Medicare: How to Make Sure You Have the
Coverage You Need
Avoid Unnecessary Gaps and Expenses
Medicare is a fantastic benefit for those over age 65, covering a majority of the medical expenses you’ll occur.
However, it is important to understand that Medicare still leaves you exposed to unlimited medical expenses. For instance, did you know that the $1,184 Part A deductible is not an annual deductible? You can incur that expense more than once a year.
You’ll also be paying 20%, and sometimes more, for your hospital charges. For doctor visits you’re left covering the Part B deductible and 20 percent of the expense.
To protect your retirement savings, it is critical that you have either a Medicare supplement plan, or a Medicare Advantage plan.
Getting the right Medicare plan is an easy process:
- Understand your options
- Pick your plan
Understanding Your Medicare Plan Options
You have a lot of options to choose from, which can feel confusing and overwhelming. But when you understand the fundamentals, it becomes much easier.
(Original) Medicare: This is the plan administered directly by the government. You can choose to take Part A (hospital coverage) and/or Part B (medical coverage), and if you have A and/or B, you can also purchase Part D (prescription coverage).
Medigap: Medigap plans help cover the gaps between what Medicare will pay and what you would otherwise pay out of pocket, such as deductibles, copayments and coinsurance. However, they do not cover gaps in prescription drug coverage.
Medigap is private insurance, also known as a Medicare supplement plan, that you can purchase to supplement your coverage, but only if you have Original Medicare, both Parts A and B.
Medicare Advantage: These plans, also known as Medicare Part C, provide your Part A and Part B Medicare benefits through a private company, but unlike Medicare they have a stop-loss to prevent unlimited medical costs from ruining you financially,
Medicare Advantage plans are similar in operation to an HMO or PPO in that you have a list of doctors to choose from. Another difference with Medicare Advantage is that many of these plans offer coverage that Original Medicare doesn’t, including benefits for dental work, vision and hearing care, and prescriptions.
Medicare Part D: This is the prescription drug part of the plan. You can purchase a stand-alone Part D plan, or choose a Medicare Advantage plan that already includes Part D.
Which Plan Is Right For You?
If you want to go to the doctors of your choice, sign up for a Medicare supplement plan. These plans will pay most of the charges that Medicare does not, in most cases leaving you with little to nothing out-of-pocket that you will have to pay.
If you would like to keep your monthly costs down, you may choose a Medicare Advantage plan instead. These plans require you to choose from a list of doctors, and you will still have a limited amount of out-of-pocket expenses that you will have to cover.
If you already know you want a Medigap plan, click here to run instant quotes. Our quote system will instantly show you which plans are available in your state, which insurance companies offer them, and what the monthly premiums would be.
If you want an expert, professional opinion on which kind of Medicare plan will offer you the most coverage at the least cost, click here to arrange a confidential consultation. There’s no cost or obligation, and we’ll be happy to help you compare Medicare Advantage plans, Medigap plans and Part D prescription drug plans.
MediGap Advisors can help you find the lowest premium for the plan you want. Even though Medigap plan benefits are standardized, insurance companies set different premiums for the same coverage. Because our licensed agents are not compelled to represent any one insurance company over another, we can help you compare what all the leading companies offer in terms of both benefits and pricing.
When Should I Enroll?
(Original) Medicare: Most people will initially be eligible to enroll in Medicare around the time of their 65th birthday. The initial enrollment window is seven months long: three months before their 65th birthday, the month of their 65th birthday, and three months after their 65th birthday. There are a few exceptions, including for people who become disabled prior to turning 65.
For those people who do not enroll when they’re first eligible, there are also open enrollment periods from October 15 through December 7 of each year.
Medigap: It’s best to sign up for Medigap coverage at the time you are first eligible to purchase it. This is because during this first period of eligibility, you will not be asked to meet medical underwriting requirements (although you may have a pre-existing condition waiting period, usually six months).
The initial eligibility period for Medigap insurance is six months long and begins on the first day of the first month that both of the following are true: you are at least 65 and you are enrolled in Medicare Part B.
You can still purchase Medigap insurance if you decide after you are first eligible for it that you’d like a Medigap policy. However, you’re likely to pay a premium penalty, and will usually have to meet the medical underwriting guidelines of the insurance carrier you've chosen.
Medicare Advantage: You can enroll in Medicare Advantage plans (Part C):
- When you are first eligible for Medicare, usually at age 65, but sometimes at earlier or later dates due to disability, the fact that you’re still working and have work-provided insurance, or other circumstances
- During open enrollment, which is October 15 through December 7 of each year (you can also change your plan from one Medicare Advantage provider to another)
- During special enrollment periods, which are tied to certain life changes
We’re Here to Help You Make the Right Choice
At Medi Gap Advisors, we understand Medicare can be confusing, so we provide extensive educational resources right on our website. This is one of the features our many satisfied customers have told us they like most, as you can read on our testimonials Web page. You may also want to check out our Better Business Bureau “A+” rating, and see the “No-Risk, Totally Thrilled Money-Back Guarantee” issued by our president, Wiley Long.
Once you begin working with your own Personal Benefits Manager, you’ll be able to call or email her or him directly, any time you need assistance.