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I will be 65 in a few months and could use some help navigating through all the Medicare options available to me. Where can I get help with my Medicare decisions?
With around 11,200 Baby Boomers turning 65 every day through 2027, you are asking a very timely question. Many individuals nearing Medicare eligibility may be confused by the choices available. In addition to Original Medicare (Parts A and B), which has been in place for more than 60 years, beneficiaries can also choose to enroll in a Part D prescription drug plan and a supplemental (Medigap) policy, both of which are sold by private insurance companies.
Another option available to those 65 and older is a Medicare Advantage plan. These plans, also offered by private insurers, bundle hospital coverage, medical care, prescription drugs and often extra benefits like vision, dental and hearing into one policy. Most operate as HMOs or PPOs and require you to receive care within a defined network of providers in your area.
Medicare Advantage plans have faced increased scrutiny in recent years over prior-authorization requirements that may delay or deny certain services. To help you determine which path makes the most sense for your situation, there are several reliable resources available depending on how much assistance you need.
A good starting point is the “Medicare & You” handbook, which provides a clear overview of the program and your options. You can download a copy or request a printed copy at medicare.gov/medicare-and-you. Once enrolled and you will typically receive a printed version in the mail in late September of each year.
The Medicare website also features a helpful tool at medicare.gov/plan-compare that allows you to compare health plans, prescription drug coverage and supplemental policies available in your area. If you prefer to speak with someone directly, call Medicare at 800-633-4227, and a representative can walk you through your options over the phone.
Another excellent free resource is your State Health Insurance Assistance Program (SHIP), which provides unbiased Medicare counseling either in person or by phone. To locate your local SHIP office, visit shiphelp.org or call 877-839-2675. You can also contact the Medicare Rights Center (medicarerights.org) at 800-333-4114 for help with specific questions. In addition, HealthMetrix Research publishes a free report at medicarenewswatch.com that compares Medicare Advantage plans by location based on cost-sharing and health status.
If you would like more hands-on help, you can work with a Medicare insurance agent. Keep in mind that agents are paid through commissions by insurance companies, making it important to choose an independent agent who represents multiple insurers, instead of just one. An independent agent gives you access to a broader range of options.
It is also important to remember that commissions are typically higher for Medicare Advantage plans than for Medigap and Part D policies used with Original Medicare. As a result, some agents may have a financial incentive to recommend Advantage coverage. That does not mean the advice is wrong, but it is wise to ask questions and understand all your choices before enrolling.
You can search for licensed agents through nabip.org, the website of the National Association of Benefits and Insurance Professionals. Taking the time now to compare your options carefully can help you avoid costly mistakes and give you confidence in the coverage you choose.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.
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