NAVIGATING THROUGH THE MEDICARE MAZE
The Medicare maze can be confusing to many. Granted, navigating through it isn’t easy. Given that, we wrote this article to help people who are looking for answers.
Medicare can be set up in different ways. As a result, there are 3 ways that seniors have their Medicare coverage in place.
As an illustration, use the information below to determine what coverage will work best for you.
Welcome to the Medicare maze!
Option 1: Original Medicare
Medicare Part A (Hospital Insurance)
Part A is the first part of the Medicare maze and is known to many as “Hospital” insurance. This part of Medicare is therefore going to cover your inpatient hospital stays.
Medicare Part A will cover 80% of your hospital bills after you have satisfied a quarterly deductible. As a result, you become responsible for 20% of the hospital bills.
It’s important to know that in the event that you’ve worked a minimum of 10 years and paid Medicare taxes, your Part A coverage is going to be free of charge.
Medicare Part B (Medical Insurance)
Part B is the second part of the Medicare maze. Part B is known as your “Medical” insurance. In other words this part covers your doctor visits, preventative care, lab work, medical supplies and much more.
If the annual deductible under Part B is satisfied then Medicare pays 80% of covered expenses. Therefore making you responsible for 20%. All things considered that’s similar to how Part A works.
Option 2: Medicare Advantage
Medicare Advantage Plans
This part of the Medicare maze is also known as managed care. Medicare Advantage is only offered by private insurance companies.
At the present time, these companies contract with Medicare to provide you with all your Part A and Part B benefits.
To put it another way, they replace your Original Medicare benefits.
Medicare Advantage Plans manage the cost of your Original Medicare. For example, they charge you co-pays and deductibles for services and procedures.
Another key point is that these private companies control what services and procedures you’ll be able to get. Under those circumstances they often require approval prior to said services.
Be that as it may, most Medicare Advantage plans offer prescription drug coverage with a few added benefits.
Notably these benefits include dental, vision, and sometimes gym memberships.
Original Medicare + Medicare Supplement Insurance + Prescription Drug Plan
The final turn in the Medicare maze! Your third option is having Original Medicare and additional coverage. For example, a Medicare Supplement plan (Medigap) and a Prescription Drug plan.
Specifically, Original Medicare only covers 80% of both hospital services and medical services after you satisfy deductibles.
This immediately leaves you exposed financially.
However, a Medicare Supplement plan, was designed to help pay for some or all costs that Original Medicare doesn’t pay for.
To clarify, Medicare supplement plans or Medigap plans are offered by private insurance companies,
Without a doubt, people love that Medicare supplements do not have limiting networks.
As long as a doctor accepts Medicare, he accepts your Medicare supplement plan.
By all means a Medicare supplement plan isn’t free. Nearly most plans will range between $85-$150. The price will range because of geographic location.
Prescription Drug Plan
These plans are offered by insurance companies in the same way that other private companies offer Medicare Advantage plans. That is to say that they were approved by Medicare.
Without doubt prescription drug plans have monthly premiums that vary depending on the carrier and their formulary.
When choosing a drug plan, certainly it’s important to have your drugs available. To be sure, perform a search for the plan with the best pricing on your specific medications.
It’s important to understand that every plan is different. In short, double check and make sure your prescriptions are covered and that the copayments assigned to your drugs fit your budget.
To conclude, the Medicare maze is made up of many turns.
At the end of the day the Medicare maze is different for everyone.
It’s up to you to make the best choice based on your own needs because everyone’s situation is unique.
Undoubtedly each choice in this article has it’s own out of pocket costs.
Do you want to know what these costs can be?
We can help get you the answers.
If you need more information on your choices, contact a Medicare Mentor immediately at 1-855-344-8733.
*Please note, we do not make any specific carrier or coverage recommendations for individuals on our blog. This area is for general questions about Medicare only. If you need help with your personal policy, click the Contact Us button below for more personal guidance. We are happy to help you!
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