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Seniors, i.e. individuals aged 65 or over are provided health insurance under the federal insurance program known as Medicare. So, if you are an individual 65 or above then getting this health insurance for yourself is the right thing to do. Regardless of whether you have been availing Medicare in the past or you are seeking to do so in the open enrollment, you need to look out for some challenges related to this program.

You may have to pay much more than you expect

All medical benefits are not covered by the health insurance benefit provided by the government in “Medicare”. The beneficiary of this program pays approximately 20% of physician fees. For many of your healthcare expenses, you may find yourself often paying out-of-pocket.

Keeping track of time

When you’re joining this program, it is important to keep a track of time. You enrollment windows open and you become eligible for this program the day you turn 65.However, if you don’t act quick enough, some of those windows may close as waiting for some time to enroll may cause you to lose a few choices. The choices you have include:

  • Changing to an Advantage Plan from an Original one
  • Changing back to Original plan from an Advantage plan
  • Switching between Advantage Plans
  • Switching to an Advantage Plan that offers drug coverage from an Advantage Plan that doesn’t offer drug coverage
  • Switching to an Advantage Plan that doesn’t offer drug coverage to an Advantage Plan that offers drug coverage
  • A Prescription Drug Plan can be availed
  • Switching between two Prescription Drug Plans
  • Prescription drug coverage can be dropped completely

Know exactly what you have to pay

It is important that you look at your total out-of-pocket healthcare cost from the preceding year, as you need to know exactly what you have to pay for like additions, minuses etc. Check for changes in co-pays, prescription drug costs, and deductibles. Make sure you do not restrict your search to just the premium cost.

Switching back may not be easy

People often think that if they don’t like an Advantage Plan, then they can simply switch back. But, the truth is; it is not that simple and you get stuck with that plan. Only during certain time periods can an Advantage Plan be dropped. A disenrollment period for Advantage Plans has come afore in recent times. If you are unhappy with the Advantage Plan you paid for, you can simply withdraw from it starting January 1st to latest by February 14 of each year. You may pick up a Prescription Drug Plan if you desire or go back to your regular Medicare coverage.

 

If you don’t understand something about enrollment in Medicare, then it is important that you seek help from someone who can guide you through the process and brief you about the current offerings of the program as well as challenges related to enrollment in the Medicare health insurance program.

Posted 9:11 AM

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