Medicare_guide_digital

First, decide what you need Meet the A, B, C & D of Medicare

To help you choose which Medicare option is right for you, make a Good health care means different things to different people, and
list of your health care needs so you can quickly compare plans. that’s why you’ll find a variety of Medicare options. We want to
Here are a few questions to get you started: help you understand every aspect so you can make a confident,
well-informed choice.
Do you need prescription drug coverage?
Do you need dental coverage? Here’s the scoop. The four basic plan types are:
Do you need vision coverage?
Do you need coverage for hearing exams and Original Medicare (Parts A and B)
hearing aids? Medicare Advantage (Part C)
Would you like 24/7 access to a nurse by phone? Medicare Supplement
Will you need worldwide emergency care? Prescription Drug Plans (Part D)
Do you want access to wellness programs or
gym memberships? Original Medicare is the base level plan. It covers some aspects of
Do you prefer a set monthly premium, or would your doctor visits and hospital stays, but it wasn’t meant to cover
you rather only pay for the care you need? everything. That’s why you might choose to get additional coverage,
available from a private insurance company approved by Medicare.
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Explore other options with extra benefits

Option 1: Medicare Advantage plans (also known as Part C)

combine Parts A and B with added benefits that can include
prescription drug coverage for all-in-one convenience.

Option 2: Medicare Supplement plans cover some of the

expenses not covered by Parts A and B to give you more
comprehensive coverage.

Option 3: Prescription drug coverage (also known as Part D)

helps pay for the medications prescribed by your doctor, which
Original Medicare does not cover.

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Original Medicare’s basic Maximize value with an all-inclusive
hospital and medical coverage Medicare Advantage plan

Original Medicare, which is administered by the federal government, Medicare Advantage (Part C) includes Part A hospital
is made up of Parts A and B. It covers certain medical services and coverage and Part B medical coverage in a convenient,
supplies in hospitals, doctors’ offices, and other health care settings. all-in-one plan.

Medicare Part A Medicare Part B Most Medicare Advantage plans also include prescription
drug coverage (Part D).
(Hospital Insurance) helps cover: (Medical Insurance) helps cover:
Many plans also give you additional valuable benefits,
Skilled nursing care Doctor visits & preventive care like extra days in the hospital.
Inpatient hospital stays Outpatient services
Hospice care Medical supplies Some plans even offer dental, vision and hearing coverage,
Some in-home care Tests and x-rays and/or access to wellness and fitness programs.

You should expect to pay premiums (at least for Part B), deductibles Unlike Original Medicare, Medicare Advantage plans have
and coinsurance for covered services. And for services and supplies an annual limit on out-of-pocket costs for medical services.
not covered by Parts A or B, you will pay the full amount out of your
own pocket. You can choose from a wide range of Medicare Advantage
plans to fit your needs and budget, with premiums and
Remember, high medical costs from an unexpected copays that are often less than Medicare Supplement plans.
illness or injury can impact your retirement savings.
So it’s smart to add private Medicare insurance Eligible for Medicare & Medicaid?
coverage to help protect your financial and
physical health. You could get specifically designed coverage with a
Medicare Advantage Special Needs Plan, known as a
D-SNP. D-SNPs all include prescription drug coverage,
and some offer extra benefits to help manage your
health conditions such as transportation assistance and
coordination of your Medicare and Medicaid services.

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Maximize flexibility with a reliable Maximize savings with affordable
Medicare Supplement plan prescription drug coverage

With a Medicare Supplement insurance plan, also Original Medicare doesn’t include prescription drug
nicknamed Medigap, you’ll still have Original Medicare coverage. You can add a prescription drug plan (PDP)
for Parts A and B coverage. from a private insurance company.

Your supplement will cover many of the out-of-pocket You can purchase a PDP by itself or with a Medicare
expenses that Original Medicare doesn’t cover. This is Supplement plan.
sometimes called “filling the gap.”
Most Medicare Advantage plans include prescription
You get the peace of mind that comes from more coverage.
predictable monthly costs and fewer surprises when
you need care. PDPs cover generic and brand-name drugs, typically
with a lower copay for generics.
You’ll have the flexibility to choose any doctor or
hospital that accepts Medicare. PDPs must cover common types of drugs, but not
specific drugs within each type. Check to see if your
Your coverage travels with you nationwide, and it’s prescriptions are in the drug list of PDPs you consider.
guaranteed for life.
Questions? Just give us a call
Even though plans are administered by private
companies, their benefits are standardized by the 1-8XX-XXX-XXXX (TTY: 711)
government with several plan types to fit different
needs and budgets. 8 a.m. to 8 p.m., Monday – Friday. Or visit anthem.com/1on1
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Take a quick quiz to find the right plan Consider what else matters to you

Which Medicare plan is best for you? Think about what matters to As you review your Medicare choices and what kind of coverage
you most as you compare coverage types. each plan provides, you’ll want to keep a few more things in mind:

