Starting in a few weeks, we will see many ads on television discussing Medicare supplements. This is because annual enrollment is every year between October 15 and December 7th. Annual enrollment is when seniors on Medicare make their decisions for the next calendar year. Everyone must go on Medicare when they reach age 65 unless they or their spouse are still working for a company with 20 or more employees.
Basic Medicare is an eighty/twenty plan with lots of deductibles. Because of this, about ninety-eight percent of recipients have some type of supplement. There two major types to choose from. One is Medigap and the other is an Advantage plan. Medigap fills in to cover some of the cost not covered by Medicare. Policies are listed under letter between A and N. All companies A plan cover the exact same benefits. There can be a big difference cost to the consumer. Squared Away Blog found a 65-year old woman in Houston, Texas could buy a Plan C policy with exactly the same coverage for $1,700 from one company and it cost $5,300 from another company.
Medigap policies allow you to go to any doctor who accepts Medicare and is accepting new patients. It is often suggested that you should ask your doctor if the accept Medicare a few months before turning 65. If they do not maybe you should look for a new doctor. Most doctors that do accept Medicare will allow current patients to stay on it once they turn 65. If you have Medigap, you will need an additional policy to cover Part D for prescription drugs.
Medigap is the biggest network of providers in the country because you can go to a doctor anywhere in the country if they are accepting Medicare and new patients. It may have fewer out of pocket cost. The negative aspect is it is usually more expensive and does not cover some of the extra thing an Advantage plan might cover. You also might not qualify if your health has gotten worse. There are no pre-existing conditions in the first six months you are eligible for Medicare, but there may be later.
Advantage plans or Part C of Medicare have networks of providers. Some are very large and some are quite small. They have lower monthly premiums, sometimes as low as zero dollar monthly charge. They may have some co-payments depending on if the provider is in network or not. Usually they have some prescription coverage built into them so they do not require an extra Part D prescription plan. Often they offer additional benefits that Medigap policies do not such as health club memberships, glasses and hearing aids.
It is important to study your specific health care needs when selecting what supplement you will purchase. It must cover the doctors that you use and include enough specialists to cover changing health care decisions. Formularies are the list of drugs that are covered by a particular plan. You must check to make sure that the particular drugs you take are covered by your plan. The difference can sometimes be thousands of dollars per year. If your medication changes during the year, you can adjust your coverage during next year’s annual enrollment period.
Choose your plan carefully and make sure whoever is helping you make plan decisions have access to both types of supplements and that they are checking multiple insurance companies to find the best economic fit for your health care needs. You also should do this review every year because there are often changes made in the plan themselves and what was best last year may not be so this year.
Call Kelly at the office and she can check your doctors and prescriptions to make sure you are not paying more than you need too. This is one way to control how much money you must set aside in your budget for medical expense.