My Medicare Enrollment Journey – What You Can Learn | Aetna Medicare (2024)

My Medicare Enrollment Journey – What You Can Learn | Aetna Medicare (1)

Becky and Bob Chiocca are doing retirement their way. And getting the most out of their Medicare Advantage plan.

"Our Aetna® Medicare plan has great coverage in our area. It has a fitness plan. And you don't have to worry as much about your finances because of its reasonable copays," Bob, 78, says. "It gives you such a level of comfort."

The Chioccas are thrilled with their Medicare plan today. But they admit that their journey to finding the right coverage wasn't a straight path. They're sharing their story in hopes that others learn from their challenges. Their main advice to people approaching retirement age: Start researching early to find Medicare plans that are right for you. And reach out to others, such as licensed brokers, for help.

"If you're just starting to look at Medicare, it can be overwhelming," Becky, 76, says.

My Medicare Enrollment Journey – What You Can Learn | Aetna Medicare (2)

Bob, who is a couple of years older than Becky, was the first to become eligible for Medicare. But early on, Becky took charge of researching her husband's Medicare coverage options. Becky started exploring plans early, when Bob was still 64 and months away from enrollment. "She became an absolute wizard when it comes to looking at Medicare Advantage plans," Bob says.

But for Becky, it wasn't exactly a magical experience. There were, after all, so many more choices to consider, a sharp contrast to the plan options often offered by employers. "When you're with a company, there might be two or three plans and that's it. It's a no-brainer," she says. "When you're on your own, it's a different story."

Sorting through Medicare plans

Becky looked up various insurance companies online and asked that information for eight or nine plans be mailed to her home. But she wasn't prepared for how big the mailings would be. "I just remember piles of paper everywhere," she says. "I had stuff all over the living room, then the dining room and then the kitchen."

Becky said that if she could do it all again, she would concentrate much of her attention on the one-sheet summaries most plans provide. "What I like about the single sheet is that they take very confusing information and summarize it. So the important benefits are easy to see and compare with other plans," she explains.

Switching Medicare plans

Becky and Bob ultimately narrowed Bob's choices to the two best-known Medicare plans in their area. Of the two, they selected the plan with the lower monthly plan premium. After Becky became Medicare eligible, she joined the same plan.

But that wasn't the end of their Medicare journey. Costs in the plan rose. And they realized the plan's provider network didn't include the exact doctors they would have liked. So they began shopping around for another plan. They switched to a different plan, but soon encountered the same obstacles.

It was a broker who recommended they check out the Advantra Silver HMO plan, one of the Medicare Advantage plans available in their area. He explained that while costs were lower, the benefits the plan offered were comparable. Becky and Bob were delighted to discover the breadth of the plan's network, with providers available across three states. "We did so well with the new plan because we know we are covered with excellent doctors," Becky says.

Help from a representative

Becky and Bob chose their new Medicare plan after working with an independent insurance agent. But they still wanted to be as informed as possible. They learned through an advertisement in their local newspaper that an Aetna representative would be holding an informational meeting in their area.

The meeting, they say, exceeded their expectations. Jim, the representative who hosted the event, "takes time and explains things," Becky says. "He takes it step-by-step and takes questions, any questions at all. He'll explain what's involved, what plans you can get, how much it costs, what your coverage is."

My Medicare Enrollment Journey – What You Can Learn | Aetna Medicare (4)

At the meeting, attendees could peruse materials that often aren't mailed home. Becky remembers that she and others were especially interested in booklets outlining drug coverage and in-network medical providers. "You can make sure that your doctors are covered, because those of us with Medicare want to see it in writing," Becky says.

Becky and Bob also connected with others at the meeting. "We talked to other people about the plan and how much we all liked it," Becky says. Though Becky and Bob had already enrolled in the Medicare plan of their choice, others at the meeting had not. But with the representative's help, those people were able to enroll in about 10 minutes.

If meetings aren't offered in your area, representatives can also call you directly. Learn more here.

Finding more positives about their Medicare plan

The very first time they switched plans, the couple focused on the money they saved. But when Bob was diagnosed with prostate cancer, they realized how important it is to have a strong network of physicians and other providers at their disposal. Testing related to Bob's condition was performed at the renowned Cleveland Clinic in Cleveland, Ohio.

"There's an abundance of excellent doctors and hospitals there," Bob says. "It's a high level of care, and it's wonderful."

They're also big fans of the SilverSneakers® program. It allows members to gain membership to thousands of gyms and fitness clubs across the country at no added cost. The program is included as part of their Medicare Advantage plan. Exercising regularly at their local gym gives them the energy they need to maintain their busy lives.

In fact, the couple says their active lifestyles and the health care they receive through Aetna are what's helped them stay healthy all these years. "We've had a wonderful life, and that's why health is so important to us," Bob says. "We want to keep this great life going as long as we can."