Medicare Medicare Your current health
Advantage Supplement
Consider how often you’ve been to the hospital lately,
Out-of- I’d like to keep costs as I want protection from whether you have chronic conditions that need constant
pocket low as possible, and I’m more of the out-of-pocket treatment, and which prescriptions you take.
costs especially interested in costs not covered by
low or no-cost options. Original Medicare. How your health might change

Choosing I’m looking to stay I want the freedom to You may feel fine now, but there may be serious illnesses
my health within a plan’s doctor choose any doctor or that run in your family or other risk factors to consider as
care and hospital network to hospital that accepts you age.
providers help control expenses. Medicare.
Your financial situation
Prescription I’d like to have my I’m okay with
drug prescription and purchasing a Review your retirement savings and your budget to assess
coverage medical coverage separate drug plan. what you can afford to pay out of pocket … or lose if you’re
all in one plan. hit with unexpected expenses.

Extra I’m looking for a plan It’s more important Your doctors and hospitals
benefits that includes things that my general
like dental, vision and medical costs are Find out if they accept Medicare and the plans you’re
hearing coverage. covered. considering, and if you’ll need to pick a primary care
physician within your plan.
Taking I don’t travel often, and I travel frequently or
your probably don’t need to have a second home, If you’re working past age 65
coverage use my plan away from and want to be covered
with you my home state. when I’m on the go. If you have an existing health plan you may want to keep it
9 until you retire, so ask your benefits administrator how it
works with Medicare.

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When you can enroll in a new plan Follow these simple do’s and don’ts
about timing
Timing is important when it comes to enrolling or changing your plan,
but it’s easy to be prepared if you keep a few things in mind. It’s important to get your Medicare coverage in place at the right
time because otherwise you could miss out on benefits … or pay a
Turning 65? New to Medicare? late enrollment penalty. Here’s how to stay on top of the situation.

You can enroll in Original Medicare anytime from three months Do
before to three months after your 65th birthday. This is called your
Initial Enrollment Period (IEP). DO enroll in Medicare Part B when you become eligible
Sign up during your Initial Enrollment Period (IEP) or as soon
- 3 months before - - 3 months after - as you retire and lose coverage through your employer. Then
you can avoid the late penalty, which is a 10% increase in your
Annual Enrollment Period: October 15 – December 7 monthly premium for every year you delayed getting Part B.

Anyone who’s eligible for Medicare can choose a new Medicare DO enroll in optional Medicare Part D, too
Advantage plan or Prescription Drug Plan during the Annual You’re not required to get prescription drug coverage, but as
Enrollment Period (AEP). This is a great time to review your current with Part B there’s a penalty if you don’t enroll when you first
coverage — and switch or add plans if your needs have changed. become eligible. So even if you don’t need it now, think about
your future needs — and sign up promptly if you want to avoid a
Special Enrollment Periods permanent penalty.

You may also enroll in a new plan or change your plan anytime Don’tDON’T miss out on Medicare Supplement coverage
outside the AEP if you are:
If you leave a Medicare Supplement plan but want to switch back
Losing your coverage or retiring more than a year later, your new premium might be higher. And
Moving out of your plan’s area in some states if you have a pre-existing condition, you might not
On Medicare and Medicaid be allowed to re-enroll. So check your state’s rules before giving
Have certain chronic conditions up your Medicare Supplement plan’s guaranteed coverage.

Enroll in Medicare Supplement anytime 12

To help you cover the expenses Original Medicare doesn’t, you can
enroll in a Medicare Supplement plan year round — without waiting
for the next AEP.

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Take the next steps FAQs

Once you understand the Medicare plan types and when to enroll, Will Medicare cover all my medical expenses?
you’re ready to review specific plans and find the best fit for you. No. Original Medicare covers some basic medical expenses,
It might help to keep these things in mind: but not all. To help you fill the gaps in coverage, you can choose
among a range of plans from private insurance companies.
Cost
Will Medicare cover my prescription drugs?
Many people look for the lowest premiums, but you Original Medicare (Parts A and B) does not cover prescription
should also evaluate deductibles, coinsurance and drugs. However, private insurance companies help cover the costs
copayments — and how they can add up each year. of generic and brand name drugs through prescription drug plans
If you choose a Medicare Advantage plan, its annual (Part D) and some Medicare Advantage plans (Part C).
out-of-pocket maximum can help limit your expenses.
Can I keep my doctor when I’m on Medicare?
Coverage With a Medicare Supplement plan, you can use any doctor who
accepts Medicare. With a Medicare Advantage plan, you can use
Look at exactly what each plan includes, particularly if any doctor who accepts Medicare and is in your plan’s network.
you’re interested in getting extra benefits like dental,
vision and hearing. Also find out if the doctors, specialists Can any insurance company offer additional Medicare coverage?
and hospitals you like are part of the plan’s network, and No, an insurance company must be approved by the federal
whether you need to pay more for out-of-network care. government to administer Medicare benefits.

