Your Health | one month ago

8 Things to Know about Medicare Open Enrollment

If you are considering a Medicare Advantage plan, consider choosing one that includes Atrium Health doctors and hospitals you trust.

If you are considering a Medicare plan, consider choosing one that includes Atrium Health doctors and hospitals you trust.

For those who qualify for Medicare, each fall brings an opportunity to review insurance needs for the coming year. Even if you’re happy with your current plan and your coverage, it’s smart to check and see if benefits, coverage limits or your needs have changed. If so, it could be time to consider enrolling in a Medicare Advantage plan.

To help, Atrium Health has partnered with eHealth, an independent insurance agency, to simplify the process for you. They can help you understand your options and choose the Medicare plan that’s best for you. Call eHealth to speak with a licensed insurance agent who can guide you through coverage options for free, with no obligation to enroll.

Representatives with eHealth are available Monday to Friday, 7 a.m. to 9 p.m., and Saturday, 10 a.m. to 7 p.m. EST (TTY users: 711). More information is available .

As you compare plans, it’s important to remember what you get by choosing a health insurance plan that includes Atrium Health:

  • Unmatched, world-class care from the region’s only nationally ranked health system which includes Levine Cancer Institute, Sanger Heart & Vascular Institute, Musculoskeletal Institute and more.
  • Access to one of the largest primary care networks in the region, on-demand care including urgent care and online video visits, and the region’s only Level I trauma center.
  • Peace of mind that you can keep your out-of-pocket costs down when you get care from us.

There’s a lot to consider when choosing the right plan for you. Here are 8 things to keep in mind as you evaluate your needs.

1. Take a moment to understand Medicare Advantage

Medicare Advantage plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage plans are offered by private companies, and in many cases, you’ll need to use health care providers who participate in the plan’s network and service area to get the lowest costs.

Medicare Advantage plans, sometimes called Part C or MA plans, are an all-in-one alternative to Original Medicare. If you join a Medicare Advantage plan, you still have Medicare.

Medicare plans and coverage can be confusing. Our online guide can help you learn more about coverage options available to you. Download our guide here.

2. Most Medicare Advantage plans cover what Original Medicare doesn’t

Examples of care covered by Medicare Advantage plans include certain vision, hearing, dental and fitness programs (like gym memberships or discounts). Plans can also choose to provide even more benefits.

For example, some plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs, and services that promote your health and wellness. Plans can also tailor their benefit packages to offer these benefits to certain chronically ill enrollees. These packages will provide benefits customized to treat specific conditions. Check with the plan before you enroll to see what benefits it offers, if you might qualify and if there are any limitations.

Each Medicare Advantage plan can charge different out-of-pocket costs. They can also have different rules for how you get services, like:

  • Whether you need a referral to see a specialist
  • Whether you have to go to doctors, facilities or suppliers that are in the plan’s network for non-emergency or non-urgent care

These rules can change every year.

3. What you pay for Medicare Advantage can vary

Your cost for a Medicare Advantage plan depends on several factors, including the scope of benefits that are covered by the plan. In many cases, you’ll need to use doctors and other providers who are in the plan’s network and service area for the lowest costs. Some plans won’t cover services from providers outside the plan’s network and service area.

Additional information can be found in our Medicare guide and at AtriumHealth.org/Medicare.

 4. Enrollment opens Oct. 15

Medicare Open Enrollment, also known as the annual enrollment period, will take place from Oct. 15 to Dec. 7, 2022. If you are over 65 (or turning 65 in the next three months), this is the time of year to review your health insurance coverage options.

During this enrollment period, newly eligible and existing Medicare patients can review Medicare coverage options and can choose to:

  • Switch from Original Medicare (Medicare Parts A and B) to Medicare Advantage, or vice versa
  • Change from one Medicare Advantage plan to another
  • Add or change Medicare prescription drug plans

Make no changes to current Medicare coverage

5. Consider plans that let you keep your Atrium Health providers

If you decide to enroll in a Medicare Advantage plan, you should consider enrolling in a plan that enables you to continue getting care from your preferred Atrium Health doctors and hospitals.

Atrium Health is an in-network provider for Medicare Advantage plans offered by:

  • Aetna Medicare from Aetna CVS Health (NC, SC)
  • ApexHealth
  • Blue Medicare from Blue Cross Blue Shield of NC
  • Blue Cross Blue Shield of SC members may have access through the Blue Card program
  • Cigna Health Care (formerly Cigna HealthSpring)
  • Humana Medicare Advantage (NC, SC)
  • United Health Care Medicare Advantage (including AARP plans)
  • WellCare (NC, SC)

Not all plans are offered in each county. Check with the plan when enrolling to confirm whether your preferred Atrium Health doctors, clinics and hospitals are included in your plan’s network. Also, the Senior Health Insurance Information Program (SHIIP) lists Medicare Advantage plans by county that are available for 2023. Call them at 855-408-1212 or . You may also contact your health insurance agent.

6. If you’re happy with your plan, keep it

If you’re happy with your existing Medicare coverage, there’s no need to do anything during the annual enrollment period. But it’s always good to check that your current plan is still available, that your plan’s benefits still align with your current health needs, and that you can continue to see your preferred doctors and hospitals.

7. Stay with your current providers until your new plan begins

Your new coverage begins Jan. 1, 2023. As long as you remain covered under your current health plan, you can continue to see your physician(s) under that plan until your new Medicare Advantage coverage begins.

As always, if you have a medical emergency, go to the closest hospital emergency room. Atrium Health hospitals provide services to all patients seeking treatment for an emergency medical condition, regardless of their health insurance plan or ability to pay for emergency services.

8. Know your options if your needs change

If you sign up for a Medicare Advantage plan during Medicare Open Enrollment and your needs later change, you may have to wait until next fall to switch plans.

However, if you signed up for Medicare Advantage during Medicare Open Enrollment, you could elect to switch health plans (either Medicare Advantage or Original Medicare) between Jan. 1, 2023, through March 31, 2023.