| Options |
Description |
Things to Consider |
| Original Medicare |
Part A & B is the federal government
insurance plan available in all 50 states. You are responsible for
deductibles, coinsurance, and copayments. |
- Part B premiums is $96.40 for most Americans.
- Part B annual deductible is $155
- Part A deductible is $1,100
- You may go to any doctor or hospital that accepts Medicare
- If the provider does not accept assignment from Medicare, you
will be responsible for the bill at time of service.
- Doctors can charge up to 15% more than Medicare approved amounts
- Not all services are covered by Medicare, and you may have some
additional out of pocket expenses
|
|
Medicare Supplement Insurance (Medigap) |
This is insurance in addition to Parts A &
B (original Medicare). Medicare pays 80% of approved amounts, the
supplement policy helps to cover the remaining 20%. There are 12
standardized policies (A - L) available through private insurance
carriers. |
- There is a premium for the plan
- Plans A-L each have different benefits
- Every policy except A, offer some deductible & coinsurance
coverage
- Some plans offer extra benefits not otherwise covered by
Medicare (at home recovery, preventive care, foreign travel, etc)
- Plans F & J have high deductible options
- Medicare "Select" policies usually cost less because you must
see specific hospitals and doctors.
|
| Medicare Advantage Plans (Part C) |
Is a plan ran by private insurance
companies that are contracted with Medicare to provide your Part A & B
coverage. Different plans available are:
- HMO = Health Maintenance Organization
- PPO = Preferred Provider Organization
- PFFS = Private Fee For Service
- MSA = Medical Savings Account
|
- Most plans do not charge a premium
- A referral is required to see a specialist with some plans
- Doctors may join or leave the plan at will
- Most plans offer extra benefits that Medicare does not cover
(dental, & eye care)
- HMOs require you to use their hospitals and doctors
- PPOs allow more flexibility to go outside the network for higher
out of pocket expense
- PFFS plans allow you to see any provider that accepts the
plans terms.
|
| Prescriptions |
Part D prescription drug plans are an
optional part of Medicare offered through private insurance companies
contracted with Medicare. |
- You and the insurance company share the 1st $2,830 in covered
prescriptions during the calendar year
- After the $2,830 is met you will be responsible for all covered
prescriptions until you spend $4,550 out of your pocket.
- After the $4,550 has been met you will be covered in the
catastrophic coverage and receive your prescriptions for 5% of the
cost.
|
Medicare is a US government health insurance program
for citizens age 65 and older, or younger persons with
disabilities, or end stage kidney renal disease.
