Medicare Basics: What you need to know about Medicare and the Annual Enrollment Period

Are you newly Medicare eligible (turning 65), planning to retire soon, or have you had Medicare for years and wonder if you’re in the right plan? Medicare can be confusing, but Ryan Dolan, Medicare Field Sales Manager at Univera Healthcare, makes it easy with answers to common questions.

Ryan Dolan

Who is eligible for Medicare?

Anyone 65 years of age or older is eligible for Medicare. You also could qualify if you receive Social Security disability for 24 consecutive months or if you have certain chronic conditions.

We hear A-E-P referenced when talking about Medicare. What is A-E-P and why is it important? 

AEP is the abbreviation for the Medicare Annual Election Period. AEP is typically the one time each year when you can make changes to your plan.  It runs every year from October 15 through December 7. If you’re happy with your plan, then you don’t have to make a change.  Or, if you’re only enrolled with original Medicare parts A (hospital) & B (medical), this is your chance to get enhanced coverage with a Medicare Advantage plan.

Who needs to pay attention to AEP?

Anyone who is already on a Medicare plan should pay attention to AEP. It doesn’t mean you have to change anything. Available plans and options – as well as your health conditions and medications – can change every year. It’s always a good idea to see what is out there and look at your options.

I’ve heard that there are $0 (zero dollar) plans out there. It seems too good to be true.

We have many great plans out there with low or no premiums each month! A $0 plan means you don’t have to pay a premium each month, but it doesn’t mean you won’t have any out-of-pocket costs (such as co-pays when you go to the doctor). $0 plans are typically for those who don’t use a lot of medical services outside of routine care (such as preventive care with your PCP or seeing specialist from time-to-time). These plans provide your core medical benefits – as well as things that original Medicare doesn’t cover, like preventive dental and eye care.

Univera Healthcare received a 5-Star Quality Rating from CMS. What does this mean?

The Centers for Medicare & Medicaid Services (CMS) gives Star ratings to health plans every year based on quality performance in clinical care and outstanding service to their Medicare members. Univera’s HMO plans have been awarded the highest possible star rating  –  5 out of 5 Stars. And for the sixth year in a row, our Medicare Part D prescription drug plans also received a 5-star rating. Plans with a 5-star rating can offer a special enrollment period where you can switch your coverage to a 5-star plan outside of AEP (between December 8, 2021 and November 30, 2022).

What are some reasons why I might want to change my plan?

Available benefits and plans change each year. It’s also important to consider any changes in your health or life situation that might impact your needs. Have you been diagnosed with a chronic condition or has your income dropped sharply? Are you planning to have a surgery or procedure in the upcoming year? Do you need to see a specific doctor who doesn’t participate in your current plan? Are you covered through your former employer, but learned that they are changing their retiree health benefits? These are all reasons that you may want to consider switching plans.

Is there someone who can help me compare plans and figure out what’s best for me?

Univera Healthcare’s Medicare experts live and work in our community, and can walk you through all available options and help you choose a plan that’s right for you. There’s a variety of ways we can meet based on your comfort level: In-person appointments, phone appointments, in person seminars or online seminars.

For more information or to schedule an appointment, go to univeraformedicare.com or call 1-(800) 697 – 0700 (TTY: 711) 8 a.m. to 8 p.m. seven days a week, from October 1 until December 30, and 8 a.m. to 8 p.m. Monday-Friday from January 1 – September 30.

Univera Healthcare is an HMO plan with a Medicare contract. Enrollment in Univera Healthcare depends on contract renewal. Our Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-883-9577 (TTY: 1-800-662-1220).

注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-877-883-9577 (TTY:1-800-662-1220).

 

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