Finding the right Medicare plan requires careful evaluation. It is important to consider costs, coverage, where you like to get your treatments, and whether you need additional cost-sharing benefits.
What Are My Choices?
With Medicare, you have four Parts to choose from:
- Part A
- Part B
- Part C (Medicare Advantage)
- Part D
Why Part A?
Part A covers treatments in hospitals, skilled nursing facilities, and mental health institutions.
If you enroll during the Initial Enrollment Period (three months before you turn 65 to three months after), and you’ve paid Medicare taxes for ten years, then you qualify for premium-free Part A.
If you’ve paid taxes for more than seven and a half years but less than ten, the premium is $274. If you’ve paid taxes for under seven and a half years, it is $499 per month.
The $1,556 deductible is per benefit period, which begins upon inpatient admission and ends after 60 consecutive days without inpatient treatment.
Coinsurance can be $0 for a given number of days as an inpatient (60 days in hospital). Afterward, a daily coinsurance of $389 is implemented, followed by a $778 per day after 90 days.
Why Part B?
Part B covers many outpatient services:
- Ambulance
- X-rays
- Screenings
- Immunizations
- Medical equipment (e.g., wheelchairs, blood glucose monitors, and oxygen tanks)
Premiums are $170.10 but can be more depending on income. It covers 80% of the Medicare-approved amount for these services after you pay your annual $233 deductible.
It’s ideal to have Part A and Part B coverage together, as they’re needed to get Part C and Part D, or Medicare Supplements.
Why Medicare Advantage?
Medicare Advantage combines inpatient and outpatient coverage while offering benefits like dental, vision, and hearing. Many plans cover prescriptions (if yours doesn’t, you can add Part D).
Costs vary, but you’ll still need to pay Part A and Part B-related costs. The average premium is $19.
Coverage is network-based with most plans, so it is ideal if you strongly prefer particular healthcare providers and facilities and would like to get extra savings specifically for them. You may need to choose a primary care physician and get referrals to see specialists.
Do I Need Part D?
Part D is necessary if you don’t already have creditable drug coverage. Costs and coverage vary between insurers. It covers specific medications within a list, also known as a formulary.
The average premium is $33.
What If I Want Medigap?
For Medigap, you’ll need to have Part A and Part B. You cannot have Medicare Advantage or Medicaid if you wish to get supplemental coverage that will help drastically reduce your out-of-pocket costs.
The Perfect Plan For You Is One Call Away
With just one phone call, we at Turning 65 Solutions can provide you with a Medicare plan that fits your medical and financial needs. Whether you want simplicity or extensiveness, we’ve got the policy for you. Call us today at 830-217-6711.