Comprehensive Overview of Medicare Plan Options

Discover the various Medicare plan options available for seniors, including Original Medicare, Advantage plans, Part D, and Medigap. Learn how each plan works, their benefits, and how to choose the best coverage to meet your healthcare needs and reduce out-of-pocket costs. Understand premiums, plan types, and eligibility to make informed decisions about securing your health coverage after retirement.

Understanding the Different Medicare Coverage Options

Exploring Medicare Plans
Contributions made during your working years toward Social Security and Medicare taxes can offer significant advantages once you reach retirement. Turning 65 typically qualifies you for Medicare Part A and Part B automatically.

Medicare Plan Types
From Original Medicare, Medicare Advantage, Part D, to Medigap policies, there's a variety of options to consider.

Original Medicare Explained

The federal government’s foundational Medicare program provides hospital coverage under Part A and medical coverage under Part B.

Understanding Part C (Medicare Advantage)

Part C offers an alternative way to access your Part A and Part B benefits.

Medicare Advantage plans, also called Part C, encompass all the coverage of Original Medicare plus extra benefits.

Some plans include prescription drug coverage (Part D).

Various Types of Medicare Advantage Plans
Alternatives include:

Health Maintenance Organization (HMO)

HMO Point-of-Service (HMO-POS)

Preferred Provider Organization (PPO)

Private Fee-for-Service (PFFS)

Special Needs Plans (SNP)

Medical Savings Account (MSA)

Choosing the Right Medicare Advantage Plan Based on Your Needs
Different plans cater to varying medical requirements:

HMO: Operates locally with a network of providers. Visits outside the network require a referral and may incur higher costs.

HMO POS: Similar to HMO but allows some out-of-network visits at increased costs.

PPO: Offers flexibility to see out-of-network providers but with higher premiums; no primary care referral needed.

PFFS: Sets its own payment rules, allowing outside-network visits but often with restrictions. No primary care provider required; specialists can be contacted directly.

SNP: Designed for individuals with specific chronic conditions or residing in specialized living facilities; includes prescriptions.

MSA: Funds are placed in a savings account to pay for services; high deductible, no prescription coverage, unused funds can be rolled over.

Part D Prescription Drug Coverage

Original Medicare doesn't cover medications, so a separate Part D plan or a Medicare Advantage plan with drug coverage is essential.

This coverage significantly reduces medication costs.

2018 Medicare Premiums Overview

Part B premium is $134; higher income earners may pay more.

The average Part D premium is approximately $34 per month.

Plan premiums vary depending on the provider and coverage options chosen.

Medicare Supplement Insurance (Medigap)

Medigap plans help cover out-of-pocket expenses such as copays and deductibles.

Coverage includes things like outpatient visit coinsurance, deductibles, and copayments.

Note: Medigap is incompatible with Medicare Advantage plans.

Carefully evaluate your coverage needs, including prescription drugs and out-of-pocket costs, before selecting a plan that best suits your healthcare requirements.