships, in addition to hospital and medical insurance,” Creamer said. “Since making a health insurance decision is specific to your unique needs, it is important to discuss with a licensed professional who can help you evaluate all of your options.”

Who can help with the decision making process?

A Medicare-certified insurance broker can help provide all of the relevant information a person should consider when making their coverage decisions and help determine a senior’s eligibility for different plans.

What does BCBSNE offer?

BCBSNE has Medicare Advantage, Medicare Supplement and Prescription Drug plans available. Learn more at Medicare.NebraskaBlue.com.

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