What You Need to Know About Your Coverage Options

If you are reaching that magic age of 65, you’ve likely already started receiving marketing to try to push you to choose a certain Medicare plan. Is there really one that’s better than the others? How much can you expect to pay? And what else do you need to know?

We’re breaking down the basics of what you need to know about Medicare in this post. And remember, we’re always here to help you choose a plan that’s right for your unique situation. You can schedule a conversation or give us a call at 309-263-1333.

What is Medicare?

Medicare is the federal health insurance program for anyone that is 65 years or older. Certain people with disabilities and End-Stage Renal Disease (ESRD) may also qualify for Medicare. Where it starts to get complicated is when you get to the different subtypes of Medicare. These are called Medicare Part A, Medicare Part B, Medicare Part C (also known as Medicare Advantage), and Medicare Part D.

The open enrollment period for Medicare takes place from October 15–December 7 each year. This is the dedicated time that you can join, switch, or remove coverage.

What Are the Medicare Parts All About?

“Parts” of Medicare represent the different types of coverage you can receive. While some won’t cost you anything extra, some do cost a premium for that specific type of care to be covered:

• Medicare Part A – If you are paying into Social Security or did before you retire, then you have this Part at no charge! Part A helps cover inpatient care and is considered hospital insurance.
• Medicare Part B – This part will cost you a premium of $170.10 per month and will help cover doctor’s visits, bloodwork, some medical equipment, and many preventative services. This is typically considered medical insurance.
• Medicare Part C or Medicare Advantage – This is a Medicare-approved plan from a private company. It includes Part A, Part B, and usually Part D. This plan restricts you to doctors that are in-network and usually has a lower out-of-pocket cost. These types of plans will usually include things that Part A & Part B alone do not, such as vision, hearing, and dental services. This Medicare plan typically does have a higher co-pay.
• Medicare Supplement Insurance – This is also called “Medigap.” The purpose of this insurance is to help fill in the gaps in Medicare. Medigap has several plans that you’ll want to discuss with a financial advisor to make sure you are choosing the right option for your specific situation. You can compare some available plans here.
• Medicare Part D – This form of Medicare is specifically for prescription drug coverage and may include many recommended shots or vaccines.

Medicare Advantage vs. Original Medicare + Plan G Medigap

When you pick Medicare coverage, you are really choosing between “Original Medicare” and “Medicare Advantage.” Original Medicare is considered Part A and Part B. You may also choose to add a Medicare Supplement Insurance policy to your coverage. Medicare Advantage includes Part A, Part B, and usually Part D from a private company. These are fairly comparable between companies, but you may pay a different premium. 

When considering which of the two options you’d like to select, be sure to consider the following:

• Do you travel a lot to where you might need out-of-network care? 
• Are you a “snowbird” or spend a lot of your time in another state?
• Do you have a lot of prescriptions and could benefit from Part D of Medicare?
• Would you rather pay a deductible or co-pay?

We find that many of our clients who either research Medicare on their own or meet with an advisor usually are comparing these two options: Medicare Advantage or Original Medicare + Plan G Medigap. 

With each of these options, you’ll get Medicare Part A and Part B. However, Plan G will typically cost an additional $110 – $140 per month. The key difference when it comes to Plan G over Medicare Advantage is that after paying the premium, you have a $233 deductible and then zero co-pays after that amount is met. There are also no restrictions on a doctor being within your network; if they accept Medicare, then they are covered by your insurance. The downside to Plan G is that it does not cover prescription drugs, vision, dental, and hearing. 

We know choosing the right Medicare coverage can be a confusing process. If you would like advice based on your specific financial and medical needs, we’re here to help! You can schedule a meeting with one of our advisors or give us a call at 309-263-1333.

 

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Insurance products are offered through the insurance business 210 Financial. 210 Financial is also an Investment Advisory practice that offers products and services through AE Wealth Management, LLC (AEWM), a Registered Investment Adviser. AEWM does not offer insurance products. The insurance products offered by 210 Financial are not subject to Investment Advisor requirements. AEWM and 210 Financial are not affiliated companies.

Neither the firm nor its agents or representatives may give tax or legal advice. Individuals should consult with a qualified professional for guidance before making any purchasing decisions. Our firm is not affiliated with the U.S. government or any governmental agency. Investing involves risk, including the potential loss of principal. A PR firm was paid to assist with media placement. 1535118 – 10/22

Content prepared by Savage Content Collective

 

1. https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare
2. https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/parts-of-medicare#:~:text=A%20fee%2Dfor%2Dservice%20health,type%20of%20Medicare%20health%20plan.
   
3. https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
4. https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap