2020 Medicare Open Enrollment Florida

2020 Medicare Open Enrollment Florida

It is also known as the Medicare Advantage plan annual election period, and it runs from October 15th to December 7th every year.

This period allows Medicare beneficiaries to review their coverage and make any necessary changes before the beginning of the next year, in this case, before 2020.

Individuals may also sign up for additional drug or medical coverage for the first time during the annual election period. Subsequently, these changes come into effect starting January 1st of the New Year (2020).

Seniors ought to note that the Medicare open enrollment period is different from the open enrollment period of state and federally run Health Insurance Marketplaces for individual health insurance plans.

These marketplaces often begin open enrollment two weeks after the start of the Medicare open enrollment period and end on December 15th, a week after the Medicare open enrollment period ends.

This often leads to confusion among people with many thinking that the two open enrollment periods are related.

However, it is important to note that these two open enrollment periods are distinct from each other.

ACA health insurance marketplaces do not sell Medicare plans.

What is Medicare?

Original Medicare is a federal health insurance program available to individuals 65 years of age or older. Original Medicare is also available to younger individuals with certain disabilities and people with end-stage renal disease. Original Medicare is a fee for service plan managed by the Federal Government and provides basic coverage for medical expenses.

 

What is Medicare part A?

Part A covers inpatient care in a hospital or a limited stay in a skilled nursing facility.

It also helps cover hospice care and home health care.

A Medicare beneficiary will not pay a Part A premium as long as he or she has worked 40 or more quarters throughout his or her life (10 years on average).

What is Medicare part B?

 

Part B is optional but very important because it covers the majority the medical services a Medicare beneficiary will obtain.

Medicare Part B covers doctor’s services, outpatient care, outpatient surgeries, physical therapy, occupational therapy, chemotherapy medications, air/ground ambulance, and many more services.

In 2019, the majority of Part B beneficiary usually have to pay a monthly premium of $135.00 however some older recipients pay a monthly premium of $109; however this payment can fluctuate due to income guidelines, late enrollment penalties, and/or annually.

What is a Medicare part D?

This is a prescription drug insurance program (PDP) available to everyone who has Medicare, regardless of income or health status. A Medicare beneficiary only must be enrolled in Medicare Part A to enroll in a Medicare Part D plan.

Private companies provide the insurance coverage; beneficiaries choose the drug plan and pay a monthly premium.

Due to the number of options available you should ask your advisor and/or review Medicare.gov’s website which provides you the tools to compare the coverage/cost of the many options that are available to Floridians.

What is a Medicare Supplement Plan?

Medicare Supplement policies are purchased in addition to Original Medicare.

Supplement Plans are designed to pay some of the costs that Original Medicare does not cover – for instance Original Medicare’s deductibles and coinsurance.

While these plans do not include prescription drug coverage, beneficiaries can purchase a separate stand-alone Medicare prescription drug plan (Part D).

If purchased, Medicare is still the primary payer.

An eligible Medicare beneficiary can apply for this type of coverage during any time of year.

However, unless he or she qualifies for the initial 6-month open enrollment period (automatically starts the month the beneficiary turns 65 and enrolled in Part B) or qualifies for a Guaranteed Issue Right, Medicare Supplement carriers can turn you down if you do not meet their medical underwriting requirements. 

Why would I select a Medicare Advantage Plan?

You understand your potential financial risk: Medicare Advantage plans are required to limit your out-of-pocket expenses for Medicare Part A and B eligible services to no more than $10,000 annually (MA plans can have a lower out of pocket limit) whereas Original Medicare places no limit on what a Medicare beneficiary’s exposure may be.

This can become particularly alarming if a claimant were to have to utilize expensive Part B medications (primarily injectable medications administered in an office setting) which include chemotherapy and rheumatoid arthritis and dialysis medications.

Not only could a Medicare eligible patient have to pay 20% of the cost of each expensive medication but generally these medications are taken quite frequently over a long period of time.  

By selecting a Medicare Advantage plan (which requires the enrollment in Part B) you are provided a clearly defined level of protection that Original Medicare does not provide. In 2019 Medicare Advantage Plan Options could have anywhere between a $3900-$6700 out of pocket limit for in-network services.

 You have a higher tolerance for accepting risk and/or are healthy: Purchasing any insurance coverage requires you to not only examine your coverage and its costs but to predict the future.

While you cannot predict the future you must evaluate the reason(s) you purchase insurance.

Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for payment.

Utilizing that definition, are you better off paying potentially over $1250+ a year to an insurance carrier for Medicare Supplement Plan G coverage that you may not utilize yet have peace of mind of knowing your out of pocket costs will be limited (if any) if something unexpected were to happen.

Or are you better off saving $1,000+ in annual premium by electing a Medicare Advantage Plan with prescription coverage with the understanding that the worst case scenario may cost you more in maximum out of pocket costs for that calendar year. There is no right or wrong answer. 

You are under the age of 65:

In this case I would highly recommend the purchase of a Medicare Advantage Plan which is available to you and where premiums are not based upon the applicants age.

Not only does a Medicare Advantage plan define your risk more sufficiently than Original Medicare but often times Medicare Advantage Plan’s prescription coverage and additional benefits (gym membership, dental, vision) can provide you some additional benefits you may otherwise not receive.

Medicare 2020 quick checklist to help you decide. (All changes take effect Jan. 1.)

  1. You have a Medicare Advantage plan and want to change plans (or revert back to just Parts A and B).
  2. You received a notice that your Advantage plan coverage is changing and you want to comparison shop.
  3. You have Original Medicare (Parts A and B), and possibly a Medigap policy and want to switch to an Advantage Plan.
  4. You want to join a Medicare prescription drug plan (Part D), switch to another, or drop this kind of coverage altogether.

If you’re happy with your coverage or OK with any upcoming changes, there’s no action needed.

2020 Medicare Open Enrollment in Florida

For help with finding and comparing Medicare Advantage or prescription drug plans, you can contact us at 813-964-7100 in Florida.

We also can assist you all over the country email us at info@mintcofinancial.com

www.MintcoFinancial.com