How UCare De-complicates Medicare

By Cheryl Swenson, Published November 27, 2021

Medicare is a different kind of health coverage, and to many people it can seem complicated. It’s a matter of finding the right solutions, instead of choosing between the few options an employer might offer At UCare, we help de-complicate Medicare by focusing on what you need first and how to work through your decision process.

When I started selling Medicare in the late 80s, there was more limited care and coverage, and answers were not easy to find.

Medicare has changed over the years, as has insurance education. But it’s still new for people aging-in to Medicare or someone looking to switch to a plan that fits them better. That’s where my team of Medicare de-complicators and I come in.

Here’s a review of important things to know. But my most important tip: if you have questions, don’t be afraid to ask!

Medicare has changed over the years, and today consists of four main “parts”:

• Medicare Part A: For hospital coverage
• Medicare Part B: For medical coverage
• Medicare Part D: For outpatient prescription drug coverage

You can expect Medicare Part A and Part B — commonly referred to as “Original Medicare” — to cover roughly 50% of the cost of services. It is often described as covering 80%, but that is only for covered services and after a deductible is met, plus there are many services not covered by Medicare. The beneficiaries cover the balance.

But what about Part C? Think of Part C (also known as a Medicare Advantage plan) as a package. It combines Part A with Part B, then may add special benefits that Medicare does not cover, such as vision and dental care. Many packages even include Part D coverage. You get all your health benefits in one package while managing your out-of-pocket costs.

Medicare limits when and how often you can change your Medicare Advantage plan to specific "election periods", when you can enroll in or leave a plan. Talk to an expert to learn the rules around how and when to start the process.

For some, Original Medicare plus Part D may be what they need. But enrolling in a Medicare Advantage plan really can make coverage better for many people. Here’s how:

• Medicare Advantage plans cover many gaps — extra coverage may include routine physicals, dental and vision, over-thecounter products and fitness benefits.
• Get all-in-one convenience with all your health benefits in one package.
• There are many options for every lifestyle and every wallet. Based on your needs, you will find the right option.
• It compares more favorably to private coverage today than ever before. In recent years, employer-offered plans have become more expensive or added large deductibles. So now, once eligible for Medicare, many people are comparing the cost of enrolling in Medicare Part B and adding a Medicare Advantage plan versus staying on the employer plan.

Not all Medicare Advantage plans are created equal. From my experience, here are some things to keep in mind when comparing plans:

• Make a list of benefits you use to meet your health needs. Then, compare plans to determine which will help cover your health needs best.
• Look up doctors and specialists you use. The good news: Most UCare plans include 96% of providers in network.
• Look up prescriptions you use in the formulary (drug list) for plans you consider. The covered drugs, deductibles and copays may differ by plan.
• Look for “cost per day” vs. “cost per stay” coverage. It makes a huge difference in hospital stays.
• Make sure you understand caps on costs. Some plans have caps on specific services, such as diagnostic tests, while others do not. Those caps can save you a lot.

Seem overwhelming? That’s normal. I’ve had callers express frustration that they don't know more. They say, “I was successful in work and life, why is this hard to me?" Simply put — it’s new.

So don’t tackle Medicare alone. We’re here to help, for UCare members and non-members alike, so don’t hesitate to call!

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