Medicare insurance plans can be confusing, especially when trying to figure out which plan is right for you. There are many different options available, and deciding which is the best fit can be tough. This blog post will discuss the most common types of Medicare insurance plans. We will provide a brief overview of each plan type and then discuss some of the pros and cons of each one. Hopefully, this information will help you decide which Medicare plan is right for you!
Original Medicare (Part A and Part B)
Original Medicare is the government-run health insurance program most seniors enroll in. It is made up of two parts: Part A covers hospitalization, while Part B covers outpatient care. Original Medicare does not cover many things, including dental, vision, and prescription drugs. Many seniors supplement their Original Medicare coverage with a private Medigap policy or a Part D prescription drug plan.
Pros:
– Parts A and B cover a lot of essential health care needs
– You can see any doctor or specialist that accepts Medicare
– No monthly premium for Part A (most people pay a monthly premium for Part B)
– No deductible or coinsurance for Part A
– Part B has a yearly deductible of $183 (in 2018)
Cons:
– Does not cover dental, vision, or prescription drugs
– Requires supplemental insurance for many people
– You may have to pay a copayment or coinsurance for some services
– Parts A and B have separate deductibles ($1,340 for Part A in 2018)
Medicare Advantage Plans (Part C)
Medicare Advantage plans are an alternative to Original Medicare. Private insurance companies offer these plans and must provide at least the same level of coverage as Original Medicare. Many Medicare Advantage plans also offer additional benefits, such as dental and vision coverage, according to Clearmatch Medicare. Most Medicare Advantage plans require paying a monthly premium, copayments, coinsurance, and deductibles for some services.
Pros:
– Can provide additional benefits not offered by the Original Medicare
– May have lower out-of-pocket costs than the Original Medicare
– May offer coverage for dental, vision, and prescription drugs
Cons:
– You must use the providers in the plan’s network
– May have higher premiums than the Original Medicare
– May require you to pay copayments, coinsurance, and deductibles for some services
Medicare Supplement Insurance Plans (Medigap)
Medicare Supplement insurance plans are designed to supplement your Original Medicare coverage. Private insurance companies offer these plans and can help pay for things that Original Medicare does not cover, such as deductibles, coinsurance, and copayments. Medicare Supplement plans do not cover dental, vision, or prescription drugs.
Pros:
– Helps pay for out-of-pocket costs not covered by Original Medicare
– You can see any doctor or specialist that accepts Medicare
– No network restrictions
Cons:
– Does not cover dental, vision, or prescription drugs
– You may have to pay a monthly premium in addition to your Part B premium
– Plans are standardized, so you may not be able to find a plan that covers exactly what you need
Medicare Part D Prescription Drug Plans
Private insurance companies offer Medicare Part D prescription drug plans and can help cover the cost of your prescription drugs. These plans have a monthly premium, and you will also pay a copayment or coinsurance for your prescriptions. Part D plans have a yearly deductible, and you may also be responsible for a late enrollment penalty if you do not enroll in a plan when you first become eligible.
Pros:
– Helps cover the cost of your prescription drugs
– Some plans have low premiums and no deductible
– You can switch plans every year during open enrollment
Cons:
– You must use the pharmacies in the plan’s network
– May have high out-of-pocket costs for some drugs
– May have a yearly deductible
– You may have to pay a late enrollment penalty if you do not enroll in a plan when you first become eligible
Medicare Advantage Prescription Drug Plans (MAPDs)
Medicare Advantage Prescription Drug plans are an alternative to Original Medicare + a separate Part D prescription drug plan. Private insurance companies offer these plans and must provide at least the same level of coverage as Original Medicare. Many MAPDs also offer additional benefits, such as dental and vision coverage. Most MAPDs require you to pay a monthly premium, copayments, coinsurance, and deductibles for some services.
Pros:
– Can provide additional benefits not offered by the Original Medicare
– May have lower out-of-pocket costs than Original Medicare + a Part D plan
– May cover dental, vision, and prescription drugs
Cons:
– You must use the providers in the plan’s network
– May have higher premiums than Original Medicare + a Part D plan
– May require you to pay copayments, coinsurance, and deductibles for some services
Medicare Savings Programs (MSPs)
Medicare Savings Programs can help you pay for your Medicare premiums, copayments, and deductibles. State and federal governments offer these programs, and they are based on your income and assets. There are four different types of MSPs:
– Qualified Medicare Beneficiaries (QMBs) programs help pay for your Medicare Part A and Part B premiums and your Medicare copayments and deductibles.
– Specified Low-Income Medicare Beneficiaries (SLMBs) programs only help pay for your Medicare Part B premiums.
– Qualifying Individuals (QIs) programs only help pay for your Medicare Part B premiums.
– Extra Help is a program that helps pay for your Medicare Part D prescription drug plan premiums and costs.
Contact your state’s Medicaid office or the Social Security Administration to see if you qualify for an MSP.
Pros:
– Helps you pay for Medicare premiums, copayments, and deductibles
– May be available if you have a low income or few assets
Cons:
– Programs are only offered in certain states
– You may have to re-apply for the program every year
– Programs have income and asset limits, so you may not qualify if your income or assets are too high
Hopefully, this information will help you decide which Medicare plan is right for you!
Veterans Benefits
Veterans who served on active duty can get health care coverage through the Veterans Health Administration (VHA). The VHA offers a comprehensive health care benefits package that covers hospitalization, surgery, mental health care, and more. Veterans can also enroll in Medicare Part A and Part B if they meet the eligibility requirements. To enroll in the VHA health care system, veterans must complete an application and submit it to their local VA office.
Pros:
– Provides comprehensive health care coverage for veterans
– Offers a wide range of health care services
– Veterans can enroll in Medicare if they meet the eligibility requirements
Cons:
– Applicants must submit an application to their local VA office
– Coverage may be limited depending on the availability of VA facilities
– Veterans may have to pay copayments for some services
Retiree Health Insurance
Retirees who are not eligible for Medicare can get health insurance through their former employer’s retiree health plan. Some employers offer retiree health plans to their retired employees. The government does not regulate these plans, so they may vary in terms of premiums, coverage, and costs. Some retiree health plans require retirees to pay the entire premium, while others may subsidize a portion of the premium. In addition, some plans may only cover certain medical expenses, such as hospitalization or prescription drugs. Before enrolling in a retiree health plan, retirees should carefully review the plan’s terms and conditions to ensure it meets their needs.
Pros:
– Offered by some employers to their retired employees
– May have lower premiums than individual health insurance plans
– May cover a portion of medical expenses
Cons:
– Not regulated by the government, so coverage and costs may vary
– Some plans only cover certain medical expenses
– Retirees may have to pay the entire premium themselves
There are a wide variety of health care coverage options available to seniors. Seniors can enroll in Medicare, obtain health insurance through their former employer, purchase an individual health insurance plan, or qualify for a government-sponsored health care program. Each option has pros and cons, so seniors should carefully compare each option to find the best fit for their needs.
