Understanding Your Medicare Insurance Choices

Original Medicare

Medicare is made up of Part A (Hospital insurance) and Part B (Medical insurance) which is offered by the government.  You may see any provider throughout the USA that accepts Medicare beneficiaries.  Part A is free for most people (there are exceptions).  Most people pay the standard Part B premium each month, which changes annually and is based on your income.  When you seek medical services you will be responsible for deductibles &/or coinsurance.  You may view these costs at Medicare.gov.  These amounts typically change annually and are set by Medicare.

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Add Supplement (Medigap) secondary coverage

Offered by private insurance companies approved by Medicare.  Plans are standardized so that coverage from company to company is the same.  Premiums will vary based on company, plan, age, gender, tobacco usage and zip code.  These plans will pay some or all of the costs that Medicare does not cover.  Plans may be medically underwritten if you are outside of a guaranteed election period.

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Add Prescription coverage (considered Part D)

To avoid paying a lifetime penalty, be sure to choose a drug plan when you are first eligible to do so.  Plans are offered by many private insurance companies approved by Medicare.  Most plans have a monthly premium.  There are 3 phases of coverage:  Deductible, Initial Coverage, and Catastrophic.  Costs change annually.  You may change your plan at least annually in the fall of each year. 

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Advantage Plans (considered Part C)

If the above does not appeal to you, then you may instead choose to get your Medicare benefits through an Advantage plan, which are offered by private insurance companies.  These plans “bundle” your coverage and include medical, prescriptions (usually) and many offer additional benefits not covered by original Medicare.  These plans are typically network driven – meaning choosing in-network providers saves you money. 

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Other options – Not ready to retire? 

Your employer may offer coverage.  Check with your HR department.  If you are a Veteran, you may be eligible for VA coverage or Tricare.  Those with limited incomes &/or disabilities may be eligible for Medicare and Medicaid.