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Last-minute questions answered as Medicare open enrollment deadline inches closer

Reminder: Medicare Annual Enrollment Period (AEP) ends December 7


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SAN ANTONIO – Seniors, if you haven’t already looked over your Medicare benefits and coverage for 2020, you still have time.

The Medicare Annual Enrollment Period ends Dec. 7.

Dr. Rowland Reyna, founder of HealthTexas Medical Group answered some commonly asked questions over the Medicare open enrollment period and the differences between Medicare versus Medicare Advantage plans.

1) What’s the main difference between Medicare and a Medicare Advantage Plan?

“A Medicare Advantage Plan covers all your health and prescription drug coverage needs," said Reyna. "It’s easier to budget because of reduced fixed costs instead of a percentage of what the bill is. There are added-value services including dental, vision, hearing, gym membership. No extra premium to your monthly Medicare Part B. It costs less and covers more services - best for those on a fixed income. Covers preventive healthcare instead of just waiting until you get sick or hurt and there is coverage worldwide.”

2) Do all Medicare Advantage Plans require you to choose a primary care doctor?

“Yes, because your primary care doctor, or PCP, is the person you rely on to help you manage your healthcare,” Reyna said. “Your doctor is the one person who will always look out for you and will make sure you are seeing doctors in your network."

3) I’m on a fixed income and often can’t budget for unexpected healthcare costs, what plans should I consider?

“Regardless of whether you are on a fixed income or just generally budget-conscious, there are a number of factors to consider in determining what might be the best plan for you,” Reyna said.

  • Determine if the plan is a good fit for your budget. Pay attention to more than just the monthly premium. You should also understand the other out-of-pocket costs, including the deductible, copays and coinsurance.
  • Make sure your medications are covered. Even if you don’t expect to change plans, it’s important to make sure the prescriptions you take regularly will still be covered next year. Remember, costs can change from year to year as well.
  • Don’t forget about dental, vision and other additional benefits. For people on Medicare, many are surprised to find that Original Medicare doesn’t cover prescription drugs and most dental, vision and hearing services. But many Medicare Advantage plans do.
  • Confirm your preferred doctors and hospitals are available through the plan you’re considering. Access to affordable, quality care is an important consideration when choosing a plan.

4) I’m hearing a lot about UnitedHealthcare’s 5 Star Plans, what exactly is a 5 Star Plan?

“Medicare Star Ratings are calculated annually by the Centers for Medicare & Medicaid Services (CMS) to rate the quality and performance of Medicare Advantage (Part C), including Special Needs Plans, and Prescription Drug Plans (Part D) on a scale of one to five, with five stars being the highest rating,” said Glenda Pope, sales director for UnitedHealthcare. “The ratings are published on Medicare.gov each October.”

“The Star Ratings system is designed to help inform Medicare beneficiaries as they compare health plans. If a plan is rated five stars, UnitedHealthcare is allowed to sell that plan year-round, providing more consumers access to a high-quality plan," said Pope.

For more information, visit healthtexas.org or call 210-731-HTMG.


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