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7 steps to understanding Medicare

First things first, what is Medicare? Medicare is a federal health insurance program that pays for several covered health services. Generally, you’re eligible for Medicare if you or your spouse worked for at least 10 years and contributed taxes to fund your Medicare benefits, are 65 years or older, and a U.S. citizen or permanent resident.

Whether you’re enrolled in a Medicare plan or not, consider these seven steps to make Medicare work for you!

Step 1: The ABCs of Medicare and different plan types

Choosing the right plan is both important and personal. When it comes to Medicare, there isn’t a one-size-fits-all option, so it’s best to evaluate everything that’s on the table. So, what are the differences between the different parts of Medicare?

  • Part A is hospital coverage.
  • Part B is medical coverage. You must pay a premium each month.
  • Part C combines your hospital, medical, and typically your drug coverage into one complete plan. Think of this as all-in-one coverage.
  • Part D is prescription drug coverage only.

Step 2: Monitor your medication situation

Many people take one or more medications on a regular basis. It’s important to review the annual drug formulary to ensure there haven’t been any coverage changes.

Step 3: Choosing the right plan for you

Remember to review your plan and coverage every year. What may have been a great plan last year may not suit your needs anymore. Keep an eye out for in-network versus out-of-network providers, review monthly premiums and annual deductibles, examine referral requirements, and look for bonus perks. Know about the options, tools, and services that are included in your plan. Find out about gym memberships, wellness, discounts, vision and dental, and other extras.

Step 4: Be in good company

When choosing the right plan for you, consider looking at what insurance companies offer. Evaluate if they are nonprofit or for-profit, and compare local versus national. Look at the level of customer service. When comparing options, make sure to check the plan network. Are your current providers and facilities in the network?

Finally, the Centers for Medicare and Medicaid Services (CMS) use a five-star quality rating system to evaluate health plans. That star rating can tell you a lot about the company’s customer service, member satisfaction, benefits, and overall quality.

Step 5: Circle these dates on your calendar

The Annual Enrollment Period occurs every year from Oct. 15 to Dec. 7. This is a great opportunity to review your coverage annually to make sure it still works for you.

Step 6: What you need to know about SSA, HSAs, and delaying Medicare

If you’re still planning to work and not retire by the time you turn 65, there are still a few things you need to know. You can continue to work and delay Medicare by staying on your employer’s health plan. Even if you plan on working past 65, it’s a good idea to verify your coverage status and avoid any lifelong penalties.

Once you are on Medicare, you can no longer contribute to a Health Savings Account (HSA). However, anything you saved in your HSA can be used toward qualifying medical expenses for the rest of your life.

If you are receiving Social Security benefits prior to age 65, your Medicare card will automatically arrive in the mail about 90 days before your 65th birthday. Remember, every situation is unique. Talk to an expert to walk you through your options.

Step 7: Consult an expert

Need expert advice on Medicare? Join KUTV and Intermountain Healthcare’s Ask the Expert program on Nov. 12 when experts from SelectHealth will discuss health insurance and Medicare. Tips and suggestions will be offered throughout the day on Channel 2 during the news and other broadcasts.

If you have questions, SelectHealth will be answering your phone calls from noon to 5:30 p.m. at 1-877-908-0680. You can also submit questions via Facebook and Twitter using #kutvasktheexpert. You can seek help from the SelectHealth Answer Team throughout the Medicare Annual Enrollment Period by calling 1-855-442-9940.

For more information visit http://intermountainhealthcare.org/asktheexpert.