Medicare 101

Medicare 101

Medicare offers multiple plans that might seem overwhelming to choose between. Where to begin? Here’s a go-to guide to help you understand what you need to know when examining which plan offers the most advantages for you.

First, there are several plans available to you through Medicare: Part A, Part B, Part C, Part D and Supplemental Policies. Each offers unique advantages, dependent upon what might be best for your individual health care needs. We’ll begin with a look at Medicare Part A.

Medicare Part A provides hospital coverage, something you obtain when you first enroll in Medicare. In general, it includes your standard hospital fees such as hospital rooms, hospital tests and hospital doctors. An advantage to this is that you’re eligible as soon as you turn 65, and even more, there are typically no premiums! However, Medicare Part A may not cover all of your health care needs.

The next option is Medicare Part B. Part B is often referred to as Medicare Insurance and offers medically necessary services and preventative services. Part B comes with a monthly premium, which can be deducted from your Social Security check. When both Part A and Part B are used, this is what we referred to as Original Medicare. However, keep in mind that though Original Medicare does cover initial basic hospital fees, it will not cover all costs and you may have to pay deductibles, co-pays or coinsurance for services that aren’t covered.

Following Medicare Part B is Medicare Part C, or Medicare Advantage. Much like the name implies, Medicare Advantage offers many benefits. Medicare Advantage combines Part A and Part B, and can also cover additional health care needs such as vision, dental and hearing. Many Medicare Advantage plans come with an annual deductible, designed to help keep your monthly premium down. Among these fees, you may also need to pay for co-pays and coinsurance for services you use, while paying nothing for services you do not use. Most Medicare Advantage plans also cover Total Care, a “one-stop” approach for health care offering an entire network of health care providers working collaboratively to manage a patient’s overall health, including: primary care providers, nurses, specialists and care managers. You can take advantage of Medicare Advantage either when you first turn 65, during the annual Open Enrollment period between Oct. 15 and Dec. 7 and also during special event periods such as moving or job changes.

Next on our list is Medicare Part D, known as prescription drug coverage. If you are interested in prescription drug coverage, it is important to note that each Medicare prescription drug plan has its own list of covered drugs. For those who are eligible, Part D is a supplemental addition that should be closely monitored to ensure you are taking full advantage of your prescription coverage. These drug plans can annually make changes to their coverage list (also known as formulary) and the annual open enrollment periods offer you the chance to switch plans that include your prescriptions.

Lastly, there are Supplemental Policies. Supplemental Policies, also known as Medigap, are designed to bridge the gap not fully covered in Original Medicare (Part A and Part B). Medigap policies may cover some or all of the costs for deductibles, copays and coinsurance. However, these policies typically do not cover vision, dental or long term care. To use a Medigap policy, you have to be enrolled in both Part A and Part B. However, you will need to continue to pay Part B premiums on top of any added expenses associated with Medigap.

There are many things to consider when selecting and evaluating a Medicare plan that is right for you.

Deciding between options involves careful evaluation that includes preparation, independent research, and selecting a plan that offers the most advantages for you.

Visit HCPNV.com/OpenEnrollment and medicare.gov for more information on which Medicare plan may be best for you and the benefits of Medicare Advantage.