Open enrollment, which begins November 1, 2021 and ends December 15, 2021 for coverage that begins on January 1, 2022, is your opportunity to get better health care.
January 15, 2022 is the last day to enroll or change plans for the 2022 coverage. After this date you can only change or enroll if you qualify under the special enrollment period.
Prosthetics and Orthotics are covered under Medicare Part B.
We recommend a Medicare plan with supplemental coverage for co-pays and deductibles.
IMPORTANT: Think about your total cost, not just the bill/premium you pay to your insurance company every month.
1. Out-of-pocket: These costs can be more than the monthly premium.
2. Deductible or spend down: How much you have to spend for covered medical services before your insurance company pays (does not include free preventive services).
3. Copayments and coinsurance: Payments made for each medical service after you reach your deductible. Coinsurance typically begins after you’ve met your deductible, so you’ll want to understand how much your deductible is as well. You’ll pay your medical bills in full (at the negotiated discounted rate that your insurer has with your medical provider) until you’ve met your deductible. Then you’ll start to pay coinsurance.
4. Out-of-pocket maximum: The most you will spend for covered services in a year. After this amount is reached, the insurance company pays 100% for covered services less copayments.
Some plans offer no monthly payment but have very high deductibles and copays. Estimating your 2022 medical costs is difficult. If you don’t anticipate any insurance costs, a no cost monthly plan with high deductibles and copays might be best for you. However, if you do anticipate using your insurance under Part B for a prosthetic limb or brace, you may want to consider paying a little bit per month for your plan to reduce your out-of-pocket expenses with deductibles and copays.
Example:
Cost of a basic below-knee prosthesis – $3,600
You are paying a low premium of $148 per month for your current insurance plan
Your insurance plan has a $5,200 out-of-pocket expense and a 15% copay
You would have to spend $5,200 before your insurance plan would cover ANY medical expenses. The $5,200 spend down is used for ALL of your medical needs.
After you have paid the $5,200, the 15% copay would be $540.
Helpful websites:
https://www.healthcare.gov – for new coverage or to change/update your current plan. Healthcare.gov has a page where you can get prices and information on 2022 health plans before you log in and register.
Area Agency on Aging: Detroit – https://www.detroitseniorsolution.org or 313-446-4444. Southfield: Area Agency on Aging 1B – https://www.aaa1b.org or 800-852-7795
Senior Care Network – your trusted guide for all senior resources in Michigan https://miseniorcare.com
Dedicated Senior Medical Center – several locations in Detroit and surrounding areas offering coordinated benefits with monthly care: https://www.dedicated.care
