Turning 65 creates an opportunity for someone to transition their health insurance coverage from personal or employer coverage to Medicare. This transition can be overwhelming because there are several parts to understand about Medicare and the amount of information being made available to you is abundant.
Medicare Parts A and B are what most people are somewhat familiar with. Both of these Parts you must enroll via your Social Security office, via the Social Security phone number or online via the web-site medicare.gov. Unfortunately, Part A and B alone will not cover all the costs of most peoples medical bills. As a result, you have the option of purchasing a Medicare Supplement or a Medicare Advantage plan to help fill in the gaps of coverage.
If you are interested in additional coverage, you can do this through Medicare Advantage Plans ( also referred to as Part C) or Medicare Supplement Plans. These are both offered through other health insurance carriers as a complement to your Medicare Part A and B coverage. If you elected to enroll in one of these, you have to chose between them as you cannot be enrolled in a Medicare Advantage Plan and a Medicare Supplement Plan at the same time.
Medicare Advantage Plans
Medicare Advantage Plans are health plan options that are approved by Medicare but run by private companies. They are part of the Medicare Program, and sometimes called “Part C.” When you join a Medicare Advantage Plan, you are still in Medicare. As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have the Original Medicare Plan, or you belong to a Medicare Advantage Plan (like an HMO or PPO). Medicare Advantage Plans have specific networks, typically having HMO and PPO plan options. You are required to have Part A and Part B and continue to pay the monthly Part B premium in order to be enrolled in a Medicare Advantage Plan.
Medicare Supplements are sometimes also referred to as Medigap Plans. With a Medicare Supplement, you can go to any doctor or provider then accepts Medicare. There are several plan options to chose from, each with its own schedule of benefits and monthly premiums. You are required to have both Part A and Part B and pay your monthly Part B premium to be enrolled in a Medicare Supplement Plan.
Prescription Drug Coverage
Medicare Part D Plans provide prescription drug coverage. These plans are offered through insurance carriers. Dealing with Medicare Part D can be difficult because each year there are typically 30 or more options to chose from. If you enroll in a Medicare Advantage Plan, you can typically choose one which includes Part D coverage. Otherwise, you can purchase a stand alone Medicare Part D Plan. Choosing the best plan option involves reviewing the plan summary detail, plan premiums, and especially the plan formulary based on what prescription drugs you are purchasing.