Are you researching Medicare because it is your first time signing up?
It’s easy to get confused. There are so many parts! How do you know what plans you need? We are here to help. This page is designed to help you get a better understanding of your options in receiving your Medicare benefits. If you have any additional questions, feel free to start a chat with a benefits advisor or call us directly at 866-466-9118 now.
Understanding the Basics
Medicare is a federal government program mostly offering insurance to individuals 65 years of age and older. There are currently over 55 million Medicare beneficiaries across the country. The parts of Medicare are organized with letters of the alphabet. For example, Medicare Part A is hospital insurance, Medicare Part B is doctor’s office insurance, Medicare Part C plans are Medicare Advantage plans, and Medicare Part D is prescription drug insurance. Medicare Part A and Part B are also known as Original Medicare.
When you first turn 65 or otherwise become eligible for Medicare, you will generally enroll in Original Medicare (Part A & Part B.) Most people are automatically enrolled. Original Medicare covers a wide variety of treatments and services at the doctor and hospital. The most important thing to remember is that Original Medicare, or Medicare Part A & Part B cover 80% of these services.
Comparing Employer Insurance with Medicare
Every day we face the situation and have found three important factors to consider when comparing an employer plan to Medicare insurance. Keep in mind that in many cases, employer insurance will become much more expensive when you turn 65. For more detailed information regarding your employer insurance, you should consult with your Human Resources department.
Factors to Review when Comparing Employer Coverage vs. Medicare:
1. Basic plan information: premiums, deductibles, copays, coinsurance, etc.
2. Additional coverage options such as dental, vision, and hearing
3. Dependent coverage: How will your dependent’s coverage change if you leave the employer option, and how could they be covered by insurance through Healthcare.gov
Medicare Plan Options
Medicare supplement insurance, also known as Medigap policy, helps you pay the remaining 20% of the costs left behind by Original Medicare. With a Medicare Supplement insurance plan, you have Original Medicare and a Medigap policy. Medigap policies are also organized with letters of the alphabet.
As shown in the Medigap Plan chart, each plan letter covers different pieces of the gaps left behind by Original Medicare. The more important thing to know about Medicare Supplement plans is that they are standardized by the federal government. No matter which insurance company sells a Plan G, the benefits are always the same.
The only difference between plans from company to another is the monthly premium. This is the same for every plan letter no matter where you are in the country. Plan G with Company #1 is the exact coverage as Plan G with Company #2 and #3; however, their premiums can be different.
Coverage for Prescription Drugs
Medicare Part D is prescription drug coverage. No matter if you take one prescription, or twenty, there is a Part D plan designed to meet your needs. To enroll in Medicare Part D, you must choose a Part D plan that works best. You can review plan options at the official Medicare website, or you can contact your Medicare Pathways benefit advisor for additional assistance. Medicare Part D is a Medicare program designed to assist the costs of prescription drugs and prescription drug premiums. It was introduced in 2003, as part of the Medicare Modernization Act and was officially available to Medicare beneficiaries in 2006.
Medicare Part D prescription drug plans cover their own set of drugs. The list of drugs that a plan covers is called a formulary. The cost of drug plans varies based on which types of drugs you need and whether you participate in your plan’s network pharmacy. There is also no standard monthly premium for Part D plans.
What are my other Medicare options?
Medicare Part C, also known as Medicare Advantage, is another coverage option you can select. These plans are offered by private insurance companies and are approved by Medicare to take over your Original Medicare Part A and Part B basic benefits. These plans all have a network (e.g., PPO, HMO, PFFS) and can change their network and coverage from year to year. Medicare Advantage also offers additional benefits within their plan, sometimes including prescription drug coverage.
What else do I need to know?
Do you feel like you have more questions regarding your Medicare options? We can help discuss Medicare basics, plan options, and help you understand more of the core concepts on how you can choose to receive your Medicare benefits. Click the chat box below, or you can give us a call at 866-466-9118. Calling this number will connect you with a licensed sales agent!
Core Concepts Review
Medicare Part A* is hospital insurance
Medicare Part B* is doctor’s office insurance
Medicare Part C plans are Medicare Advantage plans
Medicare Part D is prescription drug insurance
*Medicare Part A and Part B are known as Original Medicare
Medicare Supplement Insurance plans fill in the gaps left behind in Original Medicare
Medicare Supplement Insurance plans are also known as Medigap policies