Why do I need more than original Medicare Parts A & B?
Medicare A & B do a fair job at paying for your medical expenses, however there are a few serious gaps in coverage that require most retirees to address. For instance, the Part A hospital deductible exceeds $1,500 (2022) per admission, Skilled Nursing Facility co-insurance for rehabilitation requires over $14,000 for those who need the full 100 days to recover from a medical event, and Part B has no out-of-pocket cap on the 20% co-insurance that you must pay for chemotherapy, radiation and/or dialysis treatments that some may require in the future. These noted exposures are just a few things to be concerned with related to original Medicare A & B alone.
So what are my options to protect against these Medicare gaps? There are essentially 2 options to address these and other exposures; Medicare Supplement or Medicare Advantage. Medicare Supplement policies pay these gaps after original Medicare pays its share first. Plan G for instance covers 100% of all Medicare Parts A & B approved claims after you pay the first$233 annual Part B deductible per year (2022). Medicare Supplement also allows you to use ANY Medicare assigned medical provider in the U.S. without a referral.
Medicare Advantage (MA) is not a supplement, but rather, a replacement for Medicare Parts A & B (and sometimes D) by a private insurance company. MAs typically have a PPO or HMO network, cover at least as much as original Medicare and will limit out-of-pocket expenses to as much as $7,550 per year (2022). Some MA plans also include extra benefits such as dental, vision or gym memberships. But be aware of limited provider networks, medical procedure pre-approvals, and harder-to-budget out-of-pocket costs. Another consideration with MA plans is that it may be difficult to move to Medicare Supplement in the future as Medicare Supplement plans require medical underwriting beyond 6 months of your Part B effective date and at least 65 years of age and may not accept those with certain pre-existing conditions.
Do I also need to enroll in Medicare Part D?
Part D covers outpatient prescription drugs and it is recommended to either enroll in a Part D plan along with your Medicare Supplement or add Part D coverage as part of your MA plan. Part D is voluntary, however you will be penalized for waiting to add Part D at a later date as much as a 1% penalty for each month of deferred enrollment.
With whom can I review my Medicare product choices? Creekside Insurance Advisors Inc. specializes in all Medicare plan types and will help you be informed to make the correct decision for your own unique health insurance needs and budget. There is no cost to using our services.
For Medicare questions and needs, please contact one of your agents.