December 7 marks the end of the Medicare Annual Enrollment Period (AEP), a time for those eligible for Medicare to make important decisions about their health care coverage options for 2022. For many, navigating AEP can be confusing. This can be especially true for those with specific health needs.
For some in this position, the hardest part can be getting started — especially if they feel they are doing it alone. With so much information around AEP publicly available, I wanted to share some information specific to select groups of older adults who we work with often.
If you or a loved one fall into any of the following categories, here’s what you need to know:
Low-income older adults
According to the National Council on Aging, over 15 million older adults aged 65+ are economically insecure. While many know this age group qualifies for Medicare, not everyone is aware that it is possible to qualify for Medicaid at the same time, based on income level plus some additional criteria. If you meet the separate eligibility requirements for both Medicare and Medicaid, you can join the approximately 12.2 million others who are considered dual eligible.
Many dual-eligible beneficiaries choose to enroll in a special type of Medicare Advantage plan (Part C) called a Dual Eligible Special Needs Plan (D-SNP), which is one of the most common types of duals plans offered. D-SNPs provide all the benefits of Original Medicare (Part A hospital insurance and Part B medical insurance), plus supplemental benefits that you don’t typically receive from Medicaid or Original Medicare. D-SNP members also have access to other extra benefits available through a Medicare Advantage plan, including Part D prescription drug coverage.
Another major advantage with this type of plan is that you receive the support of a dedicated care team to help you maximize your benefits. With an Aetna D-SNP, for example, a member’s care team includes a care coordinator, nurse case manager, social worker and a member advocate. These team members work together to develop care plans with doctors and coordinate visits with health care providers. They also help address barriers to care by setting up rides to and from medical appointments.
Older adults who are Veterans
While all older adults enrolling in a health plan should consider their specific needs, as a Veteran your needs might look different than those of other Medicare-eligible individuals. It’s important to think about what type of extra support you might need based on your experiences — e.g., services to help with injuries sustained from active duty, hearing loss, among others — and ensure that your plan will cover your needs.
It’s also important for Veterans to understand how a Medicare Advantage plan might complement their existing benefits. For example, many Veterans are offered prescription drug coverage through the Department of Veterans Affairs (VA) so a Medicare Advantage plan without drug coverage (MA-only) that provides extra benefits not offered through Original Medicare might be the right choice.
MA-only plans also offer additional benefits that are not part of standard VA coverage. For example, many Veterans are unable to receive dental care from the VA, but MA-only plans often provide dental benefits, which can include cleanings, X-rays and fillings. Additionally, MA-only plans may offer vision and hearing benefits and an allowance for over-the-counter items , as well as non-traditional benefits that can help you reach your health goals, such as gym memberships.
Older adults who feel like they’re all alone (but aren’t!)
Unfortunately, not everyone has a caregiver or loved one to help guide them through the Medicare Annual Enrollment Period process. However, that doesn’t mean you have to go it alone!
You can speak with a licensed insurance agent or a trusted local broker to learn more about the plans available in your area. If you’re looking for a more hands-on learning experience, many insurers also offer local in-person or online seminars to educate you about your plan options and answer any questions that are top of mind.
If you prefer to navigate your options on your own online, you can visit Medicare.gov and enter your zip code to see all the Medicare plans available in your area. Additionally, Star Ratings show how plans perform in specific categories and can help you compare the quality of plans.
While it can feel like a daunting task, with the right resources and knowledge, Medicare-eligible individuals of all backgrounds can feel prepared to make an informed choice on the right plan for their health needs. For more information, visit AetnaMedicare.com.
About Christopher Ciano
As President of Aetna Medicare and a former caregiver for his parents, Christopher Ciano brings a unique perspective to the Medicare conversation. He oversees operations and business strategy for Aetna’s robust portfolio of Medicare Advantage plans, Medicare prescription drug plans and Medicare Supplement plans. An advocate for the aging population, Christopher is passionate about simplifying health care and helping Aetna’s more than 9.9 million Medicare members nationwide achieve their best health.