One of the most important factors to consider when choosing your Medicare Plan is the coverage available to you. Original Medicare differs from Medicare Advantage Plans, and there is also prescription drug coverage thrown in the balance.
Original Medicare makes up Part A and Part B, which cover hospital and medical insurance. With this standard plan, you are covered by any hospital that accepts Medicare. Part A covers hospital inpatient care, skilled nursing facility care, nursing home care, hospice care, and home health care. Part B covers medically necessary services and preventive services, including clinical research, ambulance services, durable medical equipment, and mental healthcare.
Medicare Advantage Plans, often called Medicare Part C, are offered by private Medicare-approved companies. Medicare pays these companies to handle your Part A and Part B coverage. You get the same benefits as with Original Medicare under Parts A and B. Additionally, most Medicare Advantage plans offer prescription drug coverage, as well as vision, hearing, and dental options.
Part C plans can be more restrictive with the healthcare providers you are able to see. Plans through Health Management Organizations (HMOs) require you to have a primary care provider and get referrals to see specialists. Plans with Preferred Provider Organizations (PPOs) do not require you to have a primary care provider and do not require referrals, but you pay more for the services of out-of-network providers.
Part D prescription drug plans are available through Medicare and have networks based on pharmacies. Pharmacy networks may operate on the local, regional, or national level. Each Part D plan offers coverage for at least two drugs for each of the most commonly prescribed categories.
Dental, Vision, Hearing
Original Medicare does not offer coverage for dental, vision, hearing, routine foot care, or long-term (custodial) care. If you need coverage for hearing aids or prescription glasses, you will need a Medicare Advantage Plan with those benefits.
Original Medicare has minimal circumstances that allow for coverage in a foreign hospital. A few of these instances are traveling through Canada between Alaska and the continental states, living in the U.S. but with the nearest hospital being foreign, or receiving medically necessary care onboard a ship within the territorial waters of the U.S.
If you travel outside of the United States frequently, you may want to consider a Medicare Supplement (Medigap) Plan. In addition to helping you pay for Part A and Part B’s expenses, certain Medigap plans pay a portion of foreign travel emergency medical expenses.
If you need assistance with choosing a Medicare plan that’s right for you, give Turning 65 Solutions a call today!