You can purchase different types of private health insurance plans to work alongside of, or replace, Original Medicare.Medicare Supplement policies are issued by private insurance companies in standardized plans. The standardized Medicare Supplement plans include: A, B, C, D, F, G, K, L, M and N.While the benefits are regulated, each private company is free to set its own premiums. You might see that one company is less expensive than another in your zip code or state.When researching a Medicare Supplement plan that best fits your needs, you should consider: price, reviews, availability in your state or zip code, and extra benefits.Medicare Advantage plans require you to pay a small copayment or coinsurance for each service or procedure. Every dollar you spend is tracked and counts against your out-of-pocket maximum, which means that you are protected against high out-of-pocket costs.You should consider Medicare Advantage if you would like your plan to cover: vision, hearing, transportation to medical appointments, and dental.
Original Medicare is a federal health insurance program that makes health care more affordable for millions of Americans. It does not cover every dollar of health care costs, however. Instead, you are expected to pay for a share of the services or procedures you require. The costs that you pay are often called gaps. Filling in these gaps in Original Medicare is a high priority for most people. The gaps in Medicare are slightly different for Part A and Part B of Original Medicare.
Gaps in Part A
For Part A, which covers inpatient events like going to the hospital, you can expect to pay the Part A deductible. The amount of this deductible was $1,408 for 2020. This means that you would have to pay the first $1,408 of total costs before Medicare starts covering your expenses. Unlike private health insurance, you may have to pay the deductible more than once in a year. This would happen if you used Part A services several times, during instances separated by more than 60 days.
Gaps in Part B
Part B covers you for outpatient services such as:
Doctor appointmentsPhysical or occupational therapyDiagnostic testing, such as blood work or X-raysOutpatient surgeries, such as arthroscopic surgeryDurable medical equipment, such as CPAP machinesCertain cancer treatments, such as chemotherapy
Part B also has the following out-of-pocket costs that you can expect to pay:
Part B deductible – $198 for 2020Part B coinsurance – 20% of the cost of every service or procedurePart B excess charges – up to 15% of the Medicare-approved cost for services
You are required to pay the first $198 for Part B services out of pocket. After this, Medicare will cover 80% of the costs. You pay the remaining 20%, plus any excess charges, as well as the coinsurance on every procedure or service for the rest of the year. There is no cap on the amount you could spend for Part A and B. Also, Original Medicare does not cover the costs of prescription drugs. As such, you will either pay full price out of pocket, or need to enroll in a standalone Part D prescription drug plan. Another gap in Original Medicare is that it will not cover you when you are traveling outside of the US. These are the gaps in Original Medicare. During some years, your total spending might be minimal, while in other years, you could pay thousands in out-of-pocket costs. This leaves most people wondering how to lower their potential costs. There are two main products Medicare-eligible individuals use to close the gaps in Original Medicare. The first is Medicare Supplement insurance, and the other is Medicare Advantage. In the information gathered below, we will briefly review the specifics of both, then discuss Medicare plan reviews.
Medicare Supplement Plan Reviews
Since Medicare Supplement insurance fills in some or all of the gaps in Original Medicare, these plans are often called Medigap plans. Medigap policies are issued by private insurance companies in standardized plans. The standardized Medigap plans include: A, B, C, D, F, G, K, L, M and N. Each of the standardized Medigap plans covers a slightly different portion of the Original Medicare gaps. All Medigap plans limit your out-of-pocket spending, and several of them provide emergency coverage outside the US.
Medicare Advantage Plan Reviews
Medicare Advantage plans, which are also known as Part C plans, cover the gaps a little differently. Instead of just covering the gaps for you, Part C plans require you to pay a small copayment or coinsurance for each service or procedure. These copays and coinsurance amounts tend to be smaller than what you would pay under Original Medicare. This is especially true for short-term hospital stays. Also, every dollar you spend is tracked and counts against your out-of-pocket maximum, which means that you are protected against high out-of-pocket costs. Many Medicare Advantage plans provide emergency coverage outside the US. Prescription drug coverage is also available with some Medicare Advantage plans.
