ROCHESTER, N.Y. (WROC) — Medicare open enrollment is currently underway starting on October 15th and lasting until December 7th.
News 8 spoke with CPA Jamie Block from Mercer Advisors to discuss health insurance for seniors and what steps to take if you are taking part in open enrollment.
What is Medicare?
Medicare is available for seniors who are 65 and older, as well as some disabled individuals. You can sign up for Medicare as early as three months before your 65th birthday, the month of your birthday, and three months after. Of course, it’s recommended you sign up sooner, so that way, there are no gaps in coverage.
What are the different parts of Medicare?
The main parts you’ll see or hear about is parts A, B, and D. A is your hospital coverage, b is your doctor’s visits, and D is your prescription drug coverage. Of course, there are additional parts like C, which is what we have a lot in Rochester, the Advantage plans.
And that basically encompasses A, B, and D all in one. There are other alternatives too, such as Medigap, or alphabet plans. Those are typically used by snowbirds who may be out of network for part of the year. It’s best to make sure you check your with a Medicare agent to figure out what plan is best for you.
Can folks on Medicare change their plan? If so, when is the time to do that?
This is very timely because we are currently in open enrollment, which starts October 15 to December 7, and you can do this every year. So, it’s very important that each individual, if you’re married, look at their plan, because there is no family plan with Medicare. So spouses have different policies based on their healthcare needs.
How can seniors determine what plan is best for them?
It is best to hire a Medicare agent, they will know the plans that are available in the area. Also, look at your health care issues as well as medication you may be on and find the best plan for your needs. One drug may be on your plan this year, and then next year, the plan may change and it may not be so each year. It’s best to look and analyze these plans with Medicare agent.
How are the Medicare premiums determined?
Part A is typically free, you’ve paid in premiums throughout your working career. But Part B premiums are calculated based on the individual’s income two years prior. Therefore, your 2023 premium is going to be based on your 2021 tax return information. For most individuals, you take your adjusted gross income and add your tax-exempt interest to get what they call modified adjusted gross income, then you take this number, and then you look on a chart provided by Social Security to determine what your premium is. So if you’re married, and this number is less than $194,000. If you’re single, and this number is less than $97,000, your premium next year would be about $164.90 a month.
If an individual is still working, do they need to sign up for Medicare?
It depends. You have to make sure you check with your HR department to see if your health insurance that you currently have will be called credible coverage. If not, you can have lifetime penalties if you don’t sign up for Medicare during that timeframe that you should. So again, very important, check with your HR, make sure you have credible coverage.