Medicare Timeline Series 1: You Have Options for your Health Coverage

If you’re nearing the Medicare enrollment window, you’ve probably discovered what most Medicare beneficiaries already know: Medicare is confusing, and the endless supply of information out there on Medicare can further muddy the waters. To help you avoid information overload and better understand Medicare and all the benefits available to you, we’ve created a three-part Medicare Timeline Series.

In this series, we’ll cover everything from what to look for when researching options to what happens if you wait too long to enroll. At the end of the three installments, our goal is to have helped you find and get enrolled in a plan that meets your individual lifestyle, budget and health needs.

To begin our series, we’d like to discuss one of the most common and perhaps harmful misconceptions about Medicare. Many assume that when they enroll in Original Medicare, or Parts A and B, their health care expenses are covered. However in most cases, Original Medicare pays 80 percent of all medical bills, and offers no prescription drug coverage. This leaves 20 percent of medical bills and 100 percent of the cost of most prescription drugs up to you. These expenses can add up quickly and without extra protection, an unexpected illness or injury can put your savings at risk. That’s why many choose to add coverage to Original Medicare. It’s also the reason why Medicare offers you a variety of coverage options. We’ll go deeper into each of these coverage options in future installments, but for now, here’s a brief overview of the plans out there that help cover what Original Medicare does not.

Medicare Advantage

One popular option is a Medicare Advantage (MA) plan. MA plans are a popular choice because of their convenience, coverage options and extra benefits. Most MA plans feel like the insurance plan you’re used to because they offer comprehensive benefits through one company. In general, MA plans cover the 20 percent that Medicare doesn’t, while offering Part D prescription drug coverage and valuable extras like dental, vision and hearing benefits. They also come with a maximum out-of-pocket limit that guarantees you’ll never have to spend over a certain amount on your medical care. Medicare Advantage plans generally have more than one coverage option to choose from, and many plans start out with a $0 premium option.

Medicare Part D + Original Medicare

Because prescriptions are often an incredibly costly part of health care, most Medicare beneficiaries seek out prescription drug coverage. One way to do that is by signing up for a Medicare Part D prescription drug coverage plan. These plans also come with monthly premiums that vary depending on the type of coverage you choose. Though with Part D you’ll have prescription coverage, it still leaves you vulnerable to the 20 percent of medical costs that Original Medicare doesn’t cover.

Medicare Supplements + Original Medicare
+ Medicare Part D

Medicare supplements are another way to cover the 20 percent of medical costs that Original Medicare doesn’t. Supplements are paid for through monthly premiums that can range anywhere from $30 to $357 depending on location, health and the type of coverage you choose. One of the biggest differences between a Medicare supplement and an MA plan is that supplements don’t offer Part D prescription drug coverage or dental, vision and hearing benefits. If you’d like to combine a supplement with drug coverage, you’d have to sign up for a separate Part D plan. This can be costly with all the varying premiums, and you’ll also have to work with three entirely separate plans.

Medicare doesn’t have to be complicated. In fact, the best part about Medicare is all the options you have. We’ll continue discussing those options and, in the next series, talk about what you need to look for when researching plans in your area.

For more information, visit Medicare.gov.

For more information on the BayCarePlus Medicare Advantage plan, visit BayCarePlus.org.