Senior Working Out

Those that are eligible for Medicare Part A (hospital) and Part B (outpatient) benefits are considered Medicare beneficiaries. How they receive those benefits is completely up to the individual. It sounds straightforward at first, but then you become inundated with phone calls, TV ads, and mail coming in every week assuring you that their plan is best. How do you know which is best?

Each person consumes healthcare in their own manner and is unique to their needs. Asking your neighbor what plan they have, can be a dangerous way to pick your healthcare option. Does that neighbor qualify for benefits that you might not? Do they get subsidy assistance on their premium or their prescription coverage? Some of the insurance carrier options available may have multiple networks or plan names that are available to certain groups and not others. For example: BlueCross offers group plans, Medicare, individuals, and multiple networks. Sometimes, it can be hard for someone to determine exactly which plan they have if you aren’t readily familiar with how these plans work.

So, arm yourself with some quick facts about the paths you can take with your Medicare choice.

Original Medicare + Medicare Supplements will offer you standardized coverage. This means that the supplement Plan type (Plans A-N) offer the same coverage from insurer to insurer. The premiums will be different but the coverage will be the same. You are comparing apples to apples except for premium differences.  You typically will pay more for Medicare + Medigap coverage but these plans will allow you to go any provider in the country that accepts Medicare.  Most will need to find a prescription drug plan as well (Part D). These drug plans can be customized to fit your needs every year.  Give us a call and we can help you select at no cost to you!

Medicare Advantage plans allow you to receive your Medicare A and B benefits but are provided by a private insurer under contract with Medicare. These plans aren’t standardized. Most of these plans offer prescription drug coverage as well as medical. However, everything about these plans can be different from insurer to insurer. i.e. premiums, copays, coinsurance amounts, prescription coverage, and the providers that are in their network. All items can change every year!

Here’s some questions to ask to simplify your Medicare planning. 

  • Do you want Medicare (the government) to pay as your primary coverage? If yes, proceed to Medicare supplement (Medigap) options.  If no, consider Medicare Advantage options.  If yes, give me a call so that I can find the Medigap plan that offers the lowest premium given your age, health, and zip code.
  • Do you want to have lower copays in exchange for copays and network restrictions? If yes, Medicare Advantage plans might be the path that you consider. The main considerations for these plans will be which doctors and medications do you need to be covered, what is the premium range that you are comfortable with. I can help you narrow down these options very quickly. I will suggest a plan that fits your needs at this time and then we can review on an annual basis.

Article written by Rob Clark, independent broker, life and health licensed since 2000