As you near retirement age, you may find yourself flooded with brochures and commercials about what Medicare option is right for you.
You know you need to sign up for something, but with so many choices how do you determine which healthcare plan will provide adequate coverage?
The Two Medicare Options
There are two ways you can acquire Medicare coverage. You can choose to have the Government as your primary source of insurance, known as Original Medicare. Or you can opt to have a private insurance company provide you with similar coverage through a Medicare Advantage plan.
The Original Medicare program (Parts A and B) is offered directly through the Government. Medicare Parts A and B typically
A Medicare Advantage plan (Part C) on the other hand is a private health insurance policy, underwritten by a private health insurance company, which replaces your original Medicare coverage (Parts A & B). With Medicare Part C, only the private company is responsible for paying your medical claims – the government is no longer responsible for those expenses.
Legally, the private company has to provide you with “equal or better” coverage than what you would get with original Medicare. Some plans go above and beyond original Medicare by offering additional benefits, such as vision, dental, and prescription drugs (Part D).
Of course, these benefits can be purchased even if you have original Medicare, so it’s wise to compare the costs carefully.
Is A Medicare Advantage Plan Right For Me?
The first significant element in assessing if an Advantage plan is a fit for you is your health history.
If you expect your health care expenses to be high, you may consider an Advantage plan because most Advantage plans have a yearly limit on your out-of-pocket costs for medical expenses.
The limit is known as your out-of-pocket maximum, and after you reach it, you pay nothing for the rest of the year. With O
Another key factor when determining whether or not an Advantage plan is right for you will be your travel plans during retirement. Medicare Advantage Plans are usually structured as HMOs, and therefore, you are limited to a network and geographic area that services are provided.
You may be limited to a selection of physicians that you can use, forcing you to stop seeing a long-time trusted physician who is not part of the network.
Also, if you plan to spend winter or summer months in another location, you may have limited coverage (except in emergency situations) forcing you to return home for treatment.
Keep in mind, these are only a few considerations for determining a coverage that is right for you. You should also consider your budget, medical needs, and coverage preferences when picking a plan.