Medicare open enrollment is right around the corner. If you are already using a Medigap plan or a Medicare advantage plan, now is your time to move if you don’t like your current carrier.
If you have a Medicare card that you give to your doctor, then you have traditional Medicare. If you only have a card from an insurance provider that you give to doctors, then you have Medicare Advantage.
When is the open enrollment period? October 15th through December 7th every year.
Who needs to pay attention?
Those that are currently using a Medigap plan, Medicare advantage plan, prescription drug plan, or if during your initial enrollment period you opted not to purchase additional coverage up and above traditional Medicare parts A & B.
What is traditional Medicare?
Traditional Medicare is composed of three parts: A, B, and D. Part A is coverage for hospitals and doesn’t have monthly costs. Part B is coverage for doctor visits, etc. and the base cost is $104 per month. This typically comes out of your Social Security check. Part D is prescription drug coverage, which is purchased through a third party.
What is the difference between a Medigap and Medicare advantage plan?
Medigap is a “gap” insurance that covers most of the holes that are not covered by traditional Medicare parts A & B. You can go to any doctor that accepts Medicare. Medicare Advantage plans combine parts, A, B, D, and Medigap into one nice package. They operate more like traditional insurance where you have a service provider and you are tied to their network.
What else should I know about Medigap?
Medigap plans are lettered from A to N with costs that vary depending on the benefits provided. The most popular plan is F as it is the most comprehensive and covers things like the Part B deductible and foreign travel emergency. Because it is the most comprehensive, it is also the most costly.
By law, all Medigap plans have the same benefits regardless of the service provider. The only difference will be the level of service. Price then is a major driving factor, but you should use a provider that is reputable. People that have comprehensive Medigap plans typically pay more on a monthly basis but feel like they don’t have to pay very much out of pocket.
What else should I know about Medicare Advantage?
Medicare advantage plans, also called Part C, will often cost less than Medigap plans and will have deductibles and co-insurance like traditional insurance through an employer. It works by Medicare giving an insurance provider a certain amount per year to manage your expenses. If the insurance provider manages your expenses for less, then they make money. Because of that, monthly costs vary significantly with some plans as low as $0 per month. People that use Medicare Advantage Plans usually pay less on a monthly basis but feel like they have more out of pocket expenses.
What are some small facts that have big impacts?
When you originally sign up for Medicare, you can choose either Medigap or Medicare Advantage without being denied. If you are on a Medicare Advantage plan and then try to go back to a Medigap plan, you could be denied based on health. You will never be denied access to a Medicare Advantage plan.
Are there differences between prescription providers?
Yes, costs can vary significantly based on the provider and the types of medications you are taking. Shop around to find out who will give you the best deal for your specific medication regimen. You can also go to Medicare.gov and enter the prescriptions you take, and it will screen for the best providers. Visit Medicare.gov and click on Drug Coverage (Part D), then click on Find Health & Drug Plans.