Confidence How soon can I enroll in Medicare?
You are eligible to enroll in Medicare beginning three months
If you’re considering a plan from a private company, before your 65th birthday.
check out their reputation. Look for a trusted company
with a solid history of providing health coverage solutions, When will my coverage start?
knowledgeable Medicare experts who can give you If you enroll as soon as you’re eligible, your coverage will begin
personal guidance, and a strong network of doctors, as early as the first day of your birthday month.
hospitals and pharmacies.
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Key Medicare terms Take advantage of covered services

Coinsurance Many preventive services are covered by Medicare to help guard
against disease and detect it earlier — at little or no cost to you. If
An insured person’s percentage of the cost of health you’re eligible, Medicare covers 100% of its approved amount for your:
care services after the deductible has been paid.
One-time “Welcome to Diabetes screening
Copayment or copay Medicare” visit
EKG heart screening
The amount a member pays for each doctor Annual Wellness visit
visit or prescription; usually the same set Hepatitis C screening
dollar amount per service or visit. Abdominal aortic aneurysm
screening HIV screening
Deductible
Alcohol misuse screening Laboratory services
The amount of expenses a member may have
to pay out of pocket for the calendar year before Bone mass measurement Lung cancer screening
the plan begins to pay benefits.
Breast cancer screening/ Medical nutrition therapy
Drug list or formulary mammogram
Obesity screening and
A specific Medicare Part D plan’s list of covered drugs, Cervical and vaginal counseling
often organized by levels of cost sharing called tiers. cancer screening
Shots for Flu, Hepatitis B
Network Depression screening and Pneumonia

A health plan’s group of doctors, hospitals, pharmacies 16
and others who provide services for plan members.

Out-of-pocket maximum

The annual total you could pay for expenses
covered by your plan; a sum of the deductible,
coinsurance and/or copayment amounts.

Premium

The amount you may pay to maintain your health and/or
prescription drug coverage, usually on a monthly basis.

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Get ready for your doctor visits Helpful hints for taking medications

Your Medicare benefits include a “Welcome to You know it’s best to take your prescriptions
Medicare” visit the first year you join, plus an in the right amount at the right time, but
annual Wellness visit every 12 months. Whether sometimes life gets in the way. Here are
you’re seeing a doctor for one of these regular some hints to help you stay on track:
visits or for a specific medical concern, you
should be prepared to discuss:

Your medical history and any What tests, screenings and Store your medications in the Post a note on your calendar
recent health changes vaccinations you should same place every day, where and after you’ve taken your
schedule for someone of your they’re easily accessible medications for the day, move
Which medications you take, age, gender and condition the note to the next day
including prescriptions, over- Once a day or once a week,
the-counter drugs, and herbal Any major life events you’ve depending on how many Ask your pharmacy if they
and dietary supplements experienced recently or drugs you take, put your have an automatic refill
anticipate happening soon medications into a pill box or program and if you can
Whether you’re experiencing organizer that lets you check get a 90-day supply of your
any side effects from your How your daily routine if you’ve taken them medications
medications may be changing including
diet, exercise and social Set an reminder alert on Take advantage of mail
interactions your phone, computer or order pharmacy services to
alarm clock get home delivery of your
maintenance medications
and refills

Questions? Just give us a call 18

1-8XX-XXX-XXXX (TTY: 711)

8 a.m. to 8 p.m., Monday – Friday. Or visit anthem.com/1on1

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Keep these websites and We’re here to help
phone numbers handy
Whether you’re new to Medicare or you already have a plan in
We’re always here for you when you have questions about place, getting the health benefits you need shouldn’t be
your Medicare options. And there are several other resources complicated. And we’ll make sure it isn’t.
available to help you, too.
Just give us a call
To sign up for Original Medicare (Parts A & B), contact the
Social Security Administration: 1-8XX-XXX-XXXX (TTY: 711)

ssa.gov/medicare 8 a.m. to 8 p.m., Monday – Friday
1-800-772-1213 (TTY: 1-800-325-0778)
or visit anthem.com/1on1
For information about Medicare from the federal government:
Schedule your free 1-on-1 consultation with one of our
medicare.gov licensed Medicare experts today. We can review your options
1-800-MEDICARE (1-800-633-4227) right over the phone, or come to you for an in-person meeting
(TTY: 1-877-486-2048) at your home or anywhere that’s comfortable for you.

To find contact information for your state’s State Health Insurance Remember, Original Medicare was never meant to
Assistance Programs (SHIPs): cover all your medical expenses. You deserve the
additional benefits and peace of mind available from a
medicare.gov/Contacts/#resources/ships private insurance company like us. We’ve helped Americans
choose the right Medicare coverage for generations — and
For help understanding your rights and benefits, contact the we’re here for you, too.
Medicare Rights Center:
Anthem Blue Cross has been providing health benefits
medicareinteractive.org since before Medicare began. Our experts are here to
1-800-333-4114 help you make sense of your options and get the benefits
you’ve earned.
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