If you are a Texas physician about to turn 65, or you are already enrolled in Medicare, you probably know 20% of your medical expenses aren’t covered, nor are most prescription medicines. That is where a Medicare Supplement plan and a Medicare Part D Prescription Drug plan can contribute – to help cover the costs that Medicare does not.
However, there are many Medicare Supplement and Medicare Part D choices on the market. The options available may seem overwhelming, and making the wrong choice can be costly.
Why Medicare Mistakes are Costly
Though traditional Medicare will cover most of your health care expenses, you may still have significant deductibles, copays, coinsurance, and plan limits to contend with – and of course, prescription drug costs. When you enroll for Medicare the first time, if you also want to enroll in a Medicare Supplement plan, you cannot be turned down for coverage. But if you do not take advantage of your guaranteed status during this enrollment window, there may be repercussions. If you apply for a Medicare Supplement plan at a later date, the insurance company will most likely charge you a higher premium rate or possibly deny you coverage altogether. By shopping wisely, you can not only obtain guaranteed coverage, but also save hundreds (or even thousands) of dollars on your premiums and out of pocket costs.
This is especially important with a Part D plan. These prescription plans may cover different medications, and in varying amounts, so that if you haven’t compared plans thoroughly, you could be paying more out of pocket for the regular prescriptions you will need.
When You May Qualify for a Special Enrollment Period
In addition to the initial enrollment period and the annual enrollment, you can make changes to your Medicare Supplement plan and Medicare prescription drug coverage when certain events happen in your life, creating a Special Enrollment Period (SEP). You should note that the rules about when you can make changes to your supplemental plans and the type of changes you can make are different for each SEP. Here are some key life changes that may trigger a Special Enrollment Period:
- If you change where you live
- If you lose your current coverage
- If you have a chance to get other coverage
- If your insurance plan changes its contract with Medicare
There are still more conditions, like being diagnosed with a severe condition that can be covered by a Medicare Chronic Care Special Needs Plan, or if certain errors or omissions were made that affected your ability to obtain the right coverage.
The SEP conditions can be tricky to understand; that’s why a trustworthy advisor can help. Know that a TMA Insurance Trust advisor is ready to help you understand your options and make the best decisions for your exact needs.
Why Work with a Medicare Advisor
Making Medicare Supplement and Part D decisions will likely lock your coverage in for another year. You can sort through the vast amount of information online - or you can take advantage of an unbiased TMA Insurance Trust advisor’s help. Texas physicians can save money, time, and headaches by taking advantage of this valuable benefit.
For example, you are entitled to ongoing, one-on-one personal assistance from an experienced insurance advisor who will research Part D providers and compare coverage to see if your prescriptions are covered and at what price. Although some organizations and financial planners charge hundreds of dollars for these consultations, you can receive this service at no charge.
Physicians often have complex Medicare choices. This is especially so if you are nearing age 65 and are still in active practice. If you have an HSA and will soon be eligible for Medicare, how does this impact your HSA? If you work beyond age 65 and retain your group health insurance plan, how will your Medicare eligibility be impacted? What if you’re eligible to enroll in Medicare but you want to keep your dependents covered by traditional health insurance? Our advisors have the experience and knowledge to help you through the complexities of all your decisions.
So if you are looking to enroll in Medicare for the first time or are considering making a change to your Medicare Supplement or Part D plan, we can help you create a personalized solution based on your individual health care needs, preferences and budget. Call us today for assistance and to get the best option for your needs.
For over 60 years, TMA Insurance Trust advisors have been serving Texas physicians, their families and staff. TMA Insurance Trust prides itself on offering unbiased information and strategies to members, along with exclusive group rates on a range of the highest-rated plans in the industry.