About the author

Alice Gomstyn is a veteran parenting blogger and business reporter. She is an admitted sugar addict but plans to cut back on the sweet stuff and load up on veggies like never before. Bring on the broccoli!

My Medicare Enrollment Journey – What You Can Learn | Aetna Medicare (2024)

FAQs

How do I get answers to Medicare? ›

Live chat with us, and find local organizations that can help answer your Medicare questions. You can also: Call us at 1-800-MEDICARE (1-800-633-4227). Help from Medicare is available 24 hours a day, 7 days a week, except some federal holidays.

What is the easiest way to explain Medicare? ›

Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources.

What is important to know about Medicare? ›

Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig's disease).

What are the three enrollment periods for Medicare Advantage? ›

The three Medicare enrollment periods — initial, special and general — are specific time frames when you can enroll in Medicare based on certain circumstances, such as choosing to delay enrollment if you continue working past age 65. As such, you may qualify for more than one at different times in your life.

What questions are asked in a Medicare exam? ›

At your Medicare annual wellness visit, your health care provider will: Review your blood pressure, heart rate, height, weight and body mass index (BMI). Review your current health problems, as well as your medical, surgical, family and social histories. Review your current medications.

How do you qualify for $144 back from Medicare? ›

To qualify for the giveback, you must:
  1. Be enrolled in Medicare Parts A and B.
  2. Pay your own premiums (if a state or local program is covering your premiums, you're not eligible).
  3. Live in a service area of a plan that offers a Part B giveback.

What are the 4 basic parts of Medicare? ›

There are four parts of Medicare: Part A, Part B, Part C, and Part D.
  • Part A provides inpatient/hospital coverage.
  • Part B provides outpatient/medical coverage.
  • Part C offers an alternate way to receive your Medicare benefits (see below for more information).
  • Part D provides prescription drug coverage.

What are the three requirements for Medicare? ›

Medicare Part B (Medical Insurance)
  • Be age 65 or older;
  • Be a U.S. resident; AND.
  • Be either a U.S. citizen, OR.
  • Be an alien who has been lawfully admitted for permanent residence and has been residing in the United States for 5 continuous years prior to the month of filing an application for Medicare.
Sep 6, 2023

How much do I have to pay for Medicare when I turn 65? ›

If you don't get premium-free Part A, you pay up to $505 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($174.70 in 2024).

What is the biggest problem with Medicare? ›

The biggest challenges reported by those in Traditional Medicare and Medicare Advantage: Out-of-pocket medical costs and health services they needed but weren't covered. “The gaps in Medicare coverage can really be notable,” says Jacobson.

What happens if you don't enroll in Medicare Part A at 65? ›

Part A late enrollment penalty

If you have to buy Part A, and you don't buy it when you're first eligible for Medicare, your monthly premium may go up 10%. You'll have to pay the penalty for twice the number of years you didn't sign up.

What is the best resource to learn about Medicare? ›

Centers for Medicare & Medicaid Services (CMS) provides information about Medicare coverage, Medicare health plans, Medicare quality initiatives and free publications. The Medicare Helpline: 1-800-MEDICARE (1-800-633-4227) TTY: 1-877-486-2048. Find your state Medical Assistance Office.

Why are people leaving Medicare Advantage plans? ›

Most individuals that dislike a Medicare Advantage plan usually have had a bad experience with in-network providers, plan authorizations for medical care, or having to wait a long time to have an appointment scheduled. Some of these concerns can be attributed to the healthcare provider.

Can I drop my Medicare Advantage plan and go back to original Medicare? ›

You can drop your Medicare Advantage Plan and return to Original Medicare. You'll also be able to join a separate Medicare drug plan. During the Medicare Advantage Open Enrollment Period, if you have Original Medicare you can't: Switch to a Medicare Advantage Plan.

Why do people say not to get a Medicare Advantage plan? ›

Restrictive networks

In some cases, you'll have a higher share of costs when you see an out-of-network doctor. In other cases, you're not covered at all if you go out of network. This is particularly important if you travel a lot because Medicare Advantage plans generally don't provide out-of-state coverage.

Can a Social Security office answer Medicare questions? ›

Although the Centers for Medicare & Medicaid Services (CMS) is the agency in charge of the Medicare program, Social Security processes your application for Original Medicare (Part A and Part B). We provide general information about the Medicare program and can help you get a replacement Medicare card.

Can AARP help with Medicare questions? ›

AARP's Medicare Question and Answer Tool offers practical and comprehensive information to help you navigate the program according to your own situation.

How do I get through to Medicare? ›

How to access
  1. Call 132 011.
  2. Visit the Medicare website.
  3. Email Medicare.
  4. Download the Express Plus app.

What are the 6 things Medicare doesn't cover? ›

Some of the items and services Medicare doesn't cover include:
  • Long-term care (also called. custodial care. Custodial care. ...
  • Most dental care.
  • Eye exams (for prescription glasses)
  • Dentures.
  • Most cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

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