UNITED STATES—Toni: I am retiring next May, and my wife and I are going to travel the US in our new Winnebago.

I am an insulin dependent diabetic and will need easy access to a pharmacy while traveling, plus if I have an emergency I do want access to decent medical care anywhere in the US.

Please give me your thoughts on what Medicare option will be good for our situation.…Thanks, Gerald from the Heights area.

Well, Gerald: Planning your Medicare is an important part of planning your retirement since one wrong move can cause you thousands of your hard-earned retirement dollars.

Many new to Medicare miss a special window of opportunity when they first enroll in Medicare Part B.  This unique time is called the Medigap/Medicare Supplement Open Enrollment period and lasts for 6 months beginning the first day of the month in which you are 65 or older and enrolled in Part B.

Gerald, if you enroll in this special 6-month window, being an insulin dependent diabetic will not affect you enrolling in a Medicare Supplement and an insurance company cannot use underwriting to issue your Medicare Supplement.

Touring the US may be another reason to choose a Medicare Supplement because there is not a network and if the healthcare provider or facility is accepting Medicare, then you can receive your care there.

Also, you will want to take time when picking your Medicare Part D plan because you will want access to a nationwide pharmacy that is not only in your area.

Another option for both healthcare and prescription drugs is a Medicare Advantage Prescription Drug plan (MAPD) which may or may not offer the flexibility of easy access to healthcare providers in various areas of the country due to that chosen plan’s specific MAPD referral process.

Below are a few of the differences between a Medicare Supplement and a Medicare Advantage Plan:

1) Medicare Supplement:

  1. A Medicare Supplement works directly with “Original Medicare”.
  2. You chose which doctor, hospital, home health agency, skilled nursing facility, etc. that accepts Medicare assignment for your healthcare.
  3. There is a monthly premium that may increase each year.
  4. You may enroll and will pay separately for a “Stand alone” Medicare                           Prescription drug (Part D) plan.

2)  Medicare Advantage Plan: 

1.To qualify for the MA plan:  a) You must be enrolled in both Medicare Parts A & B

b) Live in the service area 6 months out of a year or change when you are out of                            the area…

c) Not have end stage renal disease (kidney dialysis).

2. Verify with your doctors/hospitals to which MA plan’s network they accept

3. You must use your Medicare Advantage insurance card, not your Medicare card

4. A Medicare Advantage Plan must provide all your Part A and Part B benefits and            some Medicare Advantage Plans have Part D prescription drug plans included

5. With a Medicare Advantage plan, you may have different co pays, co-insurances or        deductibles to pay and have maximum out of pocket expenses to meet with low or             $0 monthly premiums.

Gerald if you still have questions regarding your specific Medicare needs for you and your wife call the Toni Says® office at 832-519-8664 or email info@tonisays.com. Visit www.abbs4u.com and attend ABBS (American Baby Boomer Society) Medicare courses for more Medicare specific issues.