Q. Should I buy some kind of Medigap or supplemental coverage? 

Yes, if you can afford it. Medicare has many gaps and out-of-pocket costs. If your income is low to modest, you may be eligible for a “Medicare Savings Program.”

Q. I have health problems. Will I be able to buy any of the plans listed?

If you buy your supplemental coverage during the first six months of being enrolled in Medicare Part B, or retiring from active employer health coverage, you can generally pick any of the options.

Q. What happens if I miss the 6-month enrollment period?

The Medicare Basic, Extended Basic, H, I, or J, or the Medicare Select plans are allowed to health screen and deny enrollment.  The Medicare Cost and Advantage plans cannot health screen and must accept you, except if you have end-stage renal disease.

In most cases, the six-month window is a once-in-a-lifetime chance. There are exceptions. For example, disabled people under age 65 who enroll in Medicare Part B. At 65, they get another open enrollment. Also people who are still working and covered by an employer or union plan can use a Special Enrollment period. And people over 65 who start work again and are covered at work can dis-enroll from Part B, then re-enroll later.

Q. Can I switch Medicare health plans if I’m not happy with mine?

Yes, as long as the plan you want to join accepts new members. Some will health screen applicants and most have specific open enrollment periods. If you are new to the Advantage program, you can switch  within the first 12 months of enrolling outside of the open enrollment period.

Q. Does Medicare cover nursing homes?

Neither Medicare nor Medicare supplement plans pay for custodial nursing home care. There is some skilled care provided if patients have been hospitalized for at least three days in a Medicare-approved facility, not including the discharge date, and go right into the nursing home. No benefits are paid after 100 days under Medicare Part A.

Q. Is there a way I can compare all of these plans (including Part D) on the web?

Yes. See www.medicare.gov or call the Senior Federation’s Health Plan Information Center, 651/783-5045 or toll-free 866/783-5045. The Federation does not sell or endorse any plans.

Q. How can I get Medicare coverage and Part D coverage when traveling out of state or out of the country?

Carefully select a plan by looking at “Travel Benefits” in their listings. Some supplemental plans cover emergency care only. Medicare itself has no coverage outside the U.S.

This article and the one below were excerpted from the 2008 Health Care Choices publication of the Minnesota Senior Federation. It and the 2008 Caregiving Choices are available free to Senior Federation members and for a small fee each for non-members to cover shipping and handling. To receive your copy, call 651/645-0261 or toll free, 877/645-0261.