Comparing Medicare health plans can be complicated. Keep in mind these five things to make your plan choice easier. Let’s start with a quick introduction to Medicare.
What is Medicare?
Medicare is a health insurance plan for citizens of the United States over the age of 65 and with certain other health conditions. It includes many (but not all) of the costs of healthcare for these populations.
If you’re eligible for Medicare and looking for a plan, we can help you connect with plans for Medicare Advantage, Medicare Supplement Insurance, and Medicare Prescription Drugs.
If you’re within three months of turning 65, you can apply for Medicare.
There are four Medicare options: Parts A, B, C, and D. Part C is also known as Medicare Advantage. Each part covers different things and comes with different costs. For example, original Medicare (Part A and B) doesn’t cover all of your health care expenses, so most retirees will have to enroll in additional coverages in the form of a Medicare Supplement policy or Medicare Benefit plan.
Purpose of Medicare
Medicare aims to provide health coverage for the following:
Older adults, 65 and older: This is a usual retirement age when health coverage by an employer ends. Medicare offers health coverage at a time of life when prescription and health care costs often rise.
People with some disabilities or end-stage renal disease: The goal is to provide health coverage to people who can’t work due to some disability or kidney failure and cannot obtain health coverage through any of their employers. Medicare ensures affordable access to services and care that might otherwise be costly for them.
Parts of Medicare
Original Medicare includes Part A and B. It allows beneficiaries to visit any doctor or hospital that accepts Medicare anywhere in the United States. Medicare will pay some charges for each service it covers. You pay the rest fee unless you have additional insurance that covers those costs. Original Medicare provides several health care services and supplies, but it does not cover all of your expenses.
You’ll receive Part A and Part B of the original Medicare plan when you automatically sign up for Medicare. To get prescription coverage under Original Medicare, you need to choose and join a private drug plan from Part D.
Medicare Advantage, also known as Medicare Part C, is a private alternative to Original Medicare. The Advantage plans are sold by private insurance companies that are Medicare-approved and cover the same health care services as Original Medicare (besides hospice care).
If you have a Medicare Advantage plan, you cannot buy Medicare Supplement insurance or a Medigap plan. So before choosing a Medicare Advantage plan, consider the many options that these plans offer carefully.
Suppose you have problems with a Medicare Advantage plan. In that case, you can switch plans or join Original Medicare once in 12 months during the annual open enrollment period from October 15 to December 7, and your new coverage will start from January 1 of the following year.
If your Medicare Advantage plan expires at the end of the year, you can quickly join another Medicare Advantage plan, or you can also enroll in Original Medicare.
Prescription Drug Coverage (Medicare Part D)
Medicare Part D drug coverage is sold through private insurance companies that set their own prescription prices, premiums, and other charges that can vary from plan to plan.
You should receive a monthly statement of your plan that shows your total out-of-pocket costs for covered drugs and indicates whether the amount keeps you in the coverage gap or takes you out.
Medigap/Medicare Supplemental Insurance
Medigap or Medicare supplemental insurance is also sold by private insurance companies and helps cover some health care costs.
Anyone with Medicare Part A and Part B can purchase a Medigap policy. However, the guaranteed rights only apply to people 65 or older who purchase the policy during a specific period. Also, note that Medigap insurers cannot sell more than one Medigap plan to the same person. In addition, Medigap and Medicare Supplemental Insurance are the same things.
Things to Consider While Comparing Medicare Plans
Ask yourself the following questions before finally selecting a Medicare Plan:
1. The total cost of care: It’s essential to think about your total out-of-pocket costs, copayments, including deductibles, coinsurance, maximums, and drug costs that you’ll pay with a Medicare health or drug plan.
2. Provider Options: Some plan types have a network of providers you’ll have to use if you want to pay less. Consider it as well before making a final choice.
3. Benefits: Many Medicare benefit plans include prescription medicine, vision, and dental coverage. If you want these benefits in your plan, ensure that your plan provides coverage for it. In addition, if you travel a lot and spend a massive part of the year in a different state, you must see whether your Medicare plan will cover you while you’re in a different state.
4. Monthly premium: Most drug plans charge a monthly fee which varies according to the plan. You pay a fee in addition to Medicare Part B (medical insurance) premiums.
Suppose you have the Medicare Advantage Plan or Medicare Cost Plan that includes Medicare prescription drug coverage. In that case, the amount for drug coverage may be included in the monthly premium you pay for your plan. But what you pay for Medicare prescription drug coverage may be higher depending on your budget.
And that’s why it is necessary to consider the premiums before selecting a plan. To learn more about monthly premiums for drug plans, visit Medicare.gov.
5. Consider Automatic Premium Deduction
When you join a drug plan, consider premiums automatically deducted from your Social Security payments. There are several benefits of automatic deduction of premium:
- It eliminates the stress of remembering to pay your premiums.
- Your premium will be paid on time.
- You will help the environment by not getting a paper bill.
Contact your drug plan (not Social Security) if you want your premiums to be deducted from your monthly Social Security payment. It will usually take three months for your initial deductible to start rolling in, and three months of premium will be deducted once.
Only one premium will be deducted every month after that. You can also see a delay in deductions if you switch plans. If you want to keep the premium deductible and get billed directly, contact your drug plan.
If you feel comparing and selecting the suitable Medicare plan for you is too much stress to handle, you can consult our Medicare licensed agents today.