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Every fall brings “open season” for more than hunting in Montana. The annual Medicare open enrollment period runs from October 15 to December 7 each year. During this period, people with Medicare can review features of Medicare plans offered in their area and make changes to their Medicare coverage, which go into effect on January 1 of the following year. If you’re anywhere close to age 65, you’ll probably notice lots of advertisements coming in the mail. We are all seeing a plethora of ads on TV, begging seniors to inquire about extra benefits and call about plans available in their area. Insurance sales agents are scheduling “seminars” around our communities.

Medicare comes in “parts.” Medicare Part A covers inpatient hospital care. Medicare Part B covers outpatient medical care, including physician services. Medicare Part D provides prescription drug coverage. Finally, Medicare Part C, or Medicare Advantage, bundles Parts A, B and D and is provided by a commercial insurance company rather than direct from the federal government.

Part C or Medicare Advantage has grown in popularity over the past two decades. The share of Medicare beneficiaries in MA plans has risen from 19% in 2007 to 50% in 2023. In a study by the Commonwealth Fund, the availability of extended benefits, like vision, dental, and hearing services was most often cited as the reason for choosing an MA plan.

If you are considering a Medicare Advantage insurance plan, it’s important to know that as opposed to traditional Medicare, which offers a standard benefit menu and design nationwide, regardless of where you live, MA plans will vary in their benefit structure from insurance company to insurance company and even within the same company based on where you live. Also, while most every provider accepts Traditional Medicare, MA plans tend to work with provider networks, and benefits can vary depending on whether your doctor is “in network” or “out of network.”

As you look at Medicare plans and options, it’s important to know whether your hospital and your doctor are in the insurance company’s network. Clark Fork Valley Hospital and our providers accept Traditional Medicare and all Medicare supplements that are marketed in Montana. In addition, CFVH is contracted with Blue Cross Blue Shield and Humana for Medicare Advantage, so we are IN their network. CFVH is “out of network” with United Healthcare MA which is also being sold in our county.

Who can help? Navigating Medicare on your own can be confusing. No one at CFVH can provide recommendations on what Medicare coverage option you should choose. However, there are lots of resources available to assist. A certified SHIP counselor is trained to offer free, impartial and personalized assistance to eligible individuals, their families and caregivers. In Sanders County this service is available through the Sanders County Council on Aging, 406-741-2383. Be cautious of an insurance sales person who may be biased in their desire to sell you a particular plan. However, a licensed Medicare adviser broker who meet’s the National Council on Aging’s Medicare Standards of Excellence has committed to meeting rigorous guidelines to ensure you make an educated and confident decision. Beware of those 800 numbers on the bottom of your TV screen. Happy hunting!