Medicare Open Enrollment

Medicare Open Enrollment runs from October 15, 2021 – December 7, 2021 and allows patients to select their healthcare insurance provider. Patients who are turning 65 in 2021 OR who have a disability may be eligible for Medicare Coverage. SWOFM in-network insurance providers can help. You don’t have to be a member to speak with an insurance broker, and they can help you navigate your choices during Medicare Open Enrollment. You can also visit the WellMed website.

For enrollment information or to speak with an in-network insurance provider, please contact:

Jennifer Piriz (English & Spanish) | 813-302-5844 | jpiriz@wellmed.net

Download Jennifer Piriz’s contact information

To learn more about Medicare, please continue reading for information on Medicare Enrollment, the different parts of Medicare, the differences between HMO and PPO plans, and how to select Southwest Orlando Family Medicine as your Primary Care Provider.

Medicare Enrollment

For first-time patients enrolling in Medicare, here are a few important things to keep in mind:

Most patients are eligible for Medicare once they reach age 65, or if they are on Social Security disability.
Enrollment for Medicare only occurs during certain times of the year called Open Enrollment or Special Enrollment.
Signing up for Medicare Part B when you first become eligible will help you avoid paying a penalty.
You can choose your Medicare coverage.
You may be able to get assistance with your Medicare costs.

What are the different parts of Medicare?

Medicare Part A: Hospital Insurance

Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B: Medical Insurance

Medicare Part B covers certain doctor services, outpatient care, medical supplies, and preventive services.

Medicare Part C: Medicare Advantage

Medicare Part C, often referred to as “Medicare Advantage,” refers to an “all in one” approach to healthcare. Medicare Advantage plans generally include Parts A, B, and D, as well as additional benefits, like hearing, vision, dental, and more.

Medicare Part D: Prescription Drug Coverage

Medicare Part D helps to cover the cost of prescription drugs, including many recommended shots and vaccines.

HMO vs PPO: Which plan is better?

No plan is necessarily better than another. There are different types of insurance plans to meet different needs for each individual. Some plans have more restrictions than others to encourage you to receive care from a preferred network of doctors, hospitals, pharmacies, and other medical service providers. The difference between HMO and PPO has to do with access to your insurance provider’s network.

With an HMO plan, your Primary Care Provider will refer you to specialists and other services that are within your insurance network. Although you may have less options, there are still many choices within an HMO plan. You may also have additional plan benefits for choosing an HMO.

If you prefer to choose your own specialists, a PPO plan may be the best option. A PPO plan will give you more choices for your specialists but may not have as many additional plan benefits as an HMO. Understanding the different plans available and speaking with an insurance broker can help you decide which plan best fits your needs.

Plan Type	Providers and Specialists	Summary
Health Maintenance Organization (HMO)	Limited network, no out-of-network benefits. Generally, services must be referred by a Primary Care Provider.	Member gives up flexibility in provider choice to accept greater management of their care.
Preferred Provider Organization (PPO)	Any health care provider, but benefits are reduced for out-of-network services.	Member has the most flexibility with both in and out-of-network providers.

Selecting SWOFM as your Primary Care Provider on MyMedicare.gov

MyMedicare.gov allows you to access your healthcare information and check your medical claims, view information about your deductible, create a list of your favorite health care providers, and choose your Primary Care Provider. Your PCP can be a Doctor, Physician Assistant, or Nurse Practitioner. Your Primary Care Provider is the practitioner that is responsible for coordinating your overall care.

With Southwest Orlando Family Medicine as your PCP, we will help you monitor and manage your healthcare decisions. Please watch this helpful video overview for Medicare users on how to select and/or change your primary care provider in MyMedicare.gov. Thank you for entrusting us with your healthcare.

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