Medicare covers most of your health expenses, but not all of them. Those uncovered expenses can add up quickly. According to a 2022 survey by the Commonwealth Fund, more than 23% of older adults with Medicare said they struggled to afford their premiums, not to mention the out-of-pocket costs Medicare does not cover. Understanding Medicare’s enrollment process and options for financial support can help you avoid higher premiums, gaps in your coverage, and other unexpected costs. Here are some tips to help you save on your Medicare plan.
Get enrollment support
Choosing the right Medicare plan can be confusing. According to KFF, 35% of Medicare enrollees aged 65 or older say they find it difficult to understand various aspects of health insurance. This includes knowing specific insurance terms, out-of-pocket costs, the providers that are in-network, services covered and how much insurance will pay. As a result of this challenging process, enrollees are more likely to choose the wrong plan, which can create unwanted costs. For assistance with your Medicare application, you can speak to a Medicare representative directly by calling 1-800-MEDICARE (1-800-633-4227). They are available 24/7 to answer any Medicare-related questions. Connecticut’s Program for Health Insurance Assistance, Outreach, Information and Referral, Counseling, Eligibility Screening (CHOICES) can also provide free one-on-one health insurance counseling to help you make the right choice for your care. For more information, visit https://www.shiphelp.org/about-medicare/regional-ship-location/connecticut.
Enroll at the right time
A common misunderstanding about Medicare is that you can enroll at any time as long as you are eligible for the program. The truth is you can only sign up for Medicare at certain times during the year. The first time you can enroll is known as the Initial Enrollment Period, which begins 3 months before you turn 65 and ends 3 months after you turn 65. If you do not sign up for Medicare during this time, you can still sign up between January 1 and March 31 each year. This is called the General Enrollment Period. Applying for Medicare during the wrong period can leave you with late enrollment penalties. These penalties will be added to your monthly premium and charged the entire time you have that Medicare coverage. For example, if you don’t buy Medicare Part A when you are first eligible, your premium could go up 10%. That means if your premium would typically be $100, you now have to pay $110 the whole time you are covered by Medicare. However, there are certain situations when you will be able to sign up for Medicare Part A and Part B, which covers hospital and medical insurance, without getting stuck with a penalty. These are called Special Enrollment Periods and are only available for a limited time.
Enroll in a Medicare Savings Program
Did you know you can get help from your state to pay out-of-pocket costs traditional Medicare (Part A and B) doesn’t cover? The premium for Part A is either $278 or $505 each month, depending on how long you have worked and paid Medicare taxes. The premium for Part B is about $174 each month, which can increase depending on income. These costs, of course, can add up over time but a Medicare Savings Program (MSP) can help. Medicare Savings Programs are Medicaid-managed programs that help cover Medicare premiums and other out-of-pocket expenses for lower-income enrollees. These expenses include deductibles, coinsurance, and copayments. You can apply for MSPs through your state, and they will determine which program(s) you qualify for. The application for the Medicare Savings Program in Connecticut is very easy to complete and understand.
In Connecticut, there are three different MSPs based on income eligibility:
- Qualified Medicare Beneficiary (QMB) pays both Medicare Part A and B premiums, deductibles, and coinsurances;
- Special Low-Income Medicare Beneficiary (SLMB) pays Medicare Part B premiums;
- Additional Low-Income Medicare Beneficiary (ALMB) pays Medicare Part B premiums.
Buy a Medigap policy
If you do not qualify for an MSP, you still have options for help covering out-of-pocket health care costs. A Medigap policy is health insurance sold by private insurance companies to help pay some of the costs traditional Medicare does not. If you are enrolled in Medicare and have a Medigap policy, you will have to pay the monthly Medicare premium, and an additional premium to the insurance company you bought your Medigap plan from. It’s also important to compare Medigap policies before you purchase one as costs can vary depending on the insurance company, when you buy a plan, your health conditions, and more.
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