Are You a Medicare Rookie? Pros Can Help You Find Right Plan

StatePoint  —   Roughly 4.4 million Americans will reach the age of 65 in 2024, according to the U.S. Census Bureau. While age is just a number in some respects, this particular birthday marks the time when Americans become eligible for the federal Medicare health insurance program. And if you’ll be hitting this milestone soon, you’re in good company, as athlete, entrepreneur and philanthropist, Earvin “Magic” Johnson will be doing the same.

“I’ve been a rookie a few times in my life, but this time, I’m new to Medicare,” says Johnson.

Medicare is the government health insurance program for Americans 65 and older, and those under 65 with certain disabilities, providing hospital coverage (Part A) and physician visits (Part B) to those who qualify. Rookies and pros alike can hone their health insurance selection game plan with a little coaching. That’s why Magic Johnson got these tips from Cigna Healthcare, which serves millions of Medicare customers nationwide:

1. Don’t delay. Medicare has a seven-month window around your 65th birthday called the Initial Enrollment Period. Enrolling outside this window could result in higher premiums on Medicare Part B for the rest of your life. However, if you’re still working, you may be able to keep your current plan, depending on the size of your company, and switch to Medicare without penalty when you retire. If you’re not working and you’ve already filed for Social Security, you’ll be automatically enrolled in Medicare Parts A and B when you turn 65.

2. Know what’s covered. Medicare Parts A and B are sometimes called Original Medicare and cover hospital and physician expenses. To cover things like dental, vision, hearing and pharmacy, you may opt for a Medicare Advantage plan (also known as Part C), which covers everything that Medicare does and provides additional benefits, including, in many cases, prescription drugs (also known as Part D). Assessing your budget, health needs, doctor preferences and lifestyle will be important in making the best choice for you.

3. Read the fine print. Before signing up for a particular plan, make sure that your favorite health care providers are in its network. While you may be able to go out of network for care, be prepared to pay more if you do. You’ll also want to factor in all the associated costs of a given plan, including monthly premiums, co-pays and deductibles, as well as the prices and rules around the prescription drugs you take.

4. Get help. Turn to resources and platforms that can help ensure you understand the plan you’re enrolling in. Call Medicare at 1-800-MEDICARE (1-800-633-4227) 24/7. TTY users can call 1-877-486-2048. Or, visit the Medicare Plan Finder website at Medicare.gov/plan-compare. For local assistance, refer to the State Health Insurance Assistance Program at www.shiptacenter.org. You can also contact individual Medicare plans, including Cigna at www.CignaMedicareInformation.com.

5. Use your benefits. For optimal health, make full use of your plan’s benefits. In particular, be sure to get the wellness checks and preventive screenings needed for your age and health status. If your plan offers extra perks, such as fitness or nutrition programs, take advantage of them.

“If you find out that the plan you signed up for last year is not the right fit, lean into the experts about what works best for you and make changes during AEP to set yourself up for a winning year,” says Johnson.