Senior Home Care Blog - Western Cook & Eastern DuPage Counties

It's Time for Your Medicare Checkup

By Mary Doepke, RN

Have you had your checkup this year? Your Medicare checkup, that is.

October 15 marks the start of Open Enrollment season for those with Medicare coverage. From Oct. 15 to Dec. 7, those eligible for Medicare can make changes to their coverage choices, which will go into effect Jan. 1.

Even those who are happy with their current plan are encouraged to take the time to look things over. Is Original Medicare still enough for you? Perhaps it’s time to add a prescription drug plan to your benefits, or to change your current plan to better reflect your current medications. Have you considered vision and dental coverage?

Just like one’s personal circumstances, plans, including their costs, also change over time. It’s important to be sure your current plan is still the right one for you.

Thankfully, there are resources available to help seniors, their families and caregivers sort their way through the Medicare maze.

Make an Appointment

The Senior Health Insurance Program, also known as SHIP, offers free counseling to help seniors make good, informed Medicare choices. Visit www.insurance.illinois.gov to find a SHIP location near you, or call one of the numbers below to schedule a one-on-one appointment with a Medicare expert.

 

Aging Care Connections

111 W. Harris

La Grange

(708) 354-1323

 

Solutions for Care

7222 W. Cermak Road Suite 200

North Riverside

(708) 447-2448

 

JC Lin Health Services

501 N. Cass Ave.

Westmont

(630) 281-2596

Get the guide

The American Grandparents Association is doing its part to simplify the Medicare process by providing a free guide to the latest products and changes. Download the free Guide to Understanding Medicare here.

Visit the website

Medicare.gov has compiled a list of questions to consider when reviewing your current coverage.

  1. Coverage

How well does your current plan cover the services you need?

  1. Coordination

How do your other coverage plans work in coordination with Medicare?

  1. Cost

How much are your premiums, deductibles, and other costs? How much do you pay for services like hospital stays or doctor visits? Is there a yearly limit on what you could pay out-of-pocket for medical services? Make sure you understand any coverage rules that may affect your costs.

  1. Choice

Do your doctors accept your coverage? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network ? Do you need to get referrals?

  1. Prescriptions

Do you need to join a Medicare Prescription Drug Plan? Do you already have creditable prescription drug coverage? Will you pay a penalty if you join a drug plan later? What’s the plan’s overall star rating? What will your prescription drugs cost under each plan? Are your drugs covered under the plan’s formulary? Are there any coverage rules that apply to your prescriptions? Are you eligible for a free Medication Therapy Management (MTM) program?

  1. Quality

Are you satisfied with your medical care? How have Medicare and other people with Medicare rated your health and drug plan’s care and services?

  1. Convenience

Where are the doctor’s offices? Is the pharmacy you use in the plan’s network? Can you get prescriptions by mail?

  1. Travel

Will the plan cover you if you travel to another state or outside the U.S.?

Medicare and insurance can be confusing and overwhelming, but by taking time to sort through the options and meeting with someone who knows the system, you can be sure you or your loved one has the protection they need.