YOUR. Medicare OPTIONS. What you need to know as a NEW Medicare Beneficiary. H0062_18_4251BROC Accepted

Transcription

1 YOUR Medicare OPTIONS What you need to know as a NEW Medicare Beneficiary H0062_18_4251BROC Accepted

2 Important choices can be simpe choices. Let us hep. This guide wi give you a soid foundation for understanding the basics of Medicare and some of the options avaiabe to you as a new Medicare beneficiary. If you have any questions or need assistance, et us hep. It s why we re here.

3 What are your coverage choices as a new Medicare beneficiary? Once you enro in Medicare, you have three basic choices for receiving your heath coverage: Origina Medicare (Part A and Part B) Medicare Advantage (Part C) Medicare Suppement You earn more about each in this brochure. You aso earn about Medicare Part D prescription drug coverage which is not avaiabe with Origina Medicare or Medicare Suppement pans, but is incuded with most Medicare Advantage pans. 1

4 The Parts of Origina Medicare Origina Medicare is made up of Part A and Part B. Most Medicare beneficiaries pay a monthy premium for Part B coverage. Part A is hospita coverage Part B is medica coverage 2

5 80 % 20 % Origina Medicare does not cover a of your medica and hospita expenses. It s important for you to know that Origina Medicare covers ony about 80% of your eigbe expenses. you are responsibe for the rest. Aso remember that origina medicare does not incude prescription drug coverage. 3

6 The Optiona Parts of Medicare Medicare Part C (Medicare Advantage) and Part D (Prescription Drug) are important Medicare options that are provided by pans contracted with the federa government to provide these benefits. Part C is aso known as Medicare Advantage Part D is prescription drug coverage 4

7 Is a Medicare Advantage pan right for you? A Medicare Advantage pan (Part C) is an important Medicare option that combines a of your Medicare benefits in one convenient pan. Medicare Advantage pans hep fi some of the gaps eft by Origina Medicare. may be avaiabe for a monthy premium as ow as $0. usuay incude your Part D prescription drug coverage. often provide extra benefits such as vision and denta coverage. provide a of your Part A (hospita) and Part B (medica) coverage. 5

8 Prescription Drug Coverage Medicare Part D presciption drug coverage is an important option that is avaiabe either as a standaone pan or as part of a Medicare Advantage Pan. Prescription coverage is not incuded with Origina Medicare or Medicare Suppement Pans. 6

9 What is a Medicare Suppement pan? Another aternative to Origina Medicare aone, or a Medicare Advantage pan, is a Medicare Suppement pan. Medicare Suppement pans are designed to fi gaps eft by Origina Medicare. generay cost more per month than Medicare Advantage pans. do not incude prescription drug coverage. If you want that important option, you must purchase it separatey. aow you to see any provider who accepts Medicare. 7

10 When can you enro in Medicare? Most peope are automaticay enroed in Medicare Part A when they turn 65. You can enro in Medicare Part B as eary as the first day of the month, three months before your birth month. As soon as you enro in Part B, you can choose what type of additiona coverage you want a Medicare Advantage pan or a Medicare Suppement Pan. Don t forget to aso enro in a prescription drug pan (part D) if you want to protect yoursef from the high cost of prescription drugs. THREE MONTHS BEFORE YOUR BIRTHDAY MONTH THREE MONTHS AFTER Keep in mind that if you do not choose prescription drug coverage during this Initia Eection Period, you may be subject to a penaty if you decide you want this important option ater. 8

11 You can make new choices each year A Medicare beneficiaries have an opportunity to choose or change Medicare Advantage (Part C) and Part D prescription coverage each year during the Medicare Annua Eection Period. Each year, the Medicare Annua Eection Period begins on October 15 and ends on December 7. The choices you make during the Annua Eection Period wi take effect on January 1 of the upcoming year. OCTOBER 15 DECEMBER 7 Specia eection periods There are specia circumstances in which you may join a Part C or Part D pan at other times of the year, incuding: When you first become eigibe for Medicare. If you are on both Medicare and Medicaid. If your current pan is terminated. If you move to a community not served by your current pan. JANUARY 1 9

12 Which type of coverage shoud you choose? That s going to depend on your own needs and your budget. But there s a good chance you want additiona coverage to hep pay some of the out-of-pocket costs not covered by Origina Medicare. By understanding the options avaiabe to you as a Medicare beneficiary, you be better prepared to make the right choice for your situation. 10

13 Let s review your options Origina Medicare covers ony about 80% of your eigibe heath care expenses. Part C: Medicare Advantage pans are provided by companies with a Medicare contract. incude a of your Origina Medicare benefits. usuay incude prescription drug coverage and other extra benefits. may be avaiabe with monthy premiums as ow as $0. Medicare Suppement pans do not incude a of your Origina Medicare benefits. offer the freedom to choose any doctor. do not incude prescription drug coverage. Part D: Medicare prescription drug coverage is provided by companies with a Medicare contract. may be purchased in a standaone pan or may be incuded as part of a Medicare Advantage pan 11

14 We hope you found this information hepfu. As you prepare for Medicare eigibiity, remember that we are standing by to answer your important questions and hep you make smart, confident choices 12

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16 Awe has a contract with Medicare to provide Medicare Part C and Part D benefits to our Medicare-eigibe neighbors. Questions about your Medicare options? Let us hep. Visit our Phone Directory Page to see contact information for your state. Awe is contracted with Medicare for HMO and HMO SNP pans, and with the Texas Medicaid program. Enroment in Awe depends on contract renewa. This pan is avaiabe to anyone who has both Medica Assistance from the State and Medicare. This information is not a compete description of benefits. Contact the pan for more information. Limitations, copayments, and restrictions may appy. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. However, for fu-dua beneficiaries, the State wi cover your Part B premium as ong as you retain your Medicaid eigibiity. The Formuary, pharmacy network, and/or provider network may change at any time. You wi receive notice when necessary.