Preparing for AEP: Identifying Gaps in Your Medicare Coverage

As the Annual Enrollment Period (AEP) approaches, it is essential for Medicare beneficiaries to take a closer look at their existing coverage. Medicare provides crucial healthcare benefits to you, but it may not cover all of your specific healthcare needs. As AEP approaches, look for gaps in your coverage so that you can potentially identify a plan that better suits you.

Check for gaps in your prescription drug coverage. Original Medicare does not include prescription drug coverage, leaving beneficiaries vulnerable to high medication costs. To address this gap, many individuals opt for Medicare Part D, which offers stand alone prescription drug plans. Many Medicare Advantage plans roll Part D into their coverage as well. Be sure to check each plan’s formulary, or list of covered drugs, to determine if your regular prescriptions will be covered.

Inquire about dental and vision care. Routine dental and vision care are not covered by original Medicare, yet they are essential for overall health. Medicare Advantage plans often include dental and vision benefits, making them an attractive option for those with these specific healthcare needs.

Consider the cost of long-term care. Original Medicare does not cover long-term care services, such as nursing home care or assistance with daily activities. To fill this gap, some individuals may consider long-term care insurance or certain Medicare Advantage plans that offer limited long-term care benefits.

Determine whether your policy offers coverage for hearing aids. Medicare does not cover hearing aids, which can be crucial for maintaining communication and quality of life. Some Medicare Advantage plans may provide partial coverage for hearing aids.

Evaluate your current state of health and diagnoses. In addition to Original Medicare and Medicare Advantage plans, Special Needs Plans are also available to those with certain diagnosed health conditions. These plans focus around the needs of those individuals, in order to help them better coordinate their care.

Medicare Advantage plans and Medigap policies are designed to supplement original Medicare and provide additional coverage for services not included in Parts A and B. Medicare Advantage plans, offered by private insurance companies, often bundle hospital, medical, and prescription drug coverage, and may include benefits like dental, vision, and hearing care.

On the other hand, Medigap policies work alongside original Medicare to help cover out-of-pocket costs such as copayments, coinsurance, and deductibles. These policies can provide peace of mind by reducing the financial burden associated with medical services.

Call us to schedule an appointment to discuss these options ahead of the Annual Election Period, and we can help you identify plans that might better fit your needs.

Posted by PGIA
11 months ago / August 1, 2023

Filed Under: Medicare Info