Personal fitness trackers—like the Fitbit® or Jawbone®—are popular devices to help you keep your New Year’s resolutions and stay fit all year long. The fitness tracker collects data and sends it to a phone app that tracks physical activity, calorie intake, and sleep quality. Wouldn’t it be cool if the device included an insurance tab to help people navigate their Medicare benefits, too?
Could you imagine how you’d feel slipping on the device if it said,
• “You have adequate coverage for your current health.”
• “Your doctor is in-network, and the out-of-pocket cost for your upcoming appointment is $10.”
• “Warning, you are nearing the prescription coverage gap.”
Until that technology comes along, Health Alliance Medicare can help explain Medicare basics. Most people paid for Medicare Part A through their payroll taxes while they were working, so they don’t pay a premium now. Part A covers inpatient hospital procedures, but not the doctor who does the procedure.
Medicare Part B covers the doctor and requires a monthly premium. Both A and B have deductibles (what you pay before your coverage kicks in) and coinsurance (a percentage of total cost that you pay). Figuring out coinsurance is tricky because it’s hard to plan what the overall doctor visit or hospital cost will be.
Medicare Part D is for prescription drug coverage. If you don’t choose Part D when you become eligible for Medicare, you could pay a penalty, called the Late Enrollment Penalty, if you add it later. If you pay a lot for your medicine, it’s important to read your monthly Explanation of Benefits to see if and when you’ll fall into the coverage gap.
Medicare Advantage plans, like Health Alliance Medicare, are called Part C and cover every benefit of Original Medicare and more, plus you can add prescription drug coverage. Medicare Advantage plans can be an easy transition for those turning 65 because they look a lot like employer insurance plans.
Until someone invents a Medicare app, consider Health Alliance Medicare your source for information. Helping people get started with the right information to avoid common and costly pitfalls later is the best part of our jobs.
Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. She has four adult sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.