Understanding Your Medicare Insurance Choices

Medicare Insurance and the 2 main ways to get your Medicare coverage – Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C).  Some people get additional coverage, like Medicare Prescription Drug coverage (Part D) or Medicare Supplement Insurance (Medigap).  Use these steps to help you decide what coverage you want:

Step 1:  Decide if you want Original Medicare or a Medicare Advantage Plan (like an HMO or PPO).  What’s Original Medicare?  Part A (Hospital Insurance) and Part B (Medical Insurance).  Who provides coverage?  Medicare.  How do you choose your providers?  You have your choice of doctors, hospitals, and other providers that accept Medicare.  How much does it cost?  Most people pay the Part B premium of $170.10 each month, if you sign up for Part B when you’re first eligible.  Generally, you pay a deductible and coinsurance % for your Part A and Part B services.  If you choose to buy a Medicare Supplement Insurance (Medigap) policy (see Step 3), your Medigap policy may pay some or all of these costs.

You can choose a Medicare Advantage (MA) plan.  Here are some things you should know:  What’s Medicare Advantage?  Sometimes called “Part C” – includes both Part A (Hospital Insurance) and Part B (Medical Insurance).  Many plans also include prescription drug coverage.  Who provides coverage?  Private insurance companies approved by Medicare.  How do you choose your providers?  In most MA plans, you need to use plan doctors, hospitals, and other providers, or you pay more or all of the costs.  How much does it cost?  Most people pay the Part B premium of $170.10 each month, if you signed up for Part B when you’re first eligible.  You usually pay $0 or a small monthly premium for your MA Plan (in addition to your monthly Part B premium).  You may pay a co-payment or coinsurance % for covered services.  Costs, extra coverage, and rules vary by plan.

Step 2:  Decide if you want prescription drug coverage (Part D).  If you chose Original Medicare in Step 1 and you want prescription drug coverage, you must choose and join a Medicare Prescription Drug Plan.  How much does it cost?  You usually pay a monthly premium.  The National average is approximately $33 per month.  Who provides coverage?  These plans are run by private companies approved by Medicare.  How do you choose your pharmacies?  Each plan has a list of approved pharmacies.  If you chose a Medicare Advantage (MA) Plan in Step 1 and you want prescription drug coverage, and it’s offered by your MA plan, in most cases you must get it through your plan.

Step 3:  Decide if you want supplemental coverage.  You chose Original Medicare in Step 1 and you want supplemental coverage.  What’s a Medicare Supplement Plan?  You may want to get coverage to help pay some or all of the health care costs that Original Medicare doesn’t cover, like co-payments, coinsurance %, and deductibles.  The plans are standardized (same for each company) and are: A-G and K-N. C&F are offered as select plans and F is available as a high deductible.  Costs usually range from $46-$250, depending on: age, zip code, gender, tobacco, and under writing. Premiums are in addition to Part B.  Who provides coverage?  You can choose to buy a Medigap policy from a private company that provides secondary coverage.  How do you choose your providers?  Like Original Medicare, in most cases you may choose any provider, hospital or other providers that accept Medicare.  You may not have BOTH a Supplement and an Advantage Plan.

There are Options Other Than Medicare

Other Options:  In addition to Original Medicare or an MA Plan, you may be able to join other types of Medicare health plans.  You may be able to save money or have other choices if you have limited income and resources.  You may also have other coverage, like employer or union, military or veterans’ benefits.

Have Medicare Questions? Contact Insurance Options, Inc. today!

Insurance Options, Inc., is a general insurance agency offering Medicare insurance plans.  We can meet you in our office, in your home or you may attend one of our educational or sales meetings. We provide personal attention, consider all your individual needs and tailor a plan to fit your personal needs. We do not charge a consultation fee as we are compensated directly from the insurance companies. As an added bonus you get us as your local agent available to answer your questions year round! Would you like to further explore your Medicare insurance options? Complete our online request form.