The Different Types of Medicare Plans - Insurance for Seniors, LLC.
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The Different Types of Medicare Plans

The Different Types of Medicare Plans

Currently, there are more than 62 million Medicare beneficiaries. That number is expected to rise significantly within the next few years.

While Medicare seems to be a hot political topic, it is also clear that millions of Americans rely on Medicare to pay for their healthcare needs. By knowing about the different types of Medicare plans out there, you will be better able to choose the right plans for you.

So keep on reading and we will take you through everything that you are going to want to know!

Original Medicare

Original Medicare consists of Medicare Parts A and B. It is also referred to as traditional Medicare and it works on a fee-for-service basis. This means that you can go to any hospital or doctor that accepts Medicare and Medicare will pay its share of the bill.

You pay the rest of the bill unless you have additional insurance that can cover those expenses. While Original Medicare provides a lot of health care supplies and services, it won’t cover all of your costs.

If you’re eligible for Original Medicare, then you will be automatically enrolled through Social Security. If you would like to receive care from a  private Medicare Advantage plan, such as a PPO or an HMO, instead of the traditional program, you’ll need to actively enroll in a plan.

If you would rather stick with Original Medicare, you can get coverage for prescription medications by joining a private Part D drug plan for an additional premium.

You can also get Medigap, which is a type of private supplemental insurance that covers some out-of-pocket costs in Original Medicare.

Medicare Advantage (Medicare Part C)

You can use Medicare Advantage plans as an alternative to Original Medicare. These plans are also known as Medicare Part C plans.

These are plans that are offered by private insurance companies. They cover the same health care services as Original Medicare. However, they might also offer other health care services that Original Medicare does not cover.

Two examples of Medicare Advantage plans are Preferred Provider Organizations (PPO) and Health Maintenance Organizations (HMO).

With Medicare Advantage plans, you typically pay a small copayment when you visit your doctor. You can usually only visit hospitals, specialists, and doctors who are on your plan’s list. Otherwise, you might end up paying more or the services might not be covered at all.

However, if you need emergency or urgent care, your Medicare Advantage plan will pay for the services that you get.

Medicare Part D

Medicare Part D covers prescription drugs. These plans are sold by private insurance providers that set their own prescription prices, premiums, and other expenses that can vary from one plan to another.

If you have a Medicare Part D plan, you will likely need to pay a deductible amount before your coverage starts.

Also, for each medication that is covered by your plan, you’ll pay either a percentage of the drug cost (coinsurance) or a fixed amount (copayment) for each prescription.

Coinsurance and copayment amounts will depend on whether the medication is a brand name or generic. The insurance plan will also put the drug into a certain price tier. The cheapest tier is tier 1.

Different insurance plans can put the same medications in different tiers.

Your medication costs will also vary depending on whether a plan covers your medications and the specific amount that you need. It will also depend on whether you buy drugs at a pharmacy that is part of the plan’s pharmacy network.

Because these details can change from one year to another, it’s important that you go over your plan options before you renew the policy each year.

Your coinsurance or copayment amount will also depend on what time of year you purchase the covered medication.

Medicare Supplemental (Medigap) Insurance

Also referred to as Medicare supplement insurance, Medigap plans are sold by private insurance companies. These plans are meant to pay for some of the health care costs (“gaps”) that aren’t covered by Original Medicare.

These gaps can include coinsurance, deductibles, and more. You have a one-time six-month open enrollment period for Medigap that starts the first month you turn 65 and enrolled in Medicare Part B.

This period gives you a guaranteed chance to purchase any Medigap policy sold in your state, matter what the status of your health is.

When you have Medigap, Medicare will pay its part of the covered health care costs first. The Medigap policy will then pay its share of benefits.

An insurance company that sells you a Medigap policy can only sell you a “standardized” policy.

Every Medigap policy is going to offer the same basic benefits. However, some plans will offer other benefits.

Plans are usually distinguished by certain letters. Plans with the same letter will cover the same benefits. This is true even if the plan is sold by different companies.

The Importance of Knowing the Different Types of Medicare Plans

Hopefully, after reading the above article, you now have a better idea of what the different types of Medicare plans are. As we can see, there are a variety of plans that you should know about.

The more you know about these plans, the better you will be at making decisions when it comes to your finances and your health.

Are you looking for the right kind of insurance that’s fit for you? Contact us today and see how we can help you!

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