By Christina Finkle
So you’ve reached that time in life to enter the world of Medicare and are unsure what your options may be. Hopefully this article will help!
You have 3 options available to you:
Option 1: Original Medicare
You automatically qualify for Part A when you turn 65 and have enough Social Security work credits. Part A is for hospital services. Before Part A will cover any services, you must first meet a deductible of $1,364.00 before hospital services become a 20/80 split. Once you have met your deductible, you will then be responsible for 20% of the Medicare allowable for services rendered. Medicare will pay the other 80%.
Your Part B covers your medical. Services such as your doctors, diagnostic tests and some injectable drugs that must be administered in a physicians office or hospital setting. Part B does have a monthly premium based on your income. The average person pays $134.00 per month. Again, there is a deductible associated which is $185.00 before the 20/80 split comes into play.
Original Medicare does NOT include Part D (drug coverage), which you MUST have to avoid a penalty later on, regardless of if you take any medications. Stand alone Part D (PDP) does have a monthly premium and it varies between carriers and coverage.
Option 2: Medicare Advantage (MAPD)
Most people are better served on these types of plans. Basically a MAPD plan becomes the blanket on top of your original Medicare. I say this because instead of services being billed to Medicare, they are billed to whatever carrier you choose. There are several advantages to this option.
Many of these plans include:
-Your drug coverage
-Have flat copays associated with many services
-Include extra benefits above Original Medicare such as, eye wear benefit, fitness etc.
-They range in monthly premium starting as low as $0.00 on up to over $200.00.
Please do not think that because a plan costs more that you are getting far superior coverage. That is not true. Review the benefits in comparison to a lower cost plan offered by the same carrier and do the math. I haven’t found a high cost plan yet that reflects enough of a difference from a $0.00 by the same carrier that warrants spending so much more per month in premium.
Option 3: Medicare Supplement (Medigap)
Medigap plans are all depicted by the word “Plan” followed by a letter. All Medigap plans follow Medicare guidelines to the letter, do not include Part D or extra benefits. All plans do have a monthly premium associated and although the plans are identical on each carrier, the premiums range a lot. Make sure if you choose a Medicare Supplement, you shop around between the carriers for the best monthly premium and do not forget, you will also have to purchase a stand alone Part D and it does not have to be with the same carrier you purchase your Medigap plan from.
If you have further questions or would like some guidance on which option would be best for your particular health care needs, feel free to email them to: