Mid-October, Oct.15 to be exact, marks the beginning of Medicare’s annual open enrollment period, which lasts until Dec. 7. During this period many New Orleanians who are 65 and older or otherwise have qualifying disabilities will elect to enroll in a “Medicare Advantage Plan” or Medicare Part C. Those who are eligible for Medicare Part A, which covers hospital care and some forms of nursing, and Part B, which covers medically necessary and preventative care, can elect Medicare Part C as a different way of receiving original Medicare benefits. As Louisiana Insurance Commissioner Jim Donelon* explains, “Some seniors may find value in having Medicare Part C, or Medicare Advantage.” Donelon* adds, “These plans are sold by agents representing private insurance companies and are similar to private insurance that self-employed individuals can purchase.” Through an HMO, PPO or PFFS (Private Fee for Service Plan), a Part C enrollee will receive benefits in a manner that mimics traditional insurance coverage, including, in some cases, prescription drug coverage through Medicare Part D. Donelon states, “Those who may want to consider Medicare Advantage are seniors who want to limit their out-of-pocket health spending or who are seeking more comprehensive coverage under a single insurer for doctor, hospital and drug coverage or other services not covered by original Medicare.”
Local plan providers, including Humana, have ramped up advertising efforts to attract Medicare recipients as customers. An important question these companies are raising and answering is why a recipient would elect Part C over original Medicare coverage. “Medicare Advantage plans, such as those offered by Humana, add value with extra benefits and services,” says Mitch Lubitz, media relations leader for the east region and retail segment of Humana. The plans may have no premium or a low premium, lower copays and lower or no deductibles. Lubitz gives examples; “Extra benefits on some plans include dental, vision, a nurse advice line and health and wellness programs – such as a gym membership – at no extra cost,” he says.
Persons eligible should carefully consider enrolling in a Medicare Part C plan. The Louisiana Department of Insurance website cautions, “You should not change to a new program until you have carefully analyzed it and determined how you would benefit from it.”
*CORRECTION: A previous version of this article attributed two quotes to Deputy Commissioner of Public Affairs for the Louisiana Department of Insurance Ileana Ledet instead of Louisiana Insurance Commissioner Jim Donelon. We apologize for the error.