How to navigate the Medicare maze

Medicare Open Enrollment is from October 15 through December 7. Now is the time to start determining what kind of supplemental policy and drug prescription plan is best for you.

Even if you’re already on Medicare and already have your supplemental and drug plans in place, you still will want to review them during open enrollment to reduce your worry. Plans change, drug formularies alter, and even the benefits can change from year to year on certain plans.  

Still, where do you start? Whom should you trust? Which plan best suits your needs both medically and financially?

Here are answers to four key questions to help you get moving in the right direction 

Watch our recent webinar for a full introduction to Medicare.

Why do you need additional Medicare insurance anyway?

Medicare doesn’t cover everything. Routine dental exams, most dental care or dentures, routine eye exams, glasses or contacts, hearing aids, long-term care, and more are either covered by separate insurance plans, a Medicare Advantage plan, or are paid out of pocket.

Supplemental policies—Medigap (most common supplemental policy), employer-sponsored retiree health coverage, or Medicare Advantage—cover what Medicare does not. For some, what’s known as Medicare Part C or Medicare Advantage (Original Medicare, Medigap insurance, and prescription drug coverage combined) may be an appropriate choice.

A couple of key notes to make about Original Medicare:

• Original Medicare covers 80% of Medicare approved charges. This leaves you with a co-pay of 20% that has no out of pocket maximum.  

• With traditional Medicare, there is no prescription drug coverage. By purchasing a Part C and D, you are getting both that out-of-pocket maximum and prescription drug coverage.

What about the promotions that claim “no premium cost, no deductible and no co-pay”?

There are benefits you will see in the market that are good but digging into the plan details matters. Understanding the small print of your health plan can impact your personal health and wellbeing, and knowing what plans offer can bring benefits that would be untapped without investigation.

This is an excellent reason to review plans annually with a licensed Medicare producer who can help navigate the pluses and minuses of each option. There are many useful additional benefits to be had and a licensed producer can explain plan details to help you make the decision that works best for you.

Are the drugs you take covered?

Many people purchase their Medicare coverage without asking the fundamental question: are my prescription drugs covered by Part D? Every policy has what’s known as a formulary, which lists all the drugs covered by that plan. What worked for you last year might not work for you this year.

Also, not only do the formularies change, but plans themselves can change year to year. Part D’s can be the biggest financial factor and place where the right fit for your personal needs could make all the difference.

How do you make Medicare less complicated?

Insurance, especially health insurance, can be massively confusing. Medicare is no different. 

It is complex and it is important to know that things change so last year’s fit may not be this year’s. However, you shouldn’t be expected to know everything about it. That is where partners who understand the ins and outs of the options can simplify the process for you. 

Your guide is right here

Marsh McLennan Agency has locations across the country, and we work with many available Medicare supplemental plans. We can review your options to help you choose the right fit for your needs and enroll with greater peace of mind.

To learn more, contact a Marsh McLennan Agency representative.