At Minnesota Benefit Association, our mission is to help you understand various types of insurance benefits and determine which coverage best meets your needs. We understand every Medicare decision is personal, and we’re here to help! Let’s take a look at the basics of Medicare and how to choose the right plan for your lifestyle.
The two main ways to get Medicare coverage are through Original Medicare or a Medicare Advantage Plan. First, let’s talk about Original Medicare.
In 1965, President Lyndon B. Johnson signed Medicare into law. It had two complementary parts, A and B, which are now known as Original Medicare:
While Parts A and B provide widely accepted coverage for inpatient and outpatient services (you can use any doctor or hospital that takes Medicare, anywhere in the U.S.), there are additional costs associated with the care that Original Medicare doesn’t cover.
For example, with Part A, you’d have to pay a deductible before your benefits kicks in to cover your hospital stay, and with Part B, you might pay coinsurance at your appointment, and your doctor may prescribe drugs after your visit. These costs can add up.
To help people with the out-of-pocket expenses associated with Original Medicare, the government partnered with private insurers to create supplemental coverage plans. This includes prescription drug coverage (Medicare Part D), Medicare Advantage plans (Medicare Part C), and Medicare Supplement Insurance (Medigap).
Anyone who has Medicare can access drug coverage. It’s an optional benefit that can be obtained by either adding a Part D plan to Original Medicare (which would be a separate policy with a separate monthly premium), or purchasing a Medicare Advantage plan that includes prescription drug coverage.
A couple things to know about drug coverage plans:
If you’re looking for coverage that goes beyond Original Medicare, adding drug coverage can help ensure you’re able to afford your prescriptions. But if you want even more benefits that Medicare Part A, B, and D don’t cover, you may be interested in a Medicare Advantage plan.
Now that we’ve gone through Medicare A, B, and D, you might be wondering what happened to C! Sometimes called Part C or MA Plans, Medicare Advantage plans are designed to provide an all-in-one alternative to Original Medicare. Like other types of supplemental coverage plans, they are purchased through private companies approved by Medicare.
Though not all Medicare Advantage plans work the same way, these bundled plans typically include coverage for Medicare Part A, Part B, and Part D, plus extra benefits like vision, hearing, dental, and long-term care. Some MA plans even cover wellness costs for things like gym memberships.
The most common types of Medicare Advantage plans are:
Important things to know about Medicare Advantage plans:
Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare coverage – things Part A and B don’t cover, such as copayments and coinsurance. You must have Original Medicare to purchase a Medigap policy.
If you have Original Medicare and you buy a Medigap policy, Medicare first pays its share of the Medicare-approved amount for covered health care costs. Then, your Medigap policy pays its share.
Other important things to know about Medigap policies:
If you want coverage beyond Original Medicare, it can be tricky to decide your best course of action. You can either enroll in a Medicare Advantage plan that satisfies all your wants and needs, or stick with Original Medicare and purchase supplemental coverage plans, like Part D and Medigap.
Here are a few takeaways about Medicare Advantage plans and Medigap:
At MBA, we understand that choosing the best Medicare plan can be a daunting task. There are many factors to consider, but the main things to assess are your lifestyle preferences, medical needs, and budget.
When you contact us, we’ll work as your Medicare advocate, offering free advice to ensure that you understand all of your options and feel confident about selecting a plan. When you have questions, our licensed advisors have answers, so give us a call at 651.358.2990