You’ve got options and choices to make when it is in regard to just how you get the best Medicare coverage designed for you. There are three major choices to consider.
- Original Medicare Part A and Part B
- Medicare Advantage or Medicare Supplement Plan also known as Medigap Plan
- Prescription Drug Plan
When choosing which coverage is appropriate for you, consider the actual cost of each plan.
Original Medicare (Part A & Part B):
You pay a monthly Part B premium and any copayments, coinsurances, and deductibles. There is no limit to how much you might have to pay out of pocket, but you are able to purchase additional plans to help with the out-of-pocket costs.
Medicare Supplement Plans:
You must keep the Original Medicare in force (Part A & Part B) These plans have benefits but they are a bit pricey. Plans vary in price from Insurance Company to Insurance Company for the same plan coverages.
There is a lot to be said for a Medicare Supplement or Medigap plan. First, unlike Medicare Advantage Plans, there is no network. You can visit any physician or healthcare provider that accepts Medicare. Medigap plans are guaranteed renewable (Once issued, they can’t be taken away except for non-payment of premium.)
A Medicare Supplement or Medigap plan generally will pay 20% of the costs Original Medicare (Part A & Part B) do not pay. Your providers and Medicare will coordinate your claims payment behind the scenes automatically with little or no effort on your part. You will have little or no paperwork to file, due to Medicare and Medicare Supplement plans working together to pay your covered healthcare costs.
In addition, there are some Medigap plans your premium and Part B deductibles are your only out-of-pocket costs. Medigap or Medicare Supplement plans are designed to help with both expected and unexpected costs with fewer or even no surprises. For a competitive monthly premium, you can get the peace of mind that comes with knowing some of your medical costs may be covered.
Medicare Advantage Plans:
Medicare Advantage plans unlike Medicare Supplement Plans are typically zero $0.00 monthly premium or very low cost. There is a drawback to having zero premium, there can be deductibles, copays, coinsurance, but as soon as you reach the plan yearly maximum you will not have to pay anything for health products for the remainder of the year.
These plans are designed either with Prescription Drug Coverage or without drug coverage. Many Veterans do not need Prescription Drug Coverage because they are covered through the Veterans Administration.
Typically, most Medicare Advantage Plans have other benefits such as Dental Services, Vision Plans, and Hearing Plans along with Gym Memberships.
Prescription Drug Plans
These are known as Part D, they have specific formularies or drug lists to meet your prescription plan needs. There is an initial deductible that is declared every year and can fluctuate from year to year. Once you have met your initial deductible the drugs you get are greatly reduced with some generic drugs having little or no co-pay. If you use branded drugs instead of generic versions, it is a much greater price that you have to pay.
Covers services and supplies in hospitals, doctors’ offices, and other health care settings under Part A (Hospital Insurance) or perhaps Part B (Medical Insurance). You are able to add drug coverage by joining a Medicare drug program.
Medicare Advantage Plans are required to cover all services and supplies that Original Medicare covers and most include drug coverage. They might also have additional benefits like dental, hearing, and vision.