For many adults in the United States, turning 65 means switching from private health insurance plans to Medicare. While certain people might qualify for Medicare before they are 65 years of age, most need to wait until they’re seniors before they can receive this health insurance.
If you’re at an age when you’re ready to get Medicare, you might be overwhelmed by the options available to you. There are different parts that make up this program, and it’s up to you to determine what you want to enroll in.
In order to decide which Medicare plan will best suit your needs, you need to take a look at your budget. You also need to make a realistic assessment of your health and think about the types of services you might need in the future.
While selecting a Medicare plan might seem overwhelming, it’s a manageable task. By reading the following sections, you can get a better sense of which plan might be best for you.
What are the different Medicare plans?
Before you can choose a Medicare plan for you, you need to familiarize yourself with the different Medicare parts. There are four main parts to Medicare, and they are as follows:
- Medicare Part A – Medicare Part A is part of the Original Medicare plan. It’s also usually known as the part of Medicare that provides hospital insurance to enrollees. In addition to hospital care, Medicare Part A can also help individuals who need hospice care or assistance in nursing home facilities.
- Medicare Part B – Medicare Part B is also part of the Original Medicare structure. However, unlike Part A, Part B provides coverage to individuals who need outpatient care or medical supplies. Through Part B, recipients can also access preventive and routine medical care.
- Medicare Part C – Medicare Part C is also referred to as the Medicare Advantage plan. These plans provide all the benefits that would come with Parts A and B. However, Medicare Advantage plans are made available through private insurance companies.
- Medicare Part D – Medicare Part B is a supplemental form of insurance. Individuals can enroll in Part B along with Original Medicare. This part is used to help offset enrollees’ prescription drug costs. It’s available for an additional fee.
What’s the difference between Original Medicare and a Medicare Advantage plan?
If you’re searching for a basic Medicare plan, you might wonder about the differences between Original Medicare and a Medicare Advantage plan. At first glance, these two plans might seem the same. However, there are some major differences between these two programs.
In terms of basic coverage, both Original Medicare and Medicare Advantage can provide you with services relating to:
- Hospital care.
- Preventative services.
- Routine check-ups.
However, that’s usually where the similarities end. With Medicare Advantage, your costs are likely to be different than they would be with Original Medicare. Since different providers offer Medicare Advantage, the amount you owe will vary depending on your provider.
Furthermore, keep in mind that Medicare Advantage usually offers a more diverse array of services you can enroll in. With Medicare Parts A and B, you have a clear idea of the benefits you can obtain through this program.
On the other hand, since there are various providers that offer Medicare Advantage, you have more flexibility in terms of the different services you can obtain. This means that with your plan, you might be able to obtain:
- Prescription drug coverage.
- Dental benefits.
- Vision care benefits.
Before you choose between Original Medicare and a Medicare Advantage plan, it’s important that you consider what you’ll need coverage for. You also need to think about whether there’s a particular doctor you want to use.
Depending on the plan you choose, there might be limits regarding which doctor you can use. This is true with either Original Medicare or Medicare Advantage plans. However, with the Medicare Advantage plans, you might have more flexibility in terms of the plans you can enroll in.
About Different Types of Medicare Advantage Plans
- Preferred Provider Organization (PPO)
- Health Maintenance Organization (HMO)
- Private Fee-for-Service (PFFS) Plans
- Medical Savings Account (MSA) Plans
- Special Needs Plans (SNPs)
Do I need prescription drug coverage?
When it comes to choosing which Medicare part will be most helpful for you, you must think about the types of coverage you need. At the same time, you also must plan ahead and select a plan that you think will offer you the most benefits in the event of a medical emergency.
For this reason, you might be wondering if you should enroll in the Medicare Part D drug coverage plan.
If you take daily medication, enrolling in Medicare Part D is a good choice for you. Otherwise, you’d be responsible for paying the out-of-pocket cost for your prescription each time you need it.
If you think you might need to start taking prescriptions sometime in the future, it could also be a good decision for you to enroll in Medicare Part D.
Ultimately, it is your decision as to whether you want to enroll in this insurance part. If you need help deciding if Medicare Part D will benefit you, speak with a doctor or Medicare agent.
How much does Medicare cost?
Before you enroll in a Medicare program, you first want to make sure you understand how much you’ll be expected to pay for this insurance. Unlike Medicaid, the government health insurance that’s available to low-earning households, Medicare isn’t usually free.
If you enroll in Medicare, you’re required to pay a monthly fee for whichever part you enroll in. This means that if you get Original Medicare, you need to pay for Medicare Parts A and B.
Likewise, if you enroll in Medicare Advantage, you’re responsible for paying the costs associated with the insurance company that manages your plan. These amounts can vary by provider.
In any case, the premium you’re responsible for paying for Medicare changes based on your income. For example, lower-earning individuals pay less in Medicare premiums than they would if they were in a higher tax bracket.
Furthermore, it’s important to remember that Medicare premiums can increase from one year to another. This means you might need to evaluate and adjust your budget each you’re enrolled in this program.