Trying to figure out the best Medicare plan can be very confusing. You often feel like you have to relearn the alphabet. You have Original Medicare Parts A & B, and Medicare Advantage Plans Part C, prescription drug plans, or Part D. If that is not confusing enough, you have Medicare Supplement Plans A - N. No one plan fits all, but your choice will impact your coverage for the next twelve months or longer. Here are a few steps to help you navigate this alphabet soup.
1. Research Your Options
Medicare can look overwhelming, but initially, there are only two options to choose between. Your choices are an Original Medicare plan or a Medicare Advantage plan. They each offer primary coverage, although they offer it differently.
The federal government underwrites Original Medicare Part A and Part B. Part A is your hospital insurance, and Part B is your other medical insurance benefits.
Private insurance companies offer Medicare Advantage Plans. These plans are called Part C and include hospital insurance (Part A), medical insurance (Part B), and other features and benefits.
2. Research The Coverage
Original Medicare covers your hospital services and doctor visits. When you choose original Medicare, you can see any doctor or receive assistance at any hospital that accepts Medicare in the U.S. This plan does not include prescription drug coverage or dental or vision care.
Medicare Advantage covers your hospital and doctor visits and prescription drug coverage. You can receive emergency services from any provider. But to maximize your savings, you are often limited to doctors and hospitals who are in-network.
Networks vary based on your location and can sometimes be limited. Most Medicare Advantage plans include other benefits such as dental and vision coverage.
3. Research Your Costs
Original Medicare Part A has a $0 premium if you have worked and paid into Social Security for 40 quarters. You will be responsible for meeting an out-of-pocket deductible of up to $1600 if hospitalized. This deductible covers the first 60 days of your hospital stay. Anything beyond that comes with an additional co-pay. Other services are in place to assist you with this deductible and co-pay.
Your monthly premium for Part B is income-based. For most seniors, this monthly premium is $164.90 for 2023. If you and your spouse have a high income, your premium can increase incrementally to $560.50.
Medicare Advantage plans vary in out-of-pocket costs, but once you reach your out-of-pocket limits, your plan pays at 100% for the rest of the year.
Take your time and make the right decision during open enrollment. Once you decide, this is your plan for the next twelve months.
Check out websites like My Senior Health Plan.com to learn more.