Author: Bruce Sims

Top Medicare Annual Enrollment Options

The Annual Enrollment Period for selecting Medicare options is ongoing.

Medicare coverage decisions can only occur during the period from October 15 to December 7 of each year. The “Special Election Periods” allow, under specific circumstances, changes during other parts of the year.

The annual application period receives much attention, advertising from insurance companies and comments on what is at stake?

The government provides Medicare services in part A and part B. Private insurance companies sell supplemental insurance to cover many of the costs that part A and part B do not cover and part D drug coverage.

Private insurance companies also offer Part C “Medicare Advantage” plans. They offer original Medicare services; Often with other benefits.

This will not examine the details of all options. We discuss here the choice between the original Medicare options and the Medicare Advantage options. The conclusion is the possible direct costs that a person must bear in any case.

Original Medicare has awards for Part B and any supplemental policies purchased. However, there are fewer copays and coinsurance. Medicare Advantage plans usually have much lower monthly premiums, but generally higher co-payments and reinsurance; but there are maximum “total expenses” expenses to protect against higher hospitalization expenses and other causes. To choose to use Original Medicare or Medicare Advantage plans request a projection of the amount of medical care needed.

Original Medicare is generally best suited for those who expect to need more medical services. Although the premium is higher than most Medicare Advantage plans, lower co-pay and co-insurance costs may make the best bet. If you feel you do not need much medical attention, a Medicare Advantage plan may be the best option. The lowest award saves money on Original Medicare Part B and a complementary policy; and there is a limit if you need more medical attention than expected. In addition, Medicare Advantage Plans often offer additional benefits, such as vision or dental services, that Original Medicare does not have.

Trying to calculate possible cost differences is, by itself, trying. But the general principles are a good guide on what to consider. If it is clear that a lot of medical attention is needed, original Medicare planning should be considered. When little medical attention is expected, a Medicare Advantage plan may have the advantage of a lower monthly premium; But perhaps some additional benefits.

Cost is always important. However, if you have doctors and other favorite providers, make sure they are on the network of any Medicare Advantage plan.

 

Are Medicare Advantage Plans worth it?

Medicare Advantage plans can offer powerful coverage to many seniors in Pennsylvania. These plans can pay for the cost of visits to the emergency room, doctor’s offices, clinic or pharmacy. They are not sold by Medicare, though. Rather, insurance companies are selling them. Nonetheless, they can handle the majority of out-of-pocket medical care expenses. That said, it is worth your time to consider evaluating the Medicare Advantage plans for Pennsylvania for 2020.

Medicare Advantage Plan Includes 

MA plans are designed to give seniors a lot of coverage. Medicare made sure that these plans can help people who have difficulty paying for their healthcare bills every month.

Any Advantage plans you pick will cover the cost of inpatient and outpatient medical cost. The coverage also includes emergency medical care and urgently required healthcare. But the benefits do not stop there.

Medicare Advantage plansYou can find Medicare Advantage plans that can pay for the Medicare Part D cost. This plan can handle your prescription drugs, whether they are generic or brand names.

Some plans cover the overall cost of annual checkups and some prescription medical equipment like eyeglasses and hearing aids.

Plus, there are some member perks that you can take advantage of without the extra charge. These perks would include gym memberships and other medical expenses that are regarded as non-essential but proven to be useful to some seniors.

Before you sign up to one of the plans from a certain provider, make sure to ask its perks. Doing so will help you evaluate whether such provider offers a great value to its clients.

What If You Have an Existing Medicare Insurance Policy 

The Advantage plan is a robust policy. That’s why it is used as a replacement for some healthcare plans. In most cases, you will need to give up some of your existing medical insurance coverage.

But Medicare Advantage can work with Original Medicare. Your new provider will give you the coverage under the Initial Medicare. Some MA plans will have Part D coverage.

You cannot obtain an MA plan with Part D if you already have bought Part D. Since Medicare does not allow overlapping of coverage, you should get an MA plan without Part D. But it is an affordable option if you pick an MA plan with Part D, rather than having Part D separately.

If you are not sure whether your current plan is compatible with a Medicare Advantage plan, you may contact our team today. We can guide you in picking the right deal.

What is the Overall Cost of Medicare Advantage  

Once you have a Medicare Advantage plan, you are required to pay a monthly premium. Otherwise, you will not get coverage if you wish to use the plan. Some seniors can avail of $0 monthly premium. However, the deductible for this plan is high.  Visit https://www.medicareadvantageplans2020.org to get rates online.

You can compare rates for Medicare Advantage plans online or by calling the insurance carriers direct. The rates are changing periodically. So the prices this year might be different from the rates last year or the following year.

Coverage Limitations of Medicare Advantage

There are limits for Medicare Advantage. Not all medical facilities in the US will accept your Medicare Advantage plan. Those who accept it are part of your insurer’s network.

These limitations should be carefully considered as they can affect how you will get coverage for treatment. Insurance providers will give you two main options — HMO and PPO.

For HMO plans, full coverage is only given when you go on the network. The PPO plan offers partial coverage if you go off the network and full coverage for treatments received within the network of your plan.

If you are not sure how to weigh your options, consider talking to our health insurance experts. You can ask them about which of the Medicare Advantage plans can be the right option for your circumstance.

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