Onboarding onto Your New Medicare Plan

Onboarding onto a new Medicare plan can be a significant transition, especially for those new to the Medicare system. This process involves understanding the various parts of Medicare, choosing the right plan, and familiarizing oneself with the benefits and responsibilities that come with it. Here’s a comprehensive guide to help navigate the onboarding process:

Understanding Medicare Basics

Medicare Part A and Part B

• Part A covers hospital insurance, including inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
• Part B covers medical insurance, such as doctor’s visits, outpatient care, medical supplies, and preventive services.

Medicare Part C (Medicare Advantage)

An alternative to Original Medicare, these plans are offered by private companies approved by Medicare. They include all of the benefits of Original Medicare (Part A and Part B) and usually cover additional important benefits, such as dental, hearing, and vision, which you don’t get on Original Medicare. In addition, most Medicare Advantage plans are bundled with and usually Part D (prescription drug coverage), which means you only have one monthly premium (which may be $0 on some plans).

Medicare Part D

This part covers prescription drugs and is offered through Medicare-approved private insurers. If you don’t have what’s known as “creditable coverage”, you will be required by law to enroll in this type of plan.

Choosing the Right Plan

• Assess Your Health Care Needs: Consider your current health status, prescription medications, preferred doctors and hospitals, and future health care needs.
• Compare Plans: Look at the costs, coverage, and network of doctors and hospitals for each plan. Tools like the Medicare Plan Finder can be helpful.
• Check for Additional Coverage: Some may need additional benefits like are often included in Medicare Advantage (Part C) plans or supplemental coverage, aka Medigap, for expenses not covered by Original Medicare if you don’t have a Medicare Advantage plan.

Enrollment Process

• Initial Enrollment Period (IEP): This is a 7-month period that begins three months before you turn 65, includes your birth month, and extends three months after.
• Annual Enrollment Period (AEP): This allows you to change your Medicare election between 15 Oct and 7 Dec each year.
• Open Enrollment Period (OEP): If you miss the initial period, you can enroll between January 1 and March 31 each year.
• Special Enrollment Periods (SEPs): These are available for certain life events, like moving or losing other insurance coverage.

After Enrollment

• Review Your Plan Materials: Once enrolled, you’ll receive an “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC) documents. These provide important details about your plan.
• Set Up Your Online Account: Create an account on your Medicare plan’s website for easy access to your health records, plan details, and payment options.
• Understand Your Benefits: Familiarize yourself with the services and benefits covered, including preventive services, outpatient services, and hospitalization.
• Know Your Costs: Understand the costs associated with your plan, such as premiums, deductibles, copays, and coinsurance.
• Schedule a ‘Welcome to Medicare’ Preventive Visit: This free visit is available within the first 12 months you have Part B and is a great way to get your Medicare journey started.

Staying Informed

• Annual Review: Medicare plans can change each year. Review your plan during the Open Enrollment period (October 15 to December 7) to ensure it still meets your needs.
• Stay Informed About Medicare Changes: Keep up-to-date with any changes in Medicare policies or coverage that might affect you.

Seek Assistance: If you have questions or need help, trusted, licensed Medicare agents such as Ask Claire can provide free personalized counseling.