If you’ve been enrolled in original Medicare or a Medicare Advantage plan, you know that there are no lack of options to consider. Even though it’s been around for more than 50 years, the Medicare landscape has only become more confusing and tougher to navigate.
Whatever your situation, and whatever your choice, it’s always wise to gather as much information as you can before making a decision for the next year.
Here is a list of three things to consider…
1. Part A and Part B
Original Medicare has two parts: Part A is hospital insurance, and medical insurance is covered under Part B. The two parts make up a fee-for-service health plan where, after you pay your deductible, the plan pays its share of the Medicare-approved cost, and you pay your share.
There is no out-of-pocket maximum or drug coverage included with Original Medicare. You will be responsible for deductibles, copays, and coinsurance as well. These costs are important to consider when weighing whether or not you’re getting the best possible deal for your personal situation.
2. Will you qualify for a Medigap policy?
A so-called Medigap policy — which comes with a premium that varies from plan to plan — could help cover some of those costs. This is a supplemental insurance policy sold by a private insurance company designed to fill in the ‘gaps’ of Original Medicare coverage.
With a Medigap policy, you may find yourself subject to medical underwriting. What this means is that insurance companies will try to figure out your health status when you apply for coverage. They do this to determine whether to offer you coverage, at what price, and what exclusions or limits may apply. You may want to wait and find out if you’ll be approved before you drop your Medicare Advantage plan.
While a Medigap plan will help with the costs of Part A and Part B coverage, it will not include Part D prescription drug coverage.
3. Prescription drug coverage
Medicare Part D is optional prescription drug coverage that is available to all people with Medicare for an additional charge. This coverage is offered by private companies and insurers approved by Medicare.
Part D adds prescription drug coverage to:
- Original Medicare
- Some Medicare Cost Plans
- Some Medicare Private-Fee-for-Service Plans
- Medicare Medical Savings Account Plans
Usually, drug coverage is included in a Medicare Advantage plan. If you make the move to Original Medicare, you’ll need to sign up for a standalone Part D plan. You can do this during the annual Medicare Open Enrollment Period (October 15th – December 7th).
While the process of finding and selecting the right coverage for your specific situation can be complex, our free service is not. Our Medicare Benefits Finder Quiz takes just a few minutes to complete, you’re under no obligation to do anything, and it is absolutely free to use.
Don’t settle for coverage that doesn’t meet your needs, click here to take the quiz, or give our dedicated professionals a call at 855-515-5087 (TTY 711).