Medicare Open Enrollment By the Letters
Medicare A is “hospital insurance” that covers inpatient expenses for hospitals,skilled nursing facilities, hospice and some home health services.
Medicare B is “medical insurance” that covers doctor visits, outpatient care,durable medical equipment and some home health services.
Medicare C or “Medicare Advantage” gives beneficiaries the ability to choose a private insurance company to pay for Medicare A and B services instead of traditional Medicare. Most Medicare Advantage plans include prescription coverage (Part D).
Medicare D is “prescription drug coverage” that helps to cover the cost of medications.
The “donut hole”
The “donut hole,” or coverage gap, is the point at which Part D beneficiaries have paid into their plans up to an out-of-pocket limit of about $2,400 (including your co-payment amount and the amount paid by your Medicare D insurance provider). Past that point, you are responsible for a larger portion of the cost of your medications until you exceed about $4,700 in total spending.
For 2012, as a result of the Affordable Care Act, Medicare Part D pays 50 percent of the cost of brand-name medications and 14 percent of the cost of generics once seniors enter the donut hole. By 2020, the program will cover 75 percent of the cost of generics and brand-name medications.
Talk to your pharmacist
Most people become eligible for Medicare at age 65. Your Sam’s Club Pharmacist can answer your questions about Medicare. Bring a list of all your current medications. Having this information will ensure that your Pharmacist can help you find the right plan for your needs.
Why open enrollment matters
During Open Enrollment, beneficiaries can choose or change their Medicare plans without penalty. If you don’t enroll during this period, you could pay a penalty if you choose to sign up for benefits later.
Key Open Enrollment Dates
Oct. 10, 2012
Begin looking at your Medicare choices
Open Enrollment begins
Oct.15 – Dec. 7, 2012
Choose your plan
Dec. 7, 2012
Open Enrollment closes
Jan. 1, 2013
Your new coverage begins
How to enroll
- Find a plan and enroll online at medicare.gov/find-a-plan
- Call your preferred plan directly or visit the plan’s website • Enroll in person at a kiosk set up by your preferred plan
Questions? Your Sam’s Club Pharmacist can help. Only you or your authorized representative can enroll you in a Medicare Part D plan.
Caring for someone enrolling in Medicare Part D? Sam’s Club Pharmacists can help you find a plan that fits the needs of your loved one. Visit medicare.gov/caregivers for more information.