As you approach Medicare, you may find it daunting to make the right choice. With all of the letters, mail, and advertisements, it’s no wonder people can find Medicare overwhelming. This article aims to bring you peace of mind through simplifying Medicare.
Parts A, B, C, D, MediGap (with its own suite of letters!)…what does it all mean? Original Medicare is broken into 3 main parts, A, B, and D
Part A (Hospital Care): This part of Medicare covers things like hospital stays, Hospice care and nursing care (following a qualifying hospitalization) *.
Part B (Medical insurance): This part covers doctors services, outpatient services, and medical equipment.
Part D (Prescription Drug Coverage): D is for Drug. This coverage helps pay for prescription drug costs.
Part C (More commonly referred to as Medicare Advantage): Medicare Advantage Plans bundle together Parts A & B, and often D. They may also provide coverage for hearing, dental and Vision, which are not included in Original Medicare.
Medicare Supplement/MediGap Policies: These are private insurance plans that pair with Original Medicare and pick up where Medicare leaves off. They cover expenses such as co-payments, co-insurance and deductibles.
All the mail and cold calls and how to choose a plan:
Here’s a tip you are sure to love: Recycle those Medicare Mailers and don’t take solicitation calls! You can go ahead and ignore those TV ads too. When it comes to additional coverage, you have two choices (see below). We recommend speaking with a broker to find which option would work best for you.
Medicare supplement plans are mandated to offer the same coverage from carrier to carrier. For example, if you choose a Plan G Medicare Supplement from one insurance provider, it must have the same coverage as any other provider. This means that the insurance carriers are competing on price, service, and company rating. There are a suite of plans to choose from with varying coverage levels. These plans do not offer prescription, dental, vision, or hearing coverage, but there are a few companies that offer gym benefits with their plans. Medicare Supplement plans are accepted by any provider that accepts Medicare.
Medicare Advantage is often sold to people through cold calls and TV Ads. It may be a good solution for some people, but you should consult with an unbiased broker (rather than a cold calling salesperson) before choosing a Medicare Advantage Plan. Although the plans may offer some good upfront benefits such as lower premiums, and additional benefits like hearing, dental and vision, they often end up with a much more restrictive network and potentially higher out of pocket costs. These plans also operate within a certain region, meaning you may not be able to use your plan when traveling in the US, or if you split your time between two residences.
When to Enroll:
Generally, your Medicare enrollment begins 3 months prior to the month you turn 65 and up to 3 months after the month you turn 65. There are special rules about deferring Parts B & D, due to other coverage and you can click here to see the Medicare.gov page about enrollment dates and Special Enrollment Periods
We would be happy to discuss which option would be best for your situation! The best time to reach out is about 4 moths prior to turning 65. This gives us a good gauge on pricing and available options; any sooner and prices change, or information is forgotten by the time enrollment comes around! It is also advisable not to wait too long, as you will want to have everything in place by the 1st of the month in which you turn 65.
*Medicare is not a substitute for Long Term Care coverage. Please click here for more information about Part A Nursing Home coverage