Toni: Recently I enrolled in Medicare and have not received my “Medicare & You” handbook. I’m concerned about what I should do during the Medicare season that happens in the fall. How do I find out which options are best for me? I have some health problems, and I’m concerned about making the wrong change.
I know that I will be bombarded by marketing material, and I would really appreciate any advice that you can give me in advance. Thanks. — Sam from Atlanta
Hello Sam: I have good news for you because the “2025 Medicare & You” handbook will be mailed to mroe than 65 million Medicare beneficiaries in September. It is amazing how efficient Medicare is to have these handbooks arrive in time for Medicare’s Annual Enrollment Period every year.
Sam, you have time to do your research because Medicare’s AEP begins enrolling Americans on Oct. 15 and ends at midnight Dec. 7. (Medicare’s AEP is discussed at length in Chapter 6 of my book, “Medicare Survival Guide” advanced edition.)
There are different Medicare options available for different health and financial situations. Please take your time and research your options, especially if you are like Sam and concerned about your health issues and making the wrong decision.
Below are the steps the Toni Says Medicare team uses when helping clients during Medicare’s Annual Enrollment Period:
Step 1: Decide if you want “Original Medicare” with a Medicare Supplement or “Medicare Advantage” (Part C) plan.
— The main difference between “Original Medicare” and Medicare Advantage plans is “Original Medicare” works only with Medicare, and the Medicare Supplement selected pays the deductibles or coinsurances. (If no supplemental policy is selected, then you will pay the out-of-pocket costs.) Medicare Advantage plans are also called Part C. They are administered by private insurance companies that are approved by Medicare and are primarily HMO and PPO plans.
— When choosing a Medicare Advantage plan, you must use that specific insurance company’s card, not your Medicare card.
Step 2: Decide if you need to enroll in or change your current Medicare “Part D” prescription drug plan during Medicare’s AEP.
— If you want Medicare Prescription Drug coverage to go along with “Original Medicare” then you must enroll in a standalone Medicare Part D plan and there is a monthly premium.
— If you choose a Medicare Advantage plan, make sure that the plan has Medicare Part D Prescription Drug coverage included to keep from receiving a Medicare Part D penalty for not enrolling in a Medicare prescription drug plan.
— Verify that all prescriptions, both brand name and generic, are covered under the Part D plan you’ve chosen, whether a Part D standalone plan or Medicare Advantage.
The changes that Americans can make to their Medicare during AEP are:
— Enroll in a Medicare Prescription Drug (Part D) Plan.
— Change from one Medicare Prescription Drug (Part D) Plan to a new Part D Medicare Prescription Drug Plan.
— Enroll in a Medicare Advantage (Part C) Plan with Prescription Drug Plan.
— Change from one Medicare Advantage (Part C) Plan with or without Prescription Drug plan to a new Medicare Advantage (Part C) Plan.
— Return to Original Medicare and purchase a Medicare Supplement and enroll in a stand-alone Medicare Prescription Drug (Part D) Plan.
— Return to Original Medicare only and enroll in a stand-alone Medicare Prescription Drug (Part D) Plan.
— Or Return to Original Medicare with no Part D plan. Please note there is a penalty for not enrolling in a Medicare Prescription Drug (Part D) plan when first eligible.