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How Do You Choose the Best Medicare Coverage?

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How Do You Choose the Best Medicare Coverage

Medicare is a federal health insurance program for people age 65 or older, certain people with disabilities, and people with End-Stage Renal Disease. As you near age 65, you’ll want to decide which type of Medicare coverage is best for you to enroll in: Original Medicare (which can be paired with Medicare Supplement insurance) or Medicare Advantage.

Public vs. Private

Original Medicare, the public option, covers Medicare Part A and Part B. Medicare Part A helps cover hospital stays, care in skilled nursing facilities, hospice care, and some home health care.1 Medicare Part B helps cover certain doctors’ services, preventative services, outpatient care, and medical supplies.1

Original Medicare can be combined with Medicare Supplement insurance

Medicare Supplement insurance is meant to complement existing Original Medicare coverage to help with out of pocket expenses not covered.

Medicare Supplement insurance can only be purchased when you have Original Medicare.

Medicare Advantage

Medicare Advantage Plans cover Medicare Part A, Part B, and usually Part D. They are offered by private companies approved by Medicare.

Medicare Advantage cannot be combined with Medicare Supplement insurance.

Original Medicare vs. Medicare Advantage

Both Original Medicare and Medicare Advantage allow you to use Medicare benefits, just in different ways.

This may seem like a lot to take in, so we’ve listed three factors you may want to consider when choosing the best Medicare coverage for you:

  1. Hassle
  2. Coverage
  3. Choice

1. Hassle

Original Medicare
Original Medicare and Medicare Supplement insurance policies can’t drop your coverage. Both are guaranteed renewable, which means that as long as the premiums are paid on time, you will continue to be covered.

Medicare Advantage
The coverage period for Medicare Advantage plans is one year. They have limited guarantees when it comes to coverage. They can change every year, drop your coverage, or change the providers in your network.

The federal government requires that plan sponsors send an Annual Notice of Change, or ANOC, to participants. An ANOC is sent to you each fall and “includes any changes in coverage, costs, or service area that will be effective in January.”2

2. Coverage

Original Medicare
Original Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care settings. Services are either covered under Part A or Part B.

Medicare Supplement insurance can help pay some of your out-of-pocket costs not covered by Medicare like deductibles, coinsurance, copayments, etc.

Medicare Advantage
Medicare Advantage Plans cover Medicare Part A, Part B, and usually Part D. They are offered by private companies approved by Medicare. Medicare Supplement policies provide supplemental coverage for services that Original Medicare approves.

3. Doctor and Hospital Choice

Original Medicare
Original Medicare allows you to choose from any doctor in the United States that accepts Medicare.

Under Medicare Supplement insurance, you can go to a doctor or hospital that accepts Original Medicare. If a doctor accepts Medicare, they generally accept Medicare Supplement insurance.

Medicare Advantage
With Medicare Advantage, you can choose from a network of doctors that the provider has preapproved.

If you are considering Medicare Advantage and want to stay with your doctor or hospital, ensure the doctor or hospital is in the plan's network.

Conclusion

Consider your needs and priorities for Medicare coverage as you near age 65.

Research whether Original Medicare—by itself or paired with Medicare Supplement insurance—or Medicare Advantage will better suit your needs.

Contact a licensed insurance agent to ask questions and speak more on the topic.

Sources:
1. Medicare.gov, Understanding Medicare Advantage Plans, 2020

2. Medicare.gov, Plan Annual Notice of Change (ANOC), 2020

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