Medicare101: A Healthy Solution for Your Fit Life
Medicare can be complicated - even confusing - with the multiple parts and the many choices it has to offer. There are lots of letters, plan names and terms to understand. Learning the Medicare lingo is the first step in understanding how Medicare works.
Original Medicare
(Part A & B)
Part A (Hospital)
It covers care you receive while an inpatient in a hospital or skilled nursing facility. Think of it as the room that you're in and the bed that you're on.
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Premium: $0 for most people
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Deductible: $1,556 per benefit period
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Copay: Varies
Part B (Medical)
It covers care you receive while an outpatient such as doctor visits, lab work, emergency services. But it also covers fees charged by doctors who participate in your care while in the hospital.
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Base Premium: $170.10/month
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Deductible: $233/year
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Coinsurance: 20% + any excess charges
There is no limit to what you pay under Original Medicare. The more services you use, the more you keep paying and paying and...paying. It's for this reason why most people seek additional coverage through a Medicare Supplement or Medicare Advantage plan.
Original Medicare
Part A
Hospital
Part B
Medical
Medicare Options
Option #1
Med. Supp. + Part D
Option #2
Medicare Advantage
There are two routes to choose from when seeking additional coverage with Medicare.
Original Medicare
Part A
Hospital
Part B
Medical
You can add:
Medigap
Medicare Supplement
Insurance
Medicare Supplement
(Medigap)
Medicare Supplement (Medigap) plans help cover GAPS in costs left behind by Medicare, such as deductibles, coinsurances and copayments. They are sold by private insurance companies and are used alongside Original Medicare.
There are 10 Medicare Supplement plans to choose from. Each plan is labeled with a letter and each letter provides different coverage. The more coverage a letter provides, the more it will cost you in premiums. Click here to view the different types of coverage.
But they don't cover prescription drugs.
If you decide a Medicare Supplement plan is right for you, you'll also need to purchase a separate Part D plan for prescription drug coverage.
Scroll down to learn more.
Prescription Drugs
(Part D)
Original Medicare doesn't cover most prescriptions. And Medicare Supplements don't cover them at all. So most people have to purchase a Medicare Part D plan separately to cover their medications.
Part D plans are administered by private insurance companies and they vary in cost and covered drugs from company to company.
You can obtain Part D Prescription drug coverage by:
1) Enrolling in a stand-alone Part D plan. You will pair your Part D plan alongside Original Medicare & a Medicare Supplement.
2) Enrolling in a Part C Medicare Advantage plan. Most Medicare Advantage plans INCLUDE Part D drug coverage at no additional cost.
Scroll down to learn more
Original Medicare
Part A
Hospital
Part B
Medical
You can add:
Medigap
Medicare Supplement
Insurance
You can add:
Part D
Prescription Drug
Coverage
Part C: Medicare Advantage
Part A
Hospital
Part B
Medical
INCLUDES
Part D
Prescription Drug
Coverage
INCLUDES
Routine Vision
Preventive/
Comprehensive
Dental
Hearing
Health club
Membership
Over-the-Counter
Allowance
Medicare Advantage
(Part C)
Medicare Advantage plans offer All-In-One coverage under a single plan. They pull together the services covered under Part A & Part B of Original Medicare, combine it with Part D drug coverage AND toss in EXTRA BENEFITS at no additional cost. Most plans offer this all-inclusive coverage at NO MONTHLY PREMIUM.*
No monthly premium?
Yes! Medicare Advantage plans are offered by private companies who are approved by Medicare. They are paid by the federal government to manage your benefits. You're still required to pay your Medicare Part B premium, but with a $0 premium Medicare Advantage plan there won't be anything in addition to that.
Medicare Advantage plans were created as an alternative to Medicare Supplements.
They have become increasingly popular because of their VALUE through All-In-One coverage. Approximately 40% of Medicare beneficiaries in the St. Louis metro area are enrolled in a Medicare Advantage plan.
Medicare Supplement + Part D
or
Medicare Avantage
"What plan is right for me?"
It might be tempting to follow the advice of a family member or friend of which Medicare plan is best for you. You may even think, "If that plan works for them, it'll work for me too."
The truth is: Every person has different healthcare needs. And every person has different financial means as well. So if you're wondering how to pick the right plan but don't know where to start, speak to an expert.
A Free Medicare Consultation with Scott Joyce will provide a personalized proposal including:
- Medicare Supplement vs. Medicare Advantage Comparison
- Estimated Prescription Drug Costs
- Doctor Network Participation