Typically, the first step on your journey as a Medicare beneficiary is determining which plan is right for you. Original Medicare, or Medicare Advantage. There are many details, unique to you, that will determine which one is the best fit. Part of the important details to consider is if you have retirement savings you want to protect.
You Went with Original Medicare
If you have chosen Original Medicare, we often will recommend that you supplement your plan with Medigap. People often choose to purchase this supplemental plan to help pay for health care costs that Medicare does not cover.
Some things to know:
- Medicare only covers 80% of approved expenses, which makes you responsible for the rest
- Supplemental plans will typically pay most of the balance
- Medigap does not include prescription drugs
- Medigap is design to fill Medicare Part A and Part B coverage gaps
Example of use:
You have been diagnosed with colorectal cancer. Original Medicare does cover the treatment and it includes chemotherapy, surgery and radiation therapy. However, your responsibility of 20% of the cost of this care could reduce your retirement savings to nothing quickly. You can reduce your negative financial impact with a supplement plan that can help manage these additional costs.
You Went with Medicare Advantage
If you chose the Medicare Advantage plan, these plans typically act as a private healthcare insurance where beneficiaries must use providers and hospitals in their networks, with some requiring referrals for specialty care.
Some things to know:
- Some plans require a referral for specialty services
- Plans might not cover needs outside of a specific geographical area
- They offer additional benefits not covered by Original Medicare like vision, dental and gym memberships
- There are MANY Medicare Advantage plans to choose from so it requires care when determining your best fit
Which do most People Choose?
About 52% of Medicare beneficiaries choose Original Medicare Parts A & B. This covers hospitals, doctors and medical procedures. About 81% of these beneficiaries choose Medigap to supplement their insurance. And many also purchase the additional Medicare Part D prescription drug policy (depending on their current needs). Keep in mind if you don’t get a Part D and later change your mind could encounter a penalty.
In 2022, 48% of Medicare beneficiaries chose to sign up for Medicare Advantage. Most services are covered after a small co-pay. These plans can offer a low or no annual premium, but again, we stress the importance of determining your needs to find a plan that fits you best. Because care can be limited to your network, the quality of the network should also be a large factor in your choices. These plans may include a Part D for your prescription coverage.
>Related Reading: Did you Know You Could be Eligible for Additional Benefits?
Because your Medicare choices should be determined by so many things unique to you like lifestyle, health, whether you travel (and is it abroad?), local networks (do you have a provider you love that you want to make sure is part of your plan?) and more, it is really important to find an expert that can help you navigate your Medicare journey.
Do you need help? Reach out any time by calling 865-228-8627 or 865-203-2040, or emailing us at contact@bigorangemedicare with questions. We are here for you!
*Medicare Insurance Specialty Group is not approved by, endorsed by, or affiliated with a government agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.