As you work your way through the annual Medicare Open Enrollment Period, you may have noticed that Medicare coverage has many different options to choose from. Whether you’re enrolling for the first time this year, or you’re changing your plan, it can seem daunting. Don’t let all the information overwhelm you, we’re here to help. Our team of professionals are available to assist you in finding the coverage you want, the benefits you need, and to help make sure that your plan fits your budget. First, it helps to understand the individual parts of Medicare and how the coverage works within each. Medicare consists of four basic parts:
Original Medicare (Parts A & B)
What we know as Original Medicare is managed by the federal government and is just a starting point for your healthcare once you become eligible. Part A covers inpatient hospital care, nursing facilities, hospice, and some home healthcare. Part B will help cover outpatient care, visits to the doctor, and some preventive services. Parts A & B:
- Typically there is a monthly premium and you must meet the yearly deductibles
- 80% of the approved amount is covered, then you’re responsible for the remaining 20%
- There’s no annual limit on out-of-pocket costs
- The majority of prescription drugs, routine dental care, and hearing aids are not covered
Medicare Advantage (Part C)
What is commonly referred to as Medicare Advantage is offered by private insurers and combines the benefits of Parts A & B (Original Medicare) along with dental, vision, and hearing benefits – plus much more. With Part C:
- A maximum out-of-pocket limit per plan year means that 100% of allowed healthcare costs after you satisfy the out-of-pocket limit
- Medicare Advantage can help you control and better understand your financial risk
- Many plans include Part D (prescription drug) coverage, fitness memberships, and include an allowance for over-the-counter healthcare items
Prescription Drug Coverage (Part D)
Do you rely on prescription drugs as part of your regular healthcare? Prescription drugs can be extremely expensive. Fortunately, you have several options for coverage through Medicare Part D or a Medicare Advantage plan. Part D:
- Many of the Medicare Advantage plans offer prescription drug coverage
- With original Medicare (Parts A&B), you may purchase a Prescription Drug Plan
- With many drugs, this can include mail-order service to help keep costs down
- Depending on the plan, you may need to satisfy a deductible
Medicare Advantage plans offer a flexible, broad-based approach that can be tailored to suit your specific needs, with the benefits that are available in your specific area. If you want to see what you may be missing out on, click here and take our questionnaire or call us at 855-515-5087 (TTY711) to discuss your options.
