7 common Medicare questions answered by UnitedHealthcare Medicare Plan Experts

Published by Medicare Made Clear®

Agent talking with couple at table

Medicare can seem intimidating if you’re looking to enroll for the first time or considering making changes to an existing plan. While it may feel like you’re the only person researching and reviewing plan options, that’s likely never the case. Over 63 million people were enrolled in Medicare as of October 2021 and more than 4.3 million people were enrolling for the first time that year.1 That may make you wonder, how did millions of people find a plan that fits their needs? 

While there are an abundance of tools and resources at your disposal, we asked UnitedHealthcare Medicare Plan Experts firsthand to address the most common concerns around Medicare enrollment. 

How do I know what questions to ask about Medicare?

Some consumers are so confused by Medicare that they don’t even know what questions to ask when they chat with an agent. Fortunately, UnitedHealthcare Medicare Plan Experts are equipped to help guide you through the process and help give you confidence in making a decision. 

Our Medicare Plan Experts can get the conversation started by asking you some basic questions. Your answers will then lead them to more specific queries, which will ultimately help you find the right plan for your healthcare needs, lifestyle and budget. 

How can I learn what all the Medicare acronyms mean?

It’s not uncommon to feel confused by the Medicare jargon, and it’s difficult to make decisions when you don’t know what the acronyms stand for. There are resources available to help you better understand Medicare acronyms and terminology, but here are a few you should be familiar with when it comes to Medicare enrollment.

What are the acronyms for the different Medicare enrollment periods?

Acronyms for the different Medicare enrollment periods
Acronym Enrollment Period Definition
IEP Initial Enrollment Period The seven-month window when someone turning 65 is eligible to enroll in Medicare for the first time.
SEP Special Enrollment Period A specific timeframe when people in special circumstances can enroll in Medicare.
GEP General Enrollment Period A three-month Medicare enrollment window for those who missed their Initial Enrollment Period. It runs from January 1 to March 31. Keep in mind, late penalties may apply to those who miss their IEP.
AEP Annual Enrollment Period The time each year when you can change your Medicare coverage choices. It runs from October 15 to December 7.

Can I get the same plan as my friend, family member or spouse?

Everyone takes care of their health in different ways. Some people see their primary care provider once or twice a year and others may need more care and need to see several specialists regularly. Medications and any provider preferences you have may impact your plan options as well. It may seem like the path of least resistance would be to select the same coverage as a friend, family member or spouse; however, there are reasons why Medicare is individual insurance. You likely won’t have the same healthcare or financial needs as someone close to you, and because of that, you likely wouldn’t use your insurance in the same way. Selecting a plan that fits your unique needs is important and will likely be to your benefit. A UnitedHealthcare Medicare Plan Expert can help make the selection process easier for you. 

How can some Medicare Advantage plans have $0 premiums?

Some consumers see Medicare Advantage (Part C) plans that have $0 premiums and question how that could be possible.  Before enrolling, it’s important to understand Medicare Advantage plans and how they may work for you.

Although you may not have to pay a premium to the insurance company, you must still pay your Medicare Part B premium (and your Part A premium if you don’t qualify for premium-free Part A). You must keep both Medicare Parts A & B to qualify for Medicare Advantage.

It’s also worth noting that Medicare Advantage plans with a $0 premium will still cover all services that Original Medicare (Parts A & B) covers. These plans may also Include Prescription Drug Coverage and ancillary benefits such as Vision, Dental or Fitness options.

Can out-of-pocket costs vary across Medicare plans?

Depending on the plan you choose, you may be responsible for two types of out-of-pocket costs, copays and coinsurance. A copay is a set amount, such as $10 for a visit to the doctor, for example. Coinsurance is a percentage amount, such as 20% of the billed service for an inpatient hospital stay.

If you’re on Original Medicare (Parts A & B), you’ll pay 20% coinsurance based on the Medicare-approved amount. This includes things such as inpatient care and durable medical equipment (think wheelchairs and CPAP machines). Many Medicare Advantage plans also have a 20% coinsurance payment. So, what’s the difference?  

The difference is that the 20% a Medicare Advantage plan charges is based on a discounted amount negotiated with providers, not the Medicare-approved amount, so your cost may be less.

How much should I focus on added Medicare benefits?

Our Medicare Plan Experts sometimes hear consumers prioritizing added benefits such as travel coverage, nonemergency transportation and fitness programs. Those benefits are great — but are they essential in your situation?

Take travel coverage, for example. Most people aren’t going to make a doctor’s appointment while they’re on vacation. So, is that really a need? Or is it a want? (Don’t worry. You’re covered for urgent and emergency care while you’re traveling in the U.S.)

As another example, an individual may use a fitness program to help control diabetes. For that individual, a plan that includes her preferred fitness program may be a need, not a want.

These seem like little details, but it’s smart to think about what’s important to you before making decisions on a plan.

Do I have to change plans every year or can I just stay with the same one?

Lots of consumers think they can just ignore the fall Medicare Annual Enrollment Period (AEP) if they’re sticking with their current health plan. But should you? Not necessarily.

For one thing, your needs may have changed since a year ago. Perhaps you’re seeing a new specialist who’s not in network. Or perhaps you want to add vision and dental to your plan. Or maybe your current insurer is leaving the local market.

The benefits that your current plan offers may have also changed. That’s why it’s important to review the plan’s Annual Notice of Change (ANOC) that your insurer sends you each fall. It details changes in plan coverage, costs, or service areas.

Unsure of whether you should switch? That’s where our Medicare Plan Experts come in. Just call and tell them what’s going on — explain what you think your upcoming healthcare needs might be. They will help you find a plan that suits your lifestyle and your budget. 

About Medicare Made Clear

Medicare Made Clear brought to you by UnitedHealthcare provides Medicare education so you can make informed decisions about your health and Medicare coverage.

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