Choosing Between Medicare Advantage and Medicare Supplement Plans
It can be difficult to choose between these two plan types. To figure out which is right for you, it is helpful to ask yourself the following questions:
Will I split my time between two or more homes in different states?Do I want to be able to choose any doctor in the country for medical care?Do I already have supplemental coverage, like dental, vision, and hearing, or do I want that to be included in my Medicare plan?
Medicare Supplement insurance works well for people who answered “yes” to some or all of these questions. Medicare Supplement insurance allows for maximum flexibility. Specifically, you can see any doctor in the U.S. who accepts Medicare patients. Medicare Supplement plans only cover what Original Medicare covers. This means that you will need to pay cash for things like dental, vision, and hearing care. Otherwise, you will have to purchase separate supplemental policies. These policies can work well, but they will add to the cost of your coverage. Medicare Advantage plans are a good fit for those who will live in only one place. Every Part C plan provides emergency and urgent care all across the US. However, it is important to note that you cannot just see any Primary Care Physician like you can with Medigap. Medicare Advantage plans tend to be HMO or PPO based. With an HMO, you must see doctors that are within the plan network. PPOs let you see more doctors, but non-network providers will cost you more. Part C plans often provide coverage not available in Original Medicare. You should consider Medicare Advantage if you would like your plan to cover things like:
VisionHearingTransportation to medical appointmentsDental (basic coverage may be included)
Choosing a Medicare Supplement Insurance Plan
There is a lot of confusion out there surrounding Medicare Supplement plans. It is important that the benefits of Medigap plans are standardized. Every Medigap plan (A, B, C, D, F, G, K, L, M and N) offers the same coverage, no matter which company you choose. This means that when you look at Mutual of Omaha Medicare Supplement Plan G reviews, or United Healthcare Medicare Supplement reviews, what you are really getting is people’s own individual opinions and perceptions of the company. The actual coverage is identical, because that is what the law requires. Another factor that can be different, besides customer service, is the pricing. While the benefits are regulated, each company is free to set its own premiums. As such, it may be that one company is less expensive than another in your zip code or state. In light of this information, you may be wondering what you should pay attention to most when looking for a Medigap plan. You should look for the standardized plan that you want from the insurance company that best fits your needs regarding the following criteria:
Price (monthly premium)Reviews (a good indicator of service)Availability in your state or zip codeExtra benefits
Not every Medigap company offers extra benefits. However, some do offer discounts on things like vision care or prescription drugs. Others may even offer perks like gym memberships for their customers. Another thing to look at is the financial strength of the Medigap companies. Since these are supplemental plans issued by private companies, you want to make sure that they are financially sound. You can also check to see how long a company has been in the Medigap business. You are not likely to go wrong in choosing a company that has been in the business a long while and is one with which you are already familiar. The bottom line is to remember that online reviews always relate to some type of personal experience a person has had with a company. This means that Medicare Supplement Plan N reviews, or Plan F reviews, will reflect the perceptions of customer service or ease of use, but they will provide any insight on the quality of the actual coverage.
Using Medicare Plan Reviews to Your Advantage
As you near the age to enroll in Medicare, you are likely to look at Medicare Advantage reviews or browse Medicare Supplement plan reviews. This is a good starting place as you begin to look for coverage. It is critical, though, to make sure that any plan you are interested in is available in your specific area. And, if it is a Medicare Advantage plan, you need to make sure your doctor accepts it. If you would like to have some help finding a plan, consider working with a licensed professional. This way, you can have some expert advice as you look at reviews, compare quotes, and enroll in the plan of your choice. Each Medicare plan and insurance product we feature has been independently selected and reviewed by the Medicare Expert USA team. If you make a purchase using the links included, Parade.com may be compensated. Next up, here’show to be a good caregiver and take good care of yourself, too.
