Getting the Most for Your Medicare Dollar

By R. Ruth Linden, Ph.D.–

The 2018 open enrollment period for Medicare, which falls between October 15 and December 7 each year, has closed. Medicare’s open enrollment window, however, only applies to those already enrolled who wish to change their coverage. If you will turn 65 in the coming year, the time to enroll in Medicare is three months before your 65^th birthday. If you will qualify for Social Security Disability Insurance (SDI or SSDI) or you have a diagnosis of end-stage renal disease or amyotrophic lateral sclerosis (ALS/Lou Gehrig’s disease), you are not bound by open enrollment.

If you are a Medicare beneficiary, consider these cost-saving tips:

• If you receive original Medicare Parts A and B, you may also have a Part D prescription plan. It makes good sense to review your Part D coverage annually, and particularly if you have begun taking new medication since you purchased your current plan. Switching to a more cost-effective plan could save you hundreds, even thousands, of dollars in out-of-pocket drug costs.
• Also for those receiving original Medicare, if you have a Medicare supplement (AKA Medigap plan), are reasonably healthy, and anticipate using only occasional medical services in the coming year, a high-deductible Plan F supplement could save you hundreds of dollars in monthly premiums. A high-deductible supplement does not cover your Medicare Parts A or B deductibles or your 20% coinsurance as a regular Plan F would until you have reached the calendar-year deductible of $2,200. Only when this threshold is reached will your supplement kick in and pay at 100% for Medicare-approved services. In order to reach the $2,200 deductible, you would need to accrue $11,000 in Medicare-approved claims. This level of expenditure would most likely involve at least one hospitalization and/or costly treatments, such as chemotherapy.
• California residents with Medicare supplements should review the cost of their premium as their birthday approaches because, often at the beginning of the calendar year, insurance companies release new products that may have lower premiums. Our state’s Medigap “Birthday Rule” allows you to switch to a different insurance plan with the same or lesser benefits as your current plan during the 30 days following your birthday. Even if you have a preexisting condition, you cannot be turned down for coverage.

If you have questions about Medicare coverage, please contact an independent insurance agent who specializes in Medicare. You can call me at 415-776-5901, or send me an email at ruth@treeoflifehealthadvocates.com

Ruth Linden, Ph.D. is the Founder and President of Tree of Life Health Advocates in San Francisco. She works with adults with complex illnesses—individuals with multiple, chronic conditions who may have been failed by the healthcare system. Dr. Linden has expertise in breast cancer, long-term care, clinical trials, and the end of life.