Whatchamacolumn: Head-scratching Medicare choices

**Editor’s Note: Dec. 15 is an application deadline to enroll for new Medicare services under the Affordable Care Act. However, the deadline to change below-described plans for MedAdvantage coverage is Thursday, Dec. 7. That also is the deadline for changing prescription drug coverages, and for switching between Original Medicare and Medicare Advantage.

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Three head-scratching weeks remain for Medicare open enrollment — you have until **Dec. 15 to choose among a mind-boggling array of Medicare policies for 2024.

The information available and needed to make those decision would fill this newspaper and more. It would be folly to attempt a summary here, but I can offer a couple of lengthy, interesting articles: https://tinyurl.com/medfacts24 and https://tinyurl.com/moremedfacts2024.

Making Medicare coverage decisions involves health care needs, desire for flexibility, ability to pay rising premiums, capacity to manage paperwork and willingness to take risks. For example, there are no out-of-pocket maximums in Medicare Part A (hospitalization) or Part B (medical services) — for that, you add private insurance company plans.

Medicare supplement insurance (Medigap) augments Medicare to help offset health care costs, with full flexibility on choice of health providers. Medigap coverage can have hefty and rising monthly premiums, but a few of those plans have very small additional out-of-pocket health costs.

The government also contracts with private companies to handle Medicare benefits through Medicare Advantage, and if you’ve been watching the current crush of TV advertising, you can see the government/private partnership pushing people in that direction.

MedAdvantage policies usually have zero premium costs and an array of extra health care benefits. They manage access to health providers, and have varying limits on out-of-pocket maximums that are higher for out-of-network services.

More and more Medicare patients are being drawn to MedAdvantage because of free premiums and added benefits, taking their own risks on actual maximum health costs. There is, however, one often overlooked reality people should understand about Medigap versus MedAdvantage, quoted from one of the articles linked above:

“Depending on how long you have been enrolled in Medicare Advantage, Medigap insurers may not be required to sell you a policy unless you meet the medical underwriting requirements. You may want to contact a few Medigap insurers directly to see if you will be able to purchase a Medigap policy when you switch to traditional Medicare.”

In other words, after suffering pervasive health problems while covered by MedAdvantage, your best financial choice might be a return to Medigap. However, required medical reviews could result in denial of coverage or much-increased policy premiums.

Yes, there still are roll-the-dice elements when choosing Medicare options. But to end on a lighter note, feel free to enjoy an extra leftover-turkey sandwich tonight during the last Pac-12 Civil War football game. And Go, Ducks!

Jeb Bladine can be reached at jbladine@newsregister.com or 503-687-1223.