As if life weren’t stressful enough these days, finding your way through the Medicare process can be an overwhelming experience.
Though it may seem impossible to choose the right plan out of all the choices available to you, in fact, it’s pretty easy to narrow down your choices to just two main options. But in order to clear the chaos of too many options, you need to learn the basics.
The first thing you need to know is that original Medicare has two main parts that you will need if Medicare is going to be your primary insurance during retirement.
Part A is your hospital coverage and Part B is your outpatient coverage…
- Part A covers things like inpatient stays, skilled nursing, home health care, blood, and hospice.
- Part B covers most of your other medical services like doctor visits, lab work, preventive care, surgeries and durable medical equipment.
You can for both parts enroll in person or online through the Social Security office. Medicare Parts A and B are flexible. if you are still working at retirement age, these two parts can work together with employer coverage. If you are no longer working at retirement age, they can function as your basic coverage, but you’ll likely need to add supplemental plans to fill in the gaps.
Everyone who’s ever had any kind of health insurance knows that they don’t cover 100% of all your services, and it works the same with Medicare Parts A and B. There will inevitably be deductibles and copays you’ll need to cover for various things like doctor visits or prescription drugs.
It can be very helpful to purchase supplemental coverage to pay for these additional costs and the deductibles that aren’t covered, especially if you’re planning on going through retirement with a limited income.
The two primary supplemental coverage options are Medigap plans and Medicare Advantage plans.
- Medigap plans provide payment to healthcare providers after Medicare pays its share. Since Medigap plans were created to fill in the gaps of Medicare Parts A and B, they do not include outpatient prescription drug coverage. Also, Medicare supplement open enrollment states that if you apply for a Medigap plan within 6 months of your Part B effective date, the Medigap insurance companies cannot turn you down for any reason.
- Medicare Advantage plans, also called Part C plans, are offered by private insurance companies. Unlike Medigap which supplements Medicare coverage, Medicare Advantage plans pay instead of Medicare and are often cheaper than Medigap plans. Many Medicare Advantage plans include a built-in Part D drug plan as well.
Medicare Parts A and B don’t cover most prescription medicines, which can be quite costly as you age.
In order to obtain prescription drug coverage, you’ll need to either enroll in a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan. It’s important to note that enrollment in a stand-alone Medicare Part D Prescription Drug Plan usually has a limited enrollment time, and can result in late fees if missed.
Medical expenses in retirement can take people by surprise. Your health can change from year to year, which is why it’s important to look at your health care coverage every year to make sure it meets your needs. While everyone has the same benefits available to them through Original Medicare, Medicare Advantage and Prescription Drug Plan benefits may vary.
I can help you review your current plan, and explain the Medicare options available to you. CONTACT ME to schedule a Medicare plan review to discuss your options.