Understanding Your Medicare Plan: Coverage

There are many Medicare plans available for retirees that vary based on cost, coverage, and overall plan design. Our team aims to ensure you understand your Medicare plan so that you know what you’re paying for and what each part of Medicare covers.

Original Medicare and Medigap (Supplement Plans)

Original Medicare covers Medicare parts A and B. Medicare Part A covers the following:

  • Inpatient care in a hospital
  • Skilled nursing facility care
  • Nursing home care
  • Hospice care
  • Home health care

Medicare Part B covers medically necessary services and preventive services. The standard Part B premium amount for 2020 is $144.60. Some examples of what Medicare Part B covers:

  • Ambulance services
  • Durable medical equipment (DME)
  • Mental health
  • Medically necessary services
  • Preventive services

Medigap, also known as a Medicare Supplement plan, is sold through private insurance companies. Supplements help pay for some costs that Original Medicare doesn’t cover. With a Supplement, you pay a monthly premium. Depending upon the plan, Supplements will help pay some of your out-of-pocket costs for copayments, coinsurance, and deductibles.

Medicare Advantage

Medicare Part C, or Medicare Advantage (MA), is a Medicare health plan offered to retirees from private insurance companies approved by Medicare. This plan type combines Medicare parts A, B, and if you choose, part D (prescription drug coverage) into an all-inclusive coverage option. MA plans have a low or zero-dollar premium which can make it easier for individuals to keep track of health care expenses. On an MA plan, individuals pay copayments or coinsurance as they use their plan.

MA plans are becoming increasingly popular because they often allow clients to save money and enjoy a suite of benefits. Some of these added benefits can include telehealth, an over-the-counter allowance, dental, hearing, vision, a fitness membership, and more.

Medicare Part D

Medicare Part D provides prescription drug coverage. The cost of your coverage will vary depending on the type of plan you choose and what tier your prescription drugs fall under in your specific plan. If you don’t sign up for Medicare Part D when you’re first eligible and you don’t have creditable prescription drug coverage elsewhere, you’ll likely pay a late enrollment penalty if you choose to join later. Creditable coverage refers to health care coverage outside of Medicare that must meet certain qualifications.

You can join a Prescription Drug Plan by:

  • Purchasing a Prescription Drug Plan in addition to Original Medicare
  • Joining a Medicare Advantage with Prescription Drug plan (MAPD) which is all-inclusive, as mentioned earlier

If you have any questions about Medicare or your Medicare plan, please reach out to us at 1-866-557-1313!

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