Welcome to today's live chat about Medicare open enrollment!
We have contributing editor Kim Lankford with us today, who is very well-versed in all things Medicare. Thanks for joining us, Kim.
Thanks for coming to the chat! I look forward to answering your questions. A lot of interesting Medicare options this year.
Kim, to get us started, can you tell us what’s changing about Medicare open-enrollment this year? Is there anything in particular folks should be aware of?
The biggest changes happened last year, when the open-enrollment timeframe was moved up from Oct. 15 to Dec. 7 and Medicare started to cover preventive care without copays. But there are a few smaller changes this year. The doughnut hole will continue to shrink -- the discount on brand-name drugs in the coverage gap will rise to 52.5% from 50% in 2013. And the federal subsidy for generics will rise to 21% from 14%. And now, if you have a five-star Medicare Advantage plan in your area, you can switch into that plan anytime during the year, not just during open enrollment.
So, generally good news for consumers.
Alright, ready for our first question from John Wozny?
Yes, some good changes to help cut costs and expand options. And another trend is the tightening of provider networks -- many Part D plans are starting to offer discounts for using preferred pharmacies. You need to be careful, though -- you could get a particularly good deal if you use the in-network pharmacy, but have a much bigger copay if you go out of network.
Interesting, good to know. Thanks, Kim.
The interesting thing about Medigap is that it's very different from Part D and Medicare Advantage. Even though Part D and MA plans have open enrollment in the fall, there is no annual open-enrollment period for Medigap. You have an initial open-enrollment period if you first buy a Medigap policy within six months of signing up for Medicare Part B, but if you buy a policy after that -- or if you want to switch policies later -- the insurer can charge you more or reject you for coverage because of your health. Some states have a few insurers that offer Medigap policies that offer coverage regardless of your health, but generally you will have to answer some health questions like you were asked.
Thanks, Kim. A quick follow-up from John. It sounds like he's already signed up for a Medigap policy?
Are they asking you for new medical information to keep your policy after you've already had the plan for years without a gap in coverage?
John, are you still there?
Alright, while we wait to see if we hear back from John, let's go ahead and take this next question from David.
It sounds like Security Blue HMO is a Medicare Advantage plan? But if you sign up for a MA plan during open enrollment, you should be able to pick a plan in your area regardless of your health. Another Medigap issue -- if you're relatively healthy, it can be a good idea to shop around for coverage every few years just to compare costs. The prices for some policies have increased quite a bit over the past few years, and some new policies have been introduced that can help you cut costs in return for slightly higher cost-sharing -- like Plan N. You can find out about Medigap plans in your area through your state insurance department at www.naic.org.
Oops, spoke too soon. Here's John.
Some advice for everyone. Thanks, Kim.
Thanks for your question, John. Let's go ahead and move on to this next question from Brenda.
Thanks, Kim. It's certainly important for folks to take advantage of all the Medicare resources out there (and not just the pieces of paper they get in the mail!).
Hi Brenda. You generally should at least sign up for Part A when you're 65, because it's free. (However, you may want to consider foregoing Part A if you have a high-deductible health insurance plan and want to continue to contribute to a health savings account -- you can only make HSA contributions if you haven't signed up for either Medicare Part A or Part B, even though you can use money from that account after you're on Medicare). But you need to be very careful about Part B, especially if you don't have employer coverage now. The rules can be very tricky, and you could end up with a penalty if you don't have other coverage and don't sign up during your initial enrollment period, which begins three months before the month you turn age 65 and ends three months after your birthday month. For more information about the rules, and a great explanation about who could be subject to the penalty, see Susan Garland's Survive the Medicare Enrollment Maze article in Kiplinger's Retirement Report -- we can provide a link.
And since you've brought it up, let's go ahead and take this question about HSA contributions from Linda.
That's a great question, Linda. Now that so many more employers are offering HSAs -- and so many people are working past age 65 -- a lot of them do want to stay on their employer policies and keep making HSA contributions. In order to do that, you can't sign up for either Medicare Part A or Part B, but you won't face a penalty for foregoing Part B because you have employer coverage. But the rules also vary based on the size of your employer. If your employer has fewer than 20 employees, you may be required to sign up for Medicare. And if you're already receiving Social Security benefits, you will already be enrolled in Part A. I wrote a column a few months ago about foregoing Medicare to stay on an HSA -- we can provide a link.
Thanks, Kim. I'll find that link in just a moment.
Let's go ahead and move on to this next question about Obamacare.
The Medicare and HSA column is called How to Make HSA Contributions After Age 65 -- hope that helps you find it.
About doctors not accepting Medicare payments -- some doctors decide that the reimbursements they get from Medicare are not enough to make it worthwhile to stay in the system.