Many seniors may be tempted to believe that they don’t have to worry about health care costs anymore the moment they turn 65 and are eligible for Medicare, but unfortunately this is not the case. Medicare was created as a basic insurance for seniors, but not as an all-inclusive insurance plan to cover all medical needs. You need to carefully check your health care and prescription drugs needs and compare it to what is really covered. If you can think of any medical expenses that you need now or might have in the future, it is time to consider adding additional coverage to your original Medicare plan.
As basic Medicare typically only pays up to 80% for medical expenses, it is essential to add extra coverage in order to be able to afford necessary medical care later, when you need it. So what can you do to be better covered for your health care costs?
First, let’s look at the 4 parts of Medicare which you should know about:
Whenever you hear somebody refer to original Medicare they are typically referring to Medicare Part A and Part B. While Part A provides benefits related to hospital expenses, Part B offsets costs for medically necessary services and certain preventive care, such as doctor’s visits or certain medical equipment. There are several things that Medicare does NOT cover, such as eye care, dental or hearing aids, and that you have generally to pay 20% of the Medicare-approved amount for the doctor’s visits.
Next to those parts that are provided by Medicare, there is also Part C (Medicare Advantage plans), which provides beneficiaries the option to ‘trade’ their original Medicare coverage for health care cost coverage through private insurance companies rather then through the Federal Government. Those private providers are approved and compensated by the government, and the plans they offer must include all
services that would otherwise be provided by Medicare. Many seniors prefer this kind of insurance, because most plans include much better coverage and offer many extras such as fitness programs. In order to be able to afford this, the beneficiaries will usually have to use the services of participating doctors and therapy facilities in order to be fully covered.
Similar to Part C is Part D. which regulates the prescription drug coverage under Medicare. Like advantage plans, the benefits in Part D plans must also adhere to standardized Medicare regulations and are also provided by Medicare approved private insurance companies.
Lastly, persons on Medicare have the option to keep their original Medicare plan, and add ‘supplemental’ coverage by means of a Medicare supplemental policy, also called ‘Medigap’ policies. Medigap comes as plans (not parts!) A, B, C, D, F, G, K, L, M, and N. While Medigap policies are also provided through private insurers, the difference to Part C and Part D is that all Medigap plans with the same letter must offer the exact same benefits (e.g. the benefits for a plan G offered by insurer #1 are the exact same as offered by insurer #2). This makes them very easy to compare, as you only need to compare the costs, not the benefits for a plan offered by different insurance companies in your area. Of course, you must first carefully select the plan that best fits your health care needs among the 10 offered plans. You may also find more information about the current plans by downloading the pdf from Medicare.gov Publications
With many different Medicare options to choose from, it makes sense to seek the advice of an experienced independent insurance agent who will likely be in a position to outline much more in-depth what those parameters may possibly mean to you and what you really need to be covered.