Which Medicare Option is Right For Me?
October 20, 2022 | Gabe Taylor
Original Medicare can leave a lot of gaps in your health coverage. For example, there is no maximum out-of-pocket limit on your health care costs when enrolled in just parts A and B. This means that if you have original Medicare by itself, you are vulnerable to an infinite amount of costs. Unfortunately, this is the leading cause of bankruptcy for people over the age of 65. This is why it’s so important to choose the right Medicare option for your budget and needs.
Choosing the Right Medicare Option
If you decide you need extra coverage beyond Original Medicare, you can take a couple of different routes. Deciding between these paths can feel daunting and overwhelming. Here, we’ll help you break down your Medicare options and better understand available plans.
Beyond Original Medicare, most Medicare beneficiaries select one of two main health plan types: Medicare Supplements or Medicare Advantage. Here are some basic characteristics of these plans.
Medicare Advantage Plans:
- Often includes Part D
- Network driven
- Additional benefits (vision, hearing, dental)
- One Medicare card
- Annually renewable
- Premiums are generally lower
A Medicare Advantage Plan (MAPD) provides coverage through a private insurance company. A Medicare Advantage Plan provides all the benefits of Part A, Part B (except hospice care), and in most cases, Part D. However, many Medicare Advantage Plans offer additional benefits beyond Original Medicare, including dental, vision, wellness benefits and/or travel coverage.
Most MAPD’s have a specific network of doctors that you can see. These doctors are considered in-network. You may be able to see an out-of-network doctor, but your cost will likely be higher. The networks can change from year to year within plans.
Most Medicare Advantage Plans include Part D, which means that you will have to keep track of just one card, one premium, and one company. Some Advantage plans offer additional benefits like vision, hearing, dental and a gym membership. Often these benefits are already built into the premium with no additional cost to the consumer.
Medicare Supplement (Medigap):
- Some Part D flexibility
- Broader doctor choices
- No additional benefits
- Two cards
- Guarantee renewable benefits
- Medicare authorizes your claims
- Premiums generally higher
Medicare Supplement Insurance (Medigap) is a policy that helps pay for health care costs that Original Medicare may not cover. Medigap plans are sold by private insurance companies licensed to offer these plans in your state. Medigap policies do not cover most Part D prescription medications. If you want drug coverage, you can add a standalone Medicare Part D plan that is available in your area.
A Medicare Supplement plan has a large network of providers including any facility/doctor that accepts Medicare.
Medigap can help cover health care costs like copayments, coinsurance, and deductibles that original Medicare doesn’t cover. Standardized Medigap policies are guaranteed renewable even when there are health concerns. However, Medigap does not cover eyeglasses, hearing wear or dental care like a Medicare Advantage Plan might.
When choosing a Medicare plan, there are many options and benefits to consider. Our experienced team of agents are here to help find a Medicare option that fits your health and lifestyle needs. Schedule your free, no-obligation appointment today.