Medicare is health care for Americans that are over the age of 65 in most cases. When on Medicare you do have some options, and many people ask; "What is the best Medicare Plan?" Unfortunately, it is not that simple as you really should have the plan that fits your needs. Of course, we all know if money isn't an issue then anyone could just pay for the top-priced plans and call it a day, unfortunately many of us are on fixed incomes and money can be an issue.
In my time working in the Medicare industry I have heard and seen so many different situations; from people that have an extreme excess of disposable cash to people that have to choose between their medications and their food in some months.
Differences between your options:
Original Medicare
With Original Medicare, you have coverage for your hospitals and doctors. Without diving too deep into details, you essentially have a Large deductible when you are admitted to the hospital, and a small annual deductible you must meet for the doctors. Once that is met you are paying 20% of the bill. This, of course, is an oversimplification, as, most people do not choose to stay on Orignal Medicare only.
A few pro's and con's of staying on Original Medicare
Pros:
Freedom of choice of doctors, you can go to any doctor nationwide that accepts Medicare, roughly 97% of doctors take Original Medicare.
No Referrals
Cons:
Original Medicare does not cover prescription drugs, If you choose not to pick up an additional plan for your prescriptions, you will receive a lifetime penalty once you decide to do so.
No Maximum cap- There is no stop gap on your costs with original Medicare. This means your responsible amount of monies to pay is unlimited and can really add up.
Medicare Supplement(Medigap) pros and cons.
Pros:
Since a Medigap supplements your Medicare, your Original Medicare stays intact and your supplement picks up some or all of the portions you are responsible to pay. You also retain the ability to have freedom of choice of doctors just like Original Medicare.
No Referrals
Very low out-of-pocket, if any, responsibility when you go to the doctor or hospital.
You can change a Medigap at any time as long as you can Medically qualify.
Cons:
Medicare Supplements do not cover prescription drugs, If you choose not to pick up an additional plan for your prescriptions, you will receive a lifetime penalty once you decide to do so.
In most cases, you must go through medical underwriting.
High Premiums - dependant on the state and/or your age the costs vary, in Florida for example in most areas a Plan G will be over $200 a month, $2400 a year.
Premiums increase annually in most cases.
Medicare Advantage (Medicare Part C) pros and cons.
Pros:
In most cases, these plans include drug coverage.
Additional benefits above and beyond what Medicare covers, such as dental, vision, hearing, gym memberships, and more.
Low to $0 premiums in most areas.
Plans catered to Chronic conditions such as diabetes, heart conditions, COPD, etc.
Additional benefits for Medicaid beneficiaries, and special plans for members with Medicare and Medicaid.
In some areas, some plans can reduce the amount you are paying for part B of Medicare.
Maximum out of pocket to limit the amount you would be responsible for in a given year, depending on the area and plan these can be as low as $1500 for the year or could be as much a $7,500 for the year in the network.
Cons:
Usually network-based, you have to see doctors contracted with the plan.
Referrals are needed in many cases.
Pays instead of Original Medicare, in other words, you must keep your Medicare Part A and B, as well as pay the part B premium, but Medicare is kind of in a hold status as the plan is responsible for your healthcare.
So what's best for me?
This is why I always do a thorough needs analysis with my clients as at the end of the day, you should choose a plan that is best for you and your needs, not the insurance carrier, or the agent you are speaking with. It is also best to speak with someone who represents more than just 1 to 3 insurance companies to ensure you are getting true comparison to see what's out there.
Free Plan review and consultation!!
Call 727-678-1505 to have one of our experts review your current plan, you may have benefits you are not using and we can show you have to get the most, or there could be a better plan in your area, in many cases, there are ways to change without waiting until the October Annual Enrollment Period. It never hurts to look, and it is wise to review these annually to ensure you are on the best plan for YOU!!
Or you can use our self compare tool at www.E-adviseInsurance.com if you want to take a look for yourself. Keep in mind due to companies and requirements not all plans in all states are shown on the self-enrollment tool. our agents can see all the plans in your area.
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