But the final decision for you needs to be made by you, and for unique health care and lifestyle needs. Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier.
Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.
Whether you're just starting out with Medicare, need to brush up on the facts, or are helping a loved one, start your journey here. Boost your Medicare know-how with reliable, up-to-date news and information delivered to your inbox every month.
We apologize for any inconvenience and encourage you to try again later. Working Past Medicare Costs. Shopping for Medicare. Get Started. Medicare Made Clear. Medicare Made Clear Whether you're just starting out with Medicare, need to brush up on the facts, or are helping a loved one, start your journey here.
Introduction to Medicare. Explore More. Get the Latest Boost your Medicare know-how with reliable, up-to-date news and information delivered to your inbox every month. Sign up now. Her most recent startup, 65 Incorporated, helps people 65 and older get the clear, correct, complete, and credible information they need to make important Medicare decisions. She is also the architect behind the i65 Medicare optimization software suite. We aim to help you make informed healthcare decisions.
We follow strict editorial standards to give you the most accurate and unbiased information. Should you choose Original Medicare or Medicare Advantage? Which Part D prescription drug plan is best for you? Should you buy Medicare Supplement Insurance? If you go with Original Medicare, see which Medigap policy best works for you.
Part A covers hospitalizations, some skilled nursing facility care, home health care and hospice. Part B covers physician and outpatient services and preventive services. There is government-set cost-sharing with both Part A and Part B.
About two-thirds of the 60 million Americans who are eligible for Medicare are enrolled in Original Medicare. Medicare Advantage plans are sold by private insurers as an alternative to Original Medicare. Medicare Advantage plans, also known as Medicare Part C, may offer additional benefits, including dental and vision coverage. And, most Advantage plans incorporate Part D prescription drug coverage.
Cost sharing is determined by each insurer. Medicare Part D prescription drug coverage is also administered by private insurers. Part D is an optional program that covers prescription drugs. Medicare Supplement Insurance , known as Medigap policies, help pay for out-of-pocket health care costs you incur with Original Medicare.
One main difference between Medicare Advantage and Original Medicare is access to providers. With Original Medicare, you may visit any provider that accepts Medicare payments. Medicare Advantage plans usually contract with a network of providers to help keep costs down, enabling most plans to provide additional benefits beyond those offered in Original Medicare. Providers move in and out of networks frequently. Some Medicare Advantage plans do allow members to see out-of-network providers.
And plans must cover medically necessary out-of-network emergency care. Coverage includes the entire U. This option is also attractive to those who have particular physicians and hospitals they want to use. Available from private, Medicare-approved insurance companies, Medicare Advantage policies Part C are marketed to consumers under such names as Aetna, Humana, and Kaiser Foundation Medicare plans.
They may have no premium or a lower one compared to the significant premiums for Medigap and prescription drug insurance policies.
Medicare Advantage plans cover hospitals and doctors and often include prescription drug coverage and some services not covered by Medicare, too. A little more than one-third of Medicare beneficiaries choose one of these plans. HMOs limit members to using the doctors and hospitals in their networks. PPOs generally let members get care outside the plan's network, but members may have to pay more for such care. Some plans require prior authorization for specialist care or procedures, or a referral from a primary care doctor.
Extra benefits not covered by regular Medicare, such as eyeglasses, routine dental care, or gym memberships, may be offered. Additionally, as there were more than 4, Medicare Advantage plans offered for , it's important to take the time to find the best plan for your unique circumstances.
Begin by checking on your eligibility. To avoid costly penalties and gaps in coverage, most people should sign up for Medicare Part A hospitals and Part B doctors in the seven-month window that starts three months before the month you turn 65 and runs for another three months following your 65th birthday.
If you currently get Social Security, you will be automatically enrolled; if not, you need to sign up either online or at your Social Security office. If you are working at age 65, however, and you have employer insurance through a company with more than 20 employees, you have the right to stay on your employer insurance and delay signing up for Medicare Part B until your employer coverage ends.
If you work for an employer with fewer than 20 employees, it is very important to ask the employer whether you are required to sign up for Medicare and get that decision in writing. If you have this kind of drug coverage when you become eligible for Medicare, you are generally allowed to keep it. You generally won't have to pay a penalty if you later decide to enroll in a Medicare prescription drug plan and you haven't gone for longer than 63 continuous days without creditable coverage.
You can supplement this coverage with a stand-alone Medicare Part D prescription drug plan and a Medigap supplemental insurance plan. While signing up for Medicare gets you into Parts A and B, you have to take action on your own to buy these supplemental policies. To get started, find the plans available in your zip code. Once you have created an account at Medicare. All plans must still cover most drugs used by people with Medicare.
Medigap policies are private plans, available from insurance companies or through brokers, but not on medicare. Plans F and G also offer high-deductible versions in some states.
Some plans include emergency medical benefits during foreign travel. Since coverage is standard, there are no ratings of Medigap policies. As of Jan. Medicare Advantage Health Plans are similar to private health insurance.
Most services, such as office visits, lab work, surgery, and many others, are covered after a small co-pay. Each plan has different benefits and rules. Most provide prescription drug coverage. Some require a referral to see a specialist while others do not. Some may pay a portion of out-of-network care, while others will cover only doctors and facilities that are in the HMO or PPO network. There are also other types of Medicare Advantage plans.
However, if you have Medicare Advantage and want to switch to a medigap plan plus a Part D plan, you may have limited medigap options depending on your health —although you can choose any Part D plan during open enrollment.
The plan that was best for you over the past year may not be the best one next year. That may be because the drugs you take or the doctors you see have changed. Or new plans may be introduced in your area that are a better match for you. Mutual of Omaha is entering the Part D market in several states, for example, and more insurers are introducing prescription drug plans or Medicare Advantage plans with lower premiums.
Because you can change plans every year, you can focus specifically on your drugs and dosages or the type of health care you need now; you can switch again next year if your needs or your options change.
You never know what will happen to your health, but you may have some regular expenses that you know will continue — such as visits to certain specialists — and may anticipate some special medical needs for the upcoming year. All of this information will help you choose a plan for next year.
You should have received this form around the end of September. It will indicate any changes for to the cost and coverage of your current plan. Pay particular attention to changes to drug formularies, drug tiers and co-pays that affect drugs you take. The tool makes it easy to compare the premiums and co-payments for all of the plans available in your area, and it also estimates your total out-of-pocket costs for your drugs and dosages and also for your general health condition, if you have a Medicare Advantage plan.
This is the best place to start shopping. For Part D, type in your zip code, the drugs you take and the dosages to compare plans.
0コメント