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Since 1966, the government’s Medicare program, also known as Medicare Part A and Part B, has helped millions of Americans obtain health care. It includes coverage at the hospital (known as Medicare Part A) and at the doctor’s office (known as Medicare Part B).
Unfortunately, Medicare Part A and Part B can become expensive. When going to the doctor, you must pay for 20% of your care out-of-pocket. And, there is no maximum cap on these fees, meaning the more care you need, the more you may have to pay. Medicare Part A and Part B also does not cover prescription drugs, meaning you do not get any help paying for medication at the pharmacy. Add to that the fact that there is no coverage for dental, vision, and long term care, and Medicare Part A and Part B can have gaps in coverage that may not be enough for your needs.
Fortunately, the government has authorized certain health insurance companies to offer Private Medicare plans (known as Medicare Part C) that offers coverage that Parts A and B do not. It is important to note that Medicare Part C replaces Medicare Part A and Part B, and cannot be used in conjunction with Part A and Part B plans. However, Private Medicare plans are a great way to help lower your out-of-pocket costs and get the benefits that you may deserve.
Medicare2017.org has access to many Medicare health insurance companies offering Private Medicare plan options with one simple to use website. Helping you make sense of your enrollment options has never been easier with Medicare2017.org.
Learn more about Medicare2017.org and some common Medicare questions here.
To start comparing your options, just enter your zip code to begin.
What Is It? Medicare Part A and Part B is the health insurance coverage provided by the government. Part A is for inpatient or hospital coverage and Part B is for outpatient or doctor's office coverage.
Who Is Eligible? To be eligible, you must be 65 years old, and have paid federal taxes for at least 10 of your working years,or under 65 years old with certain disabilities.
When Can I Enroll? You can enroll in Medicare Part A and Part B during the Initial Enrollment Period. The Initial Enrollment Period is the 7 months surrounding your 65th birthday (3 months before you turn 65 years old, the month you turn 65 years old, and 3 months after you turn 65 years old).
If you miss the Initial Enrollment Period, you can sign up during the General Enrollment Period, which is between January 1 and March 31. Unfortunately, you have to wait until July 1 for your coverage to begin. Additionally, you could pay higher premiums when you purchase supplemental coverage from a private insurer.
If you or your spouse are currently over 65 and have health coverage through your employer, you may be eligible to get Medicare Part A and Part B during the Special Enrollment Period. The Special Enrollment Period will begin once your employer-based coverage expires.
How Much Does It Cost? For Part A, or hospital care, most pay $0 if they have paid Medicare taxes for at least 10 years. If you did not pay taxes, you could pay as much as $413 a month in 2017. When using hospital-related services, you will need to pay a deductible of $1,316 for 2017 before the plan starts paying for the rest of the costs. If you are hospitalized multiple times a year, you may have to pay the deductible for each hospitalization. Also, if you are in the hospital for more than 60 days, you could face a co-pay of $329-$658 or more per day.
For Part B, or doctor's office care, most pay about $134 per month in 2017. The deductible is $183 each year. When using doctor's-office-related services, you will have to pay 20% of costs out-of-pocket.
How to Enroll in Medicare Part A and Part B? You can apply online at https://www.ssa.gov/medicare/, on the phone at 1-800-772-1213, or visit your local Social Security office. You can learn more at medicare.gov.
Learn more about Medicare Part A and Part B here.
What Is It? Medigap, also known as Medicare Supplement Insurance, is offered by private insurance companies. They help fill the coverage "gaps" left open by Medicare Part A and Part B. There are 10 types of Medigap plans. They are Plans A, B, C, D, F, G, K, L, M and N. Not every insurer offers all 10 plans, and prices can vary, but the amount of coverage is the same across companies.
Why Get It? Many can find Medicare Part A and Part B to have too many "gaps" in coverage. Supplementing your coverage with a Medigap plan may help to reduce the amount you pay out-of-pocket when using medical services. Multiple or extended hospitalizations (60 days or more) could potentially costa lot of money out of pocket. So could just one or two outpatient procedures. That is why it may be more cost effective to purchase a Medigap plan, even when factoring in the monthly premium.
