You might be new to Medicare or have experienced some changes and are looking to see what other options are there. It is always a good idea to review your plan once a year even if you feel like everything is going as it should. So how can we help?

If you are new to Medicare here are some basics. For most people, when they turn 65 they become eligible for the government sponsored insurance called Medicare. It has 2 parts, Part A and Part B. You can sign up for them during the 3 months prior to your birthday month, during your birthday month and 3 months after it. There are penalties for late enrollment.

Part A has no monthly premium and it covers hospitals, hospice care, skilled nursing facilities and home care.

Part B comes with a monthly premium of $185.00 (or higher depending on your income) and it covers doctors, outpatient care, durable equipment, many preventive services,…

These two are often called The Original Medicare. They do not cover prescription drugs and they do not fully cover services. For example, there is a $1676 deductible each time you’re admitted to a hospital and Part B has an annual deductible of $257 plus you are responsible for 20% of all services you receive with no limit. So there is no max out-of-pocket like you might’ve had while working. That is why many people choose to get an Advantage plan (Part C) or a Supplement plan (Medigap). Just to give you some perspective-of all Medicare beneficiaries in the US about 50% are on an Advantage plan and about 20% have a Supplement plan.

Let’s talk about your options. So, at this point, you can stay with the original Medicare, add a Supplement plan or get an Advantage plan.

What is the difference?

Medicare Supplement plans are plans offered by private carriers and they help cover some of the costs that Parts A and B do not cover. You must keep paying for Part B. They cost more, have little if any co-pays and low out of pocket costs. You are free to choose any doctor and do not need referrals to see specialists. They do not include a prescription drug plan and also do not include any dental, vision or hearing benefits. After 6 months on Medicare you may be underwritten and acceptance is not guaranteed based on some factors including your health. So you will be paying $185/month for part B plus the premium for the Supplement plan plus the premium for prescription drug plan and also for a dental/vision/hearing plan.

Medicare Advantage plans are also offered by private carrier and they work differently from Supplement plans. They replace Parts A and B (you must continue paying for Part B) and you agree to get your coverage through this plan only. You will have to see providers in the plan’s network. They usually have an HMO or PPO network of doctors. You will have small primary doctor co-pays and little higher co-pays when you see a specialist. You will use the card provided by your carrier for all medical services. Most of these plans include a prescription drug plan (PDP) and also offer dental ,vision and hearing benefits all included in one plan. Many of these plans come with a $0 premium. They have out-of-pocket maximums after which the plan will cover all costs in that year. You will be paying $185 for Part B plus the premium for the plan (many of them come with a $0 premium).