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Medicare Open enrollment is here, so let’s look at your options and what they all mean

You are now 65 and can sign up for Medicare.  Now what?  For most people it can be very confusing navigating all the choices out there. Part A, Part B, C, D Plan G Plan F and so on, it’s enough to make a person go cross eyed. What does it all mean?  Let’s look at some of the basics.

What does Medicare cover?

Let’s start with the Medicare basics and what it covers.  For starters it does not cover everything.  

·         Medicare Part A:

This is your hospital plan.  In general Part A usually covers your hospital care, skilled nursing facility care, nursing home care, hospice and home health services. It does not cover all these costs. You will most likely have to share in the cost of these services. For example for 2015 you will have a Part A deductible of $1,260.  If you are in the hospital more than 60 days you could end up paying $315 coinsurance per day.  Check with your Doctor to find out what is covered and your share of the costs.

If you worked and paid Medicare taxes while you worked, you will not have to pay a premium to get Medicare part A.

·         Medicare Part B:

This is your medical insurance and covers things like preventative care.  Part B does have a monthly premium.  For 2015 most people will pay $104.90. Depending on your income you may end up paying more each month.  Again, Part B like Part A will not cover all your expenses.  Typically you will have to pay 20% of the approved medical expenses plus a $147 deductible. Again, double check with your Doctor to find out what is covered.

·         Medicare Part D:

This is your prescription drug plan.  To get a prescription drug plan you must join a plan that is run by a private insurance company that is approved by Medicare. 

You have Options

Now you know the basics of Medicare let’s look at some other options you have.

·         Medicare Part C:

Medicare Part C is an alternative to original Medicare. It’s also known as an Advantage Plan.  It combines Part A & B together and sometimes includes Part D. If you have a Medicare Advantage plan, you will still have to pay the part B premium.   These plans are managed by private insurance companies and must cover medically-necessary services. However, plans can charge different copayments, coinsurance, or deductibles for these services.

·         Medicare Supplements also called Medigap policies

These plans are sold by private insurance companies and compliment Medicare Parts A & B. They help pay what Medicare doesn’t, like coinsurance, copays and deductibles.  Medicare supplements are broken down into different plans. The most popular plans that I see are plan G and plan F.  Plan F covers Medicare Parts A & B deductibles, Part B excessive charges (which would be the 20% you would be responsible for), and more.  Plan G essentially pays the way Plan F would except it will not pay for the Part B deductible of $147.  This makes Plan G more affordable. 

Final Thoughts

Medicare is a great plan for seniors turning 65, but it will not cover everything.  As we age we will have more health problems that will cause us to spend more money out of our pocket to pay for them.  In my experience Medicare Supplement plans are a great way to prevent your health care costs from getting out of control and is also accepted by any doctor that accepts Medicare.  Medicare Advantage plans will still cause you to have to pay out of pocket expenses and you have to make sure the plan is accepted by your doctor. 

The above information is a basic description of Medicare and options available. To learn more about out of pocket costs and what is covered you can visit www.medicare.gov or stop in and we can help you navigate the maze.   Do your research or give us a call to see which plans would best fit your needs. 

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