Understanding Medicare Plans: The Different Types of Health Insurance

advinclark March 5, 2021

0 385 4 minutes read

Are you eligible for Medicare? Are you wondering about the different types of insurance available to you?

Medicare is a federal health insurance program available to those are sixty-five and over, as well as younger people with certain disabilities. There’s a little bit of research involved in understanding Medicare plans, as well as determining which ones are right for you.

Here’s what you need to know.

Table of Contents

What Is Basic Medicare (Parts A and B)?

If you’re over age sixty-five and have worked and paid Medicare taxes for at least ten years, you’re eligible for premium-free Medicare Part A. This is also true if your spouse has worked and paid Medicare taxes for ten years or more, or if you or your spouse had Medicaid-covered government employment.

Perhaps you or your spouse didn’t pay Medicare taxes while you worked. If you’re over the age of sixty-five, you may be able to purchase part A.

Medicare Part A covers things like hospital stays and skilled nursing facilities. It will also pay for hospice, surgery, and home health care.

Medicare Part B, on the other hand, will help you pay for services from doctors and specialists. Medical equipment and some preventative services are also available through Part B.

The standard premium for Medicare Part B is $148.50 monthly. Most folks pay the standard premium. Some, however, will pay more depending upon their income.

What Is Medicare Part D?

Medicare Part D allows you to get prescription drug coverage. Depending upon your income, you could be paying anywhere from $0 to $77 per month for this extra coverage.

If you or your spouse tend to pay a lot for prescription drugs, it may be worth it for you to invest in Medicare Part D.

What Is Medicare Part C (Medicare Advantage)?

Medicare Advantage plans are offered by private companies that get approved by Medicare.

Advantage plans cover all of Part A and Part B, as well as some additional coverage. Depending upon the plan, you may get covered for vision, dental, or hearing care. You may also be covered for fitness and wellness programs such as gym memberships.

Advantage plans will also cover your prescription drugs. Some may also cover additional services such as transportation to doctor visits and adult daycare. If you or your spouse suffers from a chronic illness, plans are permitted to tailor their benefit packages for them.

Medicare does pay a fixed amount each month to the private companies that offer Medicare Advantage plans. These are required to follow rules set by Medicare.

Each Advantage plan has different rules about who can supply you with services, as well as what your out-of-pocket costs will be. Your plan could have a monthly premium or a yearly deductible. You may also get required to use in-network providers.

What Are Medigap Plans?

Medigap plans help are sold by private companies and are often used to fill in the “gaps” in original Medicare. They don’t work with Medicare Advantage plans, so you’ll need to choose one or the other if you’re looking for supplemental coverage.

Medigap policies can get used for covering healthcare costs that remain after Part A and Part B. These include copayments and deductibles. Generally, however, they won’t cover dental care, vision, or hearing aids.

You’ll pay a premium to a private insurance company for Medigap coverage each month. The plan you choose will depend upon your recurring needs.

For example, if you travel a lot, you may be interested in plans F or G, which will cover 80% of the medical costs you may incur in a different country. Plan F will also cover any coinsurance you may be paying for a skilled nursing facility.

Some plans, such as K and L, also have an out-of-pocket limit. After you’ve met it, you won’t be responsible for Medicaid costs for the rest of the year. If you’re looking into Medigap Plan K, know that it also comes with a comparatively low monthly premium.

What Are the Benefits of Medicare?

If you’re receiving social security benefits, you’ll automatically get signed up for Medicare Parts A and B. If you aren’t getting social security, you can sign up three months before your sixty-fifth birthday. It’s also possible to sign up online.

Basic medicare offers a number of advantages to seniors and those with disabilities. Firstly, it provides basic Medicare to those who otherwise wouldn’t have it. And it can end up saving them a great deal in hospital fees and doctor bills.

Medicare also allows folks to have access to prescription medications they wouldn’t otherwise be able to afford. It’s also led to improved standards for hospital enrollment.

Supplemental plans such as Medicare Advantage and various Medigap plans can also end up saving you a good deal of money in the long run. They may also be able to coordinate your care for you.

Choosing the right Medicare plan will require some thoughtful planning and cost calculation on your part. For example, does the cost of a prescription drug plan save you money based on your medications? Does it make sense to get covered for fitness programs?

Medicare coverage is a personal decision. With the right plan, however, you can save money and enjoy all of the benefits you need.