Medicare Open Enrollment is Happening Now
Everyone over 65 has the opportunity once a year to make changes to your Medicare coverage for the following calendar year. It’s called the “Open Enrollment Period.” Open enrollment for 2025 is happening right now and you have until December 7th to choose your health care plan for the upcoming year.
Essentially, during the open enrollment period you have the opportunity to decide whether you want traditional Medicare (and perhaps a secondary or supplement) or a Medicare Advantage Plan (MAP, also known as Medicare Part C) for next year. You only have one or the other, and now is when you are able to make a choice.
TRADITIONAL MEDICARE Vs MEDICARE ADVANTAGE PLANS
There are many different Medicare Advantage Plans (MAPs). And it’s important to know that a MAP is NOT the same as traditional Medicare, in the sense that MAPs don’t always reimburse your doctors, pharmacy, and other medical providers like Pretty In Pink Boutique the same way Traditional Medicare does.
Why is this important?
Which is Better? Traditional Medicare or a Medicare Advantage Plan?
Knowing whether any given Medicare Advantage Plan can save you money over Traditional Medicare is matter of doing some math. And that can get both complicated and confusing. BUT, Medicare has a lot of ways to help you figure that out. All you have to do is call 1-800-MEDICARE or go to Medicare.gov.
We are not experts on this topic, and we are not licensed insurance agents, so it’s not appropriate for us to advise you in any official capacity. But we get asked a LOT about this topic – mainly because some patients (maybe you are one) find out that their MAP doesn’t pay for bras, prosthetics, or compression garments as well as Traditional Medicare.
Are Your Compression Garments a Major Out-Of-Pocket Expense?
If you have a MAP that isn’t paying as well, going back to traditional Medicare with a supplement WILL cover your compression garments. However, you need to look at your healthcare costs as a whole. Perhaps your MAP is saving you more money on prescriptions or other costs, and it’s just better to pay out-of-pocket for the items you buy at Pretty In Pink Boutique, knowing that overall you’re still saving money versus Traditional Medicare.
In other words, you may be gaining better coverage for your compression garments, but sacrificing cost savings on prescriptions or other out-of-pocket costs. Again, this is a situation where calling 1-800-MEDICARE and talking to a Medicare representative can offer reliable information and advice.
Also remember that the insurance agent offering you a MAP, or choices of MAPs, is paid to sell you a MAP. So there is a financial incentive to anyone who signs you up for a Medicare Advantage Plan. But the same is true when an insurance agency sells you a secondary or supplement to Traditional Medicare.
This is an over-simplification, but if your compression garments are your only out-of-pocket expense all year then it would be easy to advise you that Traditional Medicare and a secondary or supplement will always pay better than a MAP. It’s not likely that your situation is that simple.
How to Compare Traditional Medicare to a Medicare Advantage Plan
Keep in mind that there are many, many choices of MAPs. They’re available from most major insurance companies. And they’re all somewhat different in terms of what they cover, and how widely they’re accepted by doctors, pharmacies, and other medical providers like Pretty In Pink Boutique.
Here is a basic way to compare Traditional Medicare to your MAP, or even how to compare one MAP to another MAP:
|
Traditional Medicare |
Medicare Alternative Plan |
|
| Monthly Cost | ||
| Annual Deductible | ||
| Co-Pays / Office Visits / Etc | ||
| Co-Insurance | ||
| Prescriptions | ||
| Your PIPB Purchases | ||
| Other | ||
|
——————— |
——————— |
|
| Grand Total |
By comparing all the costs you incur for healthcare during the year, you can fairly evaluate whether Traditional Medicare with a secondary or supplement is more favorable than a MAP. It also lets you compare one MAP against another.
Now is the Time to Review & Make Your Choice for 2025
Since you only get to decide once a year, and you’ve only got until December 7th to pick what you want for 2025, it’s important to be thinking about this right now.
If you have an insurance agency you already work with and trust, that’s an important resource to help you make this choice. And you’ll get unbiased information directly from Medicare by calling 1-800-MEDICARE.
By the way, if you do nothing, your Medicare plan will automatically stay the same for next year as it is right now.
