Choose a Plan and Enroll

April 11, 2009 in Medicare

Medicare Choices

A big decision you will need to make is whether you want Original Medicare (Part A and Part B) or Medicare Advantage. Each covers the same basic services, but they operate differently. Your choice depends on your priorities and preferences.

Once you have chosen either Original Medicare or Medicare Advantage, you will have other choices to make. If you choose Medicare Advantage, you will have to pick a specific plan from a particular company. If you choose Original Medicare, you will have choices of companies and plans when you buy add-ons like Medigap policies, Medicare Supplement plans or stand-alone drug plans.

Each year you should review your health and prescription needs because your health, finances, or coverage may have changed. If you decide other coverage will better meet your needs, you can switch plans during certain times.

Step 1Decide You Would Like

Original Medicare                                          OR                        Medicare Advantage Plan 

                                                                                                                 (HMO or PPO)

Part A (Hospital Insurance) and Part B (Medical Insurance)

  • Medicare provides this coverage
  • You have your choice of doctors, hospitals, and other providers.
  • Generally, you pay deductibles and coinsurance.
  • You usually pay a monthly premium for Part B.

 

Part C-Includes BOTH Part A (Hospital Insurance) and Part B (Medical Insurance)

  • Private insurance companies approved by Medicare provide this coverage
  • In most plans, you need to use plan doctors, hospitals and other providers or you pay more
  • You usually pay a monthly premium (in addition to your Part B premium) and a copayment for covered services.
  • Costs, extra coverage, and rules vary by plan
Step 2Decide If You Want Prescription Drug Coverage (Part D)
If you want this coverage, you must choose and join a Medicare Prescription Drug Plan. These plans are run by private companies approved by Medicare.  If you want this coverage, in most cases you must get it through your Medicare Advantage Plan.Most Medicare Advantage Plans include prescription drug coverage (Part D), usually for an extra cost. 
Step 3Decide If You Want Supplemental Coverage
You may want to get private coverage that fills gaps in Original Medicare coverage.

  • You can choose to buy private supplemental coverage, like a Medigap (Medicare Supplement Insurance) policy.
  • Costs vary by policy and company
  • Employers/unions may offer similar coverage.
Note: If you join a Medicare Advantage Plan, you don’t need a Medigap policy. If you already have a Medigap policy, you can’t use it to pay for any expenses you have under the Medicare Advantage Plan. If you already have a Medicare Advantage Plan, you can’t be sold a Medigap policy.

 

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