Tuesday, October 22, 2019
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Ask Toni: Stress free Medicare open enrollment

Toni,

I turn 65 next July, and I’m stressed by the mail I am getting this year for Medicare Open Enrollment and I’m not on Medicare yet!!How does one know what to do? Every insurance company tells me they’re the best choice.  I need some help!   Samuel from Dallas, TX

Samuel:

We experience this type of confusion every day during Medicare Open Enrollment at a Toni Says Medicare consultation. To discover which Medicare option is right for your health situation depends on what your medical needs are and what prescriptions you are taking.  There is not a specific medical plan that fits everyone because everyone’s health and financial situation is different.  Take your time and properly research your options.

Samuel, here are 3 steps that I use when helping a Toni Says® client decide which Medicare option meets their specific needs with less stress:

Step #1:  Decide if you want “Original/Traditional Medicare” or a “Medicare Advantage” plan. 

a) Talk to your doctor and see which plan he/she recommends.  Many doctors are accepting “Original/Traditional Medicare” and not Medicare Advantage plans.  If you have a doctor that is in the Medicare Advantage plan’s provider directory, make sure you call to verify that he/she is still accepting that Medicare Advantage plan.  Sometimes providers are in the directory but stopped accepting the plan long before it went to print. The most accurate way to check for a provider is from that specific company’s website.

b) The main difference between “Original/Traditional Medicare” and Medicare Advantage plans is “Original/Traditional Medicare” works only with Medicare and generally, you or your supplemental coverage pays the deductibles or coinsurances.

c) A Medicare Advantage plan is also called Part C and is administered by private insurance companies that are approved by Medicare.  You must use that insurance company’s insurance card not your Medicare (Red, White and Blue) Card. 

Step #2: If you chose “Original/Traditional Medicare, you may want to also select Medicare supplemental (Medigap) coverage.  

a) A Medicare Supplement/Medigap fills the gap of “Original/Traditional Medicare”.

b) You can choose to buy a Medicare Supplement (Medigap) policy from a private insurance company. Cost will vary by policy and company.

Step #3:  Decide if you want Medicare Part D prescriptions drug coverage.

a) If you want Medicare Prescription Drug coverage to go along with “Original/ Traditional Medicare”, then you must enroll in a standalone Medicare Part D plan with a private insurance company that is approved by Medicare and usually there is a premium. 

b) If you choose a Medicare Advantage plan, please make sure that the plan has Part D Medicare Prescription Drug coverage included. 

Stressed over the correct decision that either the Medicare Advantage plan or Medicare Supplement you are considering is your right option? Or concerned about falling into the “famous” Part D prescription drug “donut hole”? Call the Toni Says® office at 832/519-8664 or email info@tonisays.com to have your Medicare questions or concerns answered. Visit www.abbs4u.com and attend ABBS (American Baby Boomer Society) Medicare courses for more education. 

Remember…. Medicare is not cookie cutter…one plan does not fit everyone!  Your Medicare health issues are not the same as your friends!

— Toni King the author of Medicare Survival Guide® Advanced, is offering a Medicare Open Enrollment book package special at www.tonisays.com. For questions about Medicare email info@tonisays.com or call 844/250-8664.

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