Medicare Health Plans

Medicare Health Plans are federal programs instituted in the United States that provide health coverage for individuals aged 65 or older and certain younger individuals with disabilities or specific diseases.

It’s structured into several parts, each catering to different healthcare needs:

• Medicare Part A (Hospital)
• Medicare Part B (Medical)
• Medicare Part D (Medicare Advantage)
• Medicare Part D (Prescription Drug Coverage)

Original Medicare

Original Medicare is a health insurance program for US citizens age 65 and older as well as some people under 65 who have a disability or ESRD. It includes Part A (hospital insurance) and Part B (medical insurance). Part A covers the expenses associated with hospital stays and provides hospice care, skilled nursing care, and some home healthcare. Part B covers doctor visits, outpatient care, preventive services, and medical equipment. Most people don’t pay a monthly premium for Part A but there is a deductible. Part B has a monthly premium based on your income as well as an annual deductible.

Medicare Advantage (Part C)

Medicare Advantage, or Part C, plans are provided by private health insurance companies approved by Medicare. These plans typically include all of Original Medicare’s benefits and offer additional benefits such as vision, hearing, dental, and prescription drug coverage. These plans’ premium costs and benefits vary depending on the provider and region. To enroll in a Medicare Advantage plan, you must already be enrolled in Original Medicare.

Prescription Drug Coverage (Part D)

Medicare Part D is prescription drug coverage provided by private insurance companies approved by Medicare. It helps cover the costs of prescription drugs. It can be added to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans, and some Medicare Medical Savings Account Plans. Premium costs, deductibles, and coinsurance vary by plan. To enroll in a Part D plan, you must already be enrolled in Original Medicare or a Medicare Advantage plan that offers prescription drug coverage.

Medigap (Supplemental Insurance)

Medicare supplement plans help fill in the gaps or “holes” in Original Medicare coverage, such as deductibles, coinsurance, and copayments. Medigap policies are sold by private insurance companies and are designed to work alongside Original Medicare. Premium costs for Medigap policies vary depending on the provider and region. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.

Bottom Line

Medicare Health Plans can be complex and overwhelming, but it’s essential to understand the options available to ensure you receive the best healthcare coverage for your needs. It’s crucial to review your options each year during the Medicare Open Enrollment period and make changes if necessary.

Sources: Medicare.gov

FAQ

When is the Medicare Open Enrollment period?

The Medicare Open Enrollment period runs from October 15th to December 7th every year.

Can I switch between plans outside of the Open Enrollment period?

Yes, you may qualify for a Special Enrollment Period if you experience certain life events, such as moving or losing your current healthcare coverage.