What is Medicare?
Different parts of Medicare cover different services. Not having credible coverage for all of the parts can cause you to incur a late enrollment penalty when you do enroll.
If you don't qualify for premium-free Part A, you can still buy it with monthly payments. If you paid Medicare taxes for a period less than 30 quarters, your premium may be around $499. If taxes were paid for over 30 quarters, but less than 40 quarters, the premium is about $274.
The general rate for Part B Premiums (Medical Insurance) is $170.10 in 2022. This may differ depending on your income. If you are a high income earner, you may be charged an additional Income Related Monthly Adjustment Amount (IRMAA) for your part B and part D premium. Talk with me to see if you qualify for an exception to this IRMAA charge. Conversely, there are also programs offered to cover your part B Premium and help with your part D premium if your income falls within a specified range. I can help to assess your eligibility.
Part A and B of Medicare cover general hospital and medical insurance. Together, they’re called Original Medicare. Although they pay for a lot of your medical needs, they leave you to pay large deductibles and a 20% coinsurance on part B services without a limit on what that number could add up to. This leaves you financially vulnerable for medical costs.
Original Medicare also does not offer prescription drug coverage, but is mandated by Medicare. So if you don’t enroll into one of these plans, you may face a penalty down the road. Not to mention paying the full cost of prescriptions.
Other considerations include how to cover the cost of your dental, vision, and hearing needs. These services (unless medically necessary) are not covered in Original Medicare.
Medicare Supplement vs. Medicare Advantage
There are basically 2 options in covering the gaps in Original Medicare.
Medicare Supplement: You pay a monthly premium to have this type of plan. When you recieve services, Original Medicare pays first and then the supplement picks up its portion of deductibles and coinsurance that is left after Medicare pays. A supplement generally does not cover what Medicare does not cover (Rx, dental, vision, etc.), so you would need to combine this plan with a prescription drug plan and possibly a dental and vision plan as well.
Medicare Advantage Plan: $0 or low monthly premium. This style of coverage combines the benefits offered in Original Medicare with additional benefits such as prescription drugs, dental, vision, hearing, over the counter products, and other useful benefits. In an advantage plan, you are paying copays and coinsurances as you use the services and you are protected by a Maximum Out Of Pocket amount. Coverage does depend on the usage of the chosen carriers network. There are a lot of variables within these plans and it is best to consult with a knowledgeable broker when deciding which plan and carrier will best serve you.
We can make an appointment to discuss the pros and cons of each alternative and see which one is better for you.