Signing up for Medicare soon?
There are three directions to choose from when you begin the journey to find the right Medicare health plan. Having a clear understanding about the plans, their benefits and cost are important as you move forward.
1. Basic Medicare Parts A and B only, called Original Medicare. Part A covers hospitalization and Part B covers outpatient provider services. Medicare A and B have deductibles you must meet before Medicare pays toward the cost of treatments and services. Once you meet your Part B deductible, Medicare will only pay about 80% of the cost of outpatient treatments and services…you are responsible for the balance. Medicare pays only what is 'Medically Necessary AND Medicare Approved'.
2. Medicare Advantage Plans are also known as Part C or MA/MAPD. You must have Parts A and B first to go 'shopping' for these plans. MA/MAPD plans have a private contract with Medicare, and provider treatments and services come with cost sharing on your part - co-pays, deductibles and co-insurance limits. They also may offer added benefits such as dental, hearing, vision and alternative care. WARNING! You should seriously consider a Medicare Advantage with Prescription Drug Coverage. If not, you may be penalized by Medicare later for not having a prescription drug plan. Also, if you don't enroll in a drug plan when you are eligible, you will have to wait until the Annual Enrollment Period which begins October 15 of each year. Waiting could leave you without prescription drug coverage when you need it most.
3. Medicare Supplement/Medigap Plans. Again, you must have Parts A and B to shop for a Medicare Supplement plan. Medicare Supplement plans works with original Medicare - Medicare pays first then the Supplement plan pays second, leaving you with low or no additional cost sharing, depending on the plan you choose. WARNING! There is no prescription drug coverage with a Med Supp/Med Gap plan. You must purchase a separate Medicare Prescription Drug plan if you want the benefit of drug coverage.
If you need help understanding your options under Medicare, give us a call and we will put you in touch with a Northwest agent. Remember agents must follow very strict rules and regulations, be certified annually by Medicare, and by each carrier they represent. Look for an agent that offers both Medicare Advantage AND Medicare Supplement plans in your zip code. There is no fee for agent services. Your plan choice will be driven by your individual lifestyle as well as your zip code, your providers and medications.
ABOUT US - Victoria Bramley, with The Insurance Store Inc/NW, is a respected Health Insurance and Medicare planning professional with access to local and national insurance companies. From birth to end of life, she and her team are here to help you with your healthcare planning.
The Insurance Store, Inc.
252 A ST., SUITE 200