Some Medigap plans may also provide you with additional coverage, such as emergency health care when you are travelling internationally, and care at a nursing facility. Be sure to talk with the insurance company offering the plan to fully understand what the plan covers before you sign up.
Who Is Eligible? To be eligible, you must be enrolled in Medicare Part A and Part B.
When Can I Enroll? You must enroll during the Medigap Enrollment Period, which begins 6 months after you turn 65. Those under 65 can enroll if they have a disability. Remember, you must have Medicare Part A and Part B to qualify for enrollment.
If you miss the Medigap Enrollment Period, you may still be able to enroll in a plan. However, insurers are not required by law to accept your enrollment, and can deny you coverage based on pre-existing conditions.
How Much Does It Cost? Premiums for Medigap plans start at around $89* per month, but may vary depending on the plan you choose and the state you live in. Plan F tends to be a popular choice. It covers the deductible costs of Medicare Part A ($1,316 in 2017) and Part B ($183 in 2017). Plan F premiums begin around $129* per month in 2017.
How to Enroll in Medigap? You can compare leading Medigap options here on Medicare2017.org. After you choose a plan, the enrollment process is simple. To begin, just enter your zip code and tell us about yourself.
Learn more about Medigap here.
What Is It? Medicare Advantage Plans (also known as Medicare Part C) provide your Medicare Part A and Part B benefits (Parts A & B), along with additional medical coverage, all in one convenient private insurance plan. The additional coverage helps limit, and helps pay for, your out-of-pocket medical expenses.
Unlike Medicare Part A and Part B, many Medicare Advantage plans may also include coverage for prescription drugs (also known as Part D). Medicare Advantage plans may also include dental, vision, and other benefits. Since every plan varies, it is important to understand what your plan covers before signing up.
Most Medicare Advantage Plans tend to be either HMOs or PPOs. HMOs involve using a set of in-network doctors, specialists and hospitals. They typically require you to coordinate your care through a primary care physician, who can refer you to specialists when needed. PPOs tend to have larger networks and do not typically require referrals for specialists. Since Medicare Advantage HMOs and PPOs provide most of your health coverage in a single plan, they can seem similar to the insurance you may have had through an employer.
Why Get It? Medicare Advantage plans can help to reduce the amount you pay out-of-pocket for health care. Medicare Part A and Part B requires you pay for 20% of medical costs when needing outpatient care. It also requires you to pay a set fee per day when hospitalized for 60 days or more, which can vary depending your plan. Further, there is no cap on your out-of-pocket costs. There also is no coverage for prescription drugs, meaning you pay for 100% of costs at the pharmacy.
Medicare Advantage plans can help pay for all of these out-of-pocket costs, with many plans including prescription drug coverage. They also place a "worst-case" maximum limit on your out-of-pocket costs. These limits vary from plan to plan, but can be very affordable. Medicare Advantage maximum out-of-pocket limits can keep your costs both affordable and predictable.
Some people may prefer Medicare Advantage over Medigap because they enjoy the convenience of having one plan. Medigap plans work on top of, or in addition to, Medicare Part A and Part B. Medicare Advantage plans replace Medicare Part A and Part B, and often include additional benefits.
Who Is Eligible? Those who are eligible for Medicare Part A and Part B can enroll in Medicare Advantage. To be eligible for Medicare Part A and Part B, you must be 65 years or older. Those under 65 may eligible if they are disabled.
When Can I Enroll? There are three enrollment periods for Medicare Advantage.The first is the Initial Enrollment Period. Initial Enrollment is the 7 month period surrounding your 65th birthday -- 3 months before you turn 65, the month you turn 65, and 3 months after you turn 65.
You can also enroll in a Medicare Advantage Plan during the Medicare Open Enrollment Period. The 2017 Medicare Open Enrollment Period begins on October 15 and ends on December 7. If you already have a plan, but would like a new one, this is also the time where you are permitted to change plans.
The third way to enroll for a Medicare Advantage plan is during the Special Enrollment Period. The Special Enrollment Period is only open to those who recently had a major life change, such as if you recently moved or lost health coverage.
Since Special Enrollment is limited, it is important that you do not miss the Initial or Open Enrollment Periods. Your coverage could be delayed if you wait to enroll in a Special Enrollment period.
