If you are nearing 65, it is time to start thinking about Medicare and have a good understanding of what type(s) of options you will need. It is a common misconception for some people that Medicare covers everything. However, they soon find out that they were sadly mistaken when realize the many gaps that are not covered with the basic plan. With only a limited amount of time to enroll, you want to be sure that you are getting the Medicare options that best suit your current and anticipated healthcare needs.
Just the Basics With Parts A & B
The money that you paid into Medicare during your working years entitles most people to Part A coverage from the government for free. Part B coverage has a monthly premium of $104.90 for 2015, for those who have a higher income this amount could be higher. Both Part A and Part B have coinsurance and deductibles.
With Parts A & B, you will need to pay out-of-pocket for, include:
- Prescription drugs
- Vision care
- Dental care
- Hearing care
- Doctors that do not accept Medicare
Advantages of a Medicare Advantage Plan
Some people stick to the basic Part A and Part B and hope for the best. But for others who have many medical expenses or want more flexibility with their insurance, there is the option of a Medicare Advantage plan. Also known as Medicare Part C, this type of plan is administered by a private insurer that has been approved by Medicare. Medicare Advantage combines Parts A & B coverage into one plan. You usually have an option to go with an HMO or PPO plan that will require you to stay within their network of doctors.
Depending upon the Medicare Advantage plan chosen, it may offer such extras as:
- Eye exams
- Dental care
- Hear aids
- Prescriptions under some plans
Dealing With Prescription Costs
With current and future drug costs, being caught without prescription drug coverage can be risky. If you do not opt for a Medicare Advantage plan, Medicare Part D can provide you with coverage for prescription drugs. If you do have Medicare Advantage, be sure to consult with your insurance advisor to make sure you are covered for prescriptions because having both Part D and Medicare Advantage for prescription coverage could create a conflict that can cause one or the other from being automatically cancelled. The problem that not many people realize with the Part D option is that if you do not choose it when you begin Medicare and wait to choose it later, you will be fined for each month that you did not carry that option.
To Supplement or Not To Supplement?
Despite the previous Medicare options, there may be out-of-pocket costs that fall outside the scope of their coverage. For this, the option of having a Medicare Supplement policy is available. This Medicare option available from private insurers covers the expenses that are not met under Parts A and B, such as copays and deductibles that otherwise would cause a financial burden for many patients. This coverage can be used along with Parts A and B at providers who accept Medicare.