Are you new to Medicare? Before you choose coverage, learn about the different parts of Medicare, or contact a Medicare advocate for more information.
There are two main ways to get your Medicare coverage: Original Medicare (Part A & Part B) or a Medicare Advantage (Medicare Part C) Insurance Plan. Some people get additional coverage, like Medicare Part D Prescription Drug Plans (to cover prescription drug plans) or Medicare Supplements, also known as Medigap Policies. Here are a few tips & tricks to help you decide what coverage you want:
Step 1: Decide if you want Original Medicare or a Medicare Advantage Insurance Plan (like an HMO or PPO).
When you choose Original Medicare Part A (hospital insurance) and Part B (medical insurance), Medicare provides coverage. You have your choice of doctors, hospitals, and other provides that accept Medicare. In 2017, the standard Part B premium amount is $134 (or higher depending on your income). However, most people who receive Social Security benefits pay less than this amount (on average, around $109.) 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, it may pay some of these costs.
When you choose a Medicare Advantage Insurance Plan (sometimes called “Part C”), you are enrolling in hospital insurance and medical insurance (Part A & Part B) through a private insurance company approved by Medicare. In most Medicare Advantage Insurance Plans, you need to use plan doctors, hospitals, and other providers or you pay more or all of the costs. You usually pay a monthly premium for your Medicare Advantage Insurance Plan (in addition to your monthly Part B premium), and you may also pay a copayment or coinsurance for covered services. Costs, extra coverage, and rules vary by plan.
Step 2: Decide if you want prescription drug coverage (Medicare Part D.)
If you chose Original Medicare in Step 1: If you want prescription drug coverage, you must choose and join a Medicare Part D Prescription Drug Plan. You usually pay a monthly premium. These plans are run by private insurance companies approved by Medicare.
If you chose Medicare Advantage Insurance Plans in Step 1: If you want prescription drug coverage, and it’s offered in your Medicare Advantage plan, in most cases you must get it through your plan.
Step 3: Decide if you want supplemental coverage.
If you chose Original Medicare in Step 1: You may want to get coverage to help pay some of the healthcare costs that Original Medicare does not cover, like copayments, coinsurance, and deductibles. These plans are sold by private insurance companies approved by Medicare.
If you chose Medicare Advantage Insurance Plans in Step 1: If you join an MA plan, you can’t use Medigap insurance to pay for your plan costs, like copayments, deductibles, and premiums.
For more information, or if you have any additional questions, please contact your Medicare advocate at Medicare Pathways by calling 866-466-9118 today.