How Much Does It Cost? Monthly premiums for Medicare Advantage plans greatly vary based on the plan you choose and the state you live in. Some plans cost $0** per month, while others cost much more. The average premium for Medicare Advantage is around $39** per month.
How to Enroll? You can compare multiple Medicare Advantage plan options here on Medicare2017.org! After you choose a plan for your needs, it is easy to apply. To begin, just enter your zip code and tell us about yourself.
Learn more about Medicare Advantage here.
What Is It? Medicare Part A and Part B does not include coverage for prescription drugs at the pharmacy. Fortunately, the government has allowed certain private insurers to offer Medicare Prescription Drug plans (also known as Medicare Part D).
There are two types of Part D plans. The first type is Medicare Advantage Prescription Drug Plans (MAPDPs). This type of coverage is included as part of a Medicare Advantage plan, so you will only be able to access this plan’s coverage if you enroll in a Medicare Advantage plan (also known as Medicare Part C).
The other type is standalone Prescription Drug Plans (SPDPs). This is the type of coverage you get separately along with Medicare Part A and Part B. So, you have two choices for drug coverage: Medicare Part A, Part B, and a standalone prescription drug plan (Medicare Part D), or Medicare Advantage with a Medicare Advantage Prescription Drug Plan.
Why Get It? Paying for prescription drugs out-of-pocket can be very expensive. If you are currently taking medication, or think you may need to, it is highly recommended to get a Medicare Prescription Drug Plan.
Who Is Eligible? You must be eligible for Medicare Part A and Part B to get a Medicare Prescription Drug plan.
When Can I Enroll? Both Medicare Advantage Prescription Drug Plans and Standalone Prescription Drug Plans are best purchased during the Initial Enrollment Period or the Open Enrollment Period.
The Initial Enrollment Period is the 7-month period surrounding your 65th birthday -- 3 months before you turn 65, the month you turn 65, and 3 months after you turn 65. If you fail to get coverage during this time, you could face having to pay the Medicare Part D penalty. Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($35.63 in 2017) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.
After the Initial Enrollment Period, the next time you can enroll in a prescription drug plan is the Open Enrollment Period, which begins on October 15 and ends on December 7. You may also switch Prescription Drug plans during the Open Enrollment period if you are already enrolled in one and would like to change plans.
Lastly, it may be possible to enroll in a Prescription Drug plan during the Special Enrollment Period. It is important to remember that the Special Enrollment Period is only open to those who recently had a major life change, such as a move or a loss of health coverage.
Since Special Enrollment is limited, it is important that you do not miss the Initial or Open Enrollment Periods. Your coverage start could be delayed, and you could also face paying a penalty for not having coverage. As of 2017, the penalty is $35.63 times the numbers of months you went without coverage. For example, if you went 36 months without Part D, you would have to pay $1,282.68 for the year.
How Much Does It Cost? Monthly premiums for Medicare Prescription Drug Plans vary by carrier, plan, the state you live in, and the prescription drugs you require. Premiums for MAPDPs (those that go with Medicare Advantage plans) average around $5-$20*** per month, but can start as low as $0*** per month. SPDPs (those that go with Medicare Part A and Part B plans) start around $11.40*** per month.
The deductible, or the amount you have to pay before the plan kicks-in, can also greatly vary. However, by law, your deductible cannot exceed $400 per year in 2017. Many plans may have deductibles that are even more affordable.
Also, it is important to note that once your total prescription drug costs exceed $3,700, the insurance temporarily pays less -- 60% for brand name and 49% for generic drug costs -- for the next $1,740 in drug costs. This coverage gap is known as the "Part D Donut Hole." After that, the plan kicks back in as catastrophic coverage and starts paying for nearly all of the new costs.
When shopping for a plan, it is important to compare plans side by side, and by formulary. The formulary is the exact drugs that the plan covers, and different formularies have different costs.
How to Enroll? You can compare Medicare Prescription Drug options here on Medicare2017.org! You can apply once you find the right plan for your needs. To begin, just enter your zip code and tell us about yourself.
Learn more about Medicare Prescription Drug Plans here.