Understanding Medicare and using it to its full advantage can be hard. As a licensed insurance agent, even we spend well over 100+ hours a year learning the various plans and changes to coverage. There are four main types of Medicare, or Parts, that consumers need to understand; original Medicare (Medicare Part A & B), Medicare Advantage, Medicare Supplements, and Prescription Drug Coverage or Part D. Unfortunately, studying involves a big, thick handbook called ‘Medicare & You’ which provides valuable information, but most people find it difficult to relate too. At The Premier Agency, we recommend you take it one step at a time and, eventually, navigating Medicare will be a piece of cake! With the help of course of a trusted independent insurance advisor like us!
Medicare is designed for people 65 and older, however you may be eligible at a younger age if you have a qualifying disability. Traditional or Original Medicare is really a combination of Parts A and B. This is your hospital coverage (Part A) and your medical coverage (Part B). What most people don’t understand is that Medicare does not cover your entire medical bill. There are deductibles, co-pays, and co-insurance. For specifics, we’ll need to talk but generally speaking, Part A requires a sizable deductible and has limitations on coverage for things like hospital stays and more. Think of your Part B coverage as an 80/20 plan. Medicare covers 80%, you cover the balance. Again, there is a whole lot more to that so to learn more, give us a call today.
To cover this gap in coverage that traditional or original Medicare doesn’t cover and to minimize our clients out of pocket expenses, we look to Medicare Advantage Plans and Medicare Supplement Plans. Medicare Advantage Plans take the place of original Medicare and typically add extra benefits such as fitness programs, credits for over the counter products, and free telehealth visits, dental, vision, hearing aids, and more. These are things original Medicare doesn’t cover! In addition, most Medicare Advantage Plans also include coverage for prescription drugs! There are pros and cons to Medicare Advantage Plans, so fortunately you have another option. If you don’t want to enroll in a Medicare Advantage plan, you might look at a Medicare Supplement Plan to help cover your out-of-pocket expenses. These plans are often referred to as Gap coverage and covers the gap between what Medicare covers and what you have to pay. They follow the same guidelines as Medicare and normally don’t include any additional benefits…
Last up is your Prescription Drug Coverage or Part D. That’s right, original Medicare doesn’t provide coverage for prescription drugs either. You need a separate plan for that. Fortunately, they are all regulated by Medicare, however each plan is different and may provide different levels of coverage. So if you plan on sticking with original Medicare, you will need to spend even more time learning about Part D plans. Option 2, look for a Medicare Advantage plan that provides prescription drug coverage.
If that wasn’t enough, you should also be on the lookout for changes in your Medicare coverage. If you have not gotten that information in the mail, check the Medicare Plan Finder tool or call us for more information. Plans change all the time and knowing what is covered and what isn’t covered is really important!
At The Premier Agency, our goal is to take the stress and frustration out of navigating Medicare. We are here to help guide you through the process and enable you to make an informed decision when it comes to what plan is right for you. If you have any questions or we can help you in any way, please contact us today!