Medicare is a federal government program that provides health insurance to those age 65+ or under 65 receiving disability insurance. It is important to understand your Medicare coverage options and to select a plan carefully. How you choose to receive your benefits can affect your out-of-pocket costs and where you go to get your care.
Medicare Advisors is here to help you understand your options and make the best coverage decision possible to fit your needs and your budget.
(Part A and Part B)
- You can go directly to the doctor or hospital. You do not need any permission/referral from your primary care doctor.
- You typically are charged 20% coinsurance and deductibles for the services you receive.
- You are responsible for the Part B monthly premium and there are limits on the amounts doctors can charge for their services.
- You replace your Medicare benefits with that of a private insurance company.
- Part C plans must offer the equivalent benefits as Original Medicare and many offer dental, vision and prescription drug coverage.
- These plans are very affordable and attractive for those who like the, “all-in-one” idea, because they bundle together part A, B, and D of Medicare into one simple plan.
- Medicare Advantage resembles group insurance plans you may have had through an employer where you use a local network of providers and pay copays for services from doctors, labs, hospitals and more.
MEDICARE SUPPLEMENT INSURANCE
- Also known as “Medigap Insurance”.
- Medigap plans help fill the “gaps” in Original Medicare like copayments, coinsurance and deductibles.
- These plans are sold by private insurance companies and are not government issued.
- Medigap plans DO NOT cover the costs of prescription drugs-for that, you would need a Medicare Prescription Drug Plan (Part D).
- The federal government has standardized Medigap plans which makes shopping for one very straightforward because you merely have to compare prices.
- Policies are guaranteed renewable, even if you experience health problems, so long as the premiums are paid.
PRESCRIPTION DRUG PLAN
- You simply have insurance for your prescription medications.
- You pay a monthly premium to a private insurance company and in return, use their network of pharmacies to pay a copay or percentage of the drug instead of paying full price.
- Part D is optional, however, Medicare will penalize those who do not enroll in a plan when first eligible or have credible coverage elsewhere.
- You should pick a plan carefully, not all medications are covered and every company has their own formulary of medications they do cover.