Medicare Coverage Choices

You become eligible for Medicare when you reach age 65. If are nearing eligibility, you need to make your Medicare coverage choice at least three to four months in advance. You have two basic choices: Original Medicare Coverage and Medicare Advantage Plans. Medicare comprises four parts: A, B, C and D Part A covers hospital stays and emergency care Part B covers doctor visits and routine health procedures Part C is the Medicare Advantage Plan approved by Medicare and run by private companies Part D is prescription drug coverage Original Medicare Coverage This includes Medicare Part A and Part B and is provided by Medicare.

• You can choose your doctors, hospitals, and other providers, and you or your supplemental coverage pays deductibles and coinsurance. While most people do not have to pay for Part A, everyone must pay a monthly premium for Part B.
• If you want Prescription Drug Coverage (Part D), you must join a Medicare Prescription Drug Plan offered by a Medicare-approved private company.
• Any gaps in insurance can be covered by adding on a supplemental policy like Medigap from a private insurance company.

Medicare Advantage Plans This comprises plans like a HMO or PPO provided by a private insurer approved by Medicare.

• With most plans, you need to use approved doctors, hospitals, and other providers, and if you don’t, you have to pay more or all of the costs.
• Besides the premium for Part B, you also have to pay a monthly premium and a co-payment or coinsurance for services that are covered. Costs, extra coverage, and rules differ from plan to plan.
• Prescription drug coverage is usually offered by most these plans. If it is not, you can choose to join a Medicare Prescription Drug Plan.
• With a Medicare Advantage Plan, you don’t need and can’t use a Medigap policy.

Besides the above two choices, Medicare also offers other types of plans. These include Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE). Most of the plans provide Part A and Part B coverage, and some also cover Part D. Your choice of plan can be influenced by health and/or prescription drug coverage that you may have from a former or current employer or union. What Medicare Does Not Cover While Medicare offers basic protection against health care costs, it does not cover all your medical expenses or the costs of most long-term care. For that, you need a long term care plan. It would cover nursing home and other charges such as at-home health care, custodial care like help (not from skilled nurses) with dressing, walking, or eating, adult day care, and so on. Making the Right Choice To understand all about how Medicare works and make an informed choice, talk to an independent ohio medical insurance agent. You can get comprehensive information on various kinds of plans and how to fill gaps in coverage. Professional guidance is also necessary when it comes to buying long-term health insurance.