What type of Medicare plans are available? Why should I buy a Medicare Advantage plan as opposed to Original Medicare? What are Medicare Part C and Part D plans? If I enroll in Medicare, do I need anything else? These are all questions we frequently hear in Elk River, MN.
Understanding the Medicare health insurance system can be challenging to grasp because there are many different options and coverage combinations. We are here to answer your questions and help you understand how Medicare insurance coverage works.
The first big question you need to answer is whether you should purchase only Original Medicare and/or Medicare Supplement plans or if you should enroll in a Medicare Advantage Plan.
Original Medicare is medical coverage supplied by the government that you earn the ability to purchase after working in the American workforce for a certain amount of time. Medicare includes two parts.
Part A: Covers hospital stays, hospice, and some home care
Part B: Covers outpatient services, physician visits, and some home health visits
Original Medicare coverage is universal and covers 80% of the costs involved in your healthcare. This means you are responsible for 20% of every medical bill. There is no maximum out-of-pocket. Therefore your portion can be very expensive if you have an extensive procedure or hospital stay.
Medicare Advantage Plans
Medicare Advantage plans go beyond Original Medicare with better cost sharing for more services, a maximum out-of-pocket (MOOP), extra benefits, and additional support. Medicare Advantage plans operate similarly to Original Medicare, but the difference is that the government pays private insurance companies to offer the Advantage plans. Therefore, each private company may offer plans with a few differences or advantages. Different types of plans include HMO, PPO, SNP, and PFFS plans.
The benefits of enrolling in a Medicare Advantage plan are that your care is mainly centralized in one place, there is a maximum out-of-pocket cost to you, and there are additional benefits that are not available under Original Medicare.
Essentially, most Medicare Advantage plans include prescription drug coverage. With Original Medicare, you must purchase a separate policy if you want a prescription drug plan. Medicare Advantage plans come with prescription drug coverage. Medicare Advantage plans often also come with extra coverage for services like chiropractic care, acupuncture, dental care, vision, hearing, and services outside the United States.
These types of benefits are vital to you because you can go to a dentist and have preventive care done at low costs. Also, you may qualify for hearing aids, contact lenses, and eyeglass frames at a discounted price, potentially saving you thousands of dollars.
Another notable feature of Medicare Advantage plans is they help you keep your savings with the maximum out-of-pocket.
There are many additional benefits that are not covered under Original Medicare as well. Maybe you are looking for more activity and want a gym membership? Great news, Medicare Advantage plans often come with fitness memberships to help you stay active. Some offer discounts on healthy food at grocery stores and also over-the-counter items you might find in a pharmacy or first aid section, such as band-aids, vitamins, cough syrups, and much more.
If you like to travel, Medicare Advantage plans travel with you. If you’re traveling worldwide and need emergency care, you would have coverage, unlike with Original Medicare.
There are three enrollment periods for Medicare Advantage.
The Medicare Initial Election Period (IEP) begins three months before your 65th birthday and remains open for the three months after your 65th birthday.
The Medicare Advantage Open Enrollment Period (MAOEP) runs from January 1st through March 31st. It allows Medicare Advantage enrollees to switch from their current Medicare Advantage plan to another or back to Original Medicare if they are unhappy.
The Annual Election Period (AEP) is from October 15th through December 7th.
Questions? We’re here to help.
Are you looking for a Medicare Advantage Plan in Elk River or a Medicare Advantage Plan in Waite Park? At Patriot Insurance Brokers, we are here to assist you with finding the plans that are best for you.
This includes answering your questions about items that are medicare covered, assisting you to stay on the plan you are currently on, or helping you to switch to a better plan. We can also assist you by looking at your health history and comparing prescriptions for your best coverage.
Patriot Insurance Brokers Waite Park and Patriot Insurance Brokers Elk River are here to support you. Please contact our team of experts with questions about your health plan or plan benefits. We look forward to assisting you in finding the best plan that fits your needs.