So you’re turning 65 and don’t know where to start?
If you haven’t reviewed your basic Medicare Benefits, you can learn more here.
You might be wondering, do I even need a plan to Supplement my Medicare?
Aside from the deductibles you will have to pay on Medicare, you will be responsible for 20% coinsurance for all doctor and outpatient services. This includes chemotherapy. There is no annual cap on your out-of-pocket expenses when you have Original Medicare only (Parts A & B), without a supplement.
If you decide these expenses are too much of a risk to you and your family financially, you will probably consider supplementing your coverage.
This leaves you with two choices: enroll in either a Medicare Supplement, or a Medicare Advantage Plan.
A Medicare Supplement is insurance that covers what Medicare doesn’t. Medicare pays your doctor it’s portion, and the Medicare Supplement pays it’s portion. The plans are standardized, which means the benefits are exactly the same no matter what carrier you purchase it from. This means there is no need to pay more than you have to for a Medicare Supplement.
A Medicare Advantage Plan is the bundling together of Medicare Parts A, B and sometimes D, all in one plan. Medicare pays private insurance companies to dispense your Medicare benefits to you, most often in the form of an HMO (managed care) plan. These types of plans are very popular because they are often zero, or low premium, and give the beneficiary far more benefits than Medicare alone.
To get you started, look over the following two lists related to each plan type. Whichever list contains more statements you agree with – that is likely to be the plan for you.
Are any of these Statements true for you with regards to a Medicare Supplement?
- It’s worth it to me to pay more for the freedom to go to the doctors and specialists of my choice.
- It’s important that I can go directly to a specialist without a referral.
- I like knowing I can go to most any hospital throughout the country.
- I’d rather pay a higher premium each month, knowing I will have little, if any out-of-pocket expense when I do get sick.
- I don’t mind having a separate prescription plan, with additional premium.
*if more statements are true for you from this list, a Medicare Supplement (Medigap) plan might be right for you!
Are Any of the following statements true for you with regards to a Medicare Advantage Plan?
- If I can find a plan with my doctor in the network, I wouldn’t mind an HMO.
- I like the security of managed care, even though referrals are required. I feel I’m taken care of.
- As long as my favorite hospital is in my plan, I’m happy.
- A zero, or low premium is very important to me, and I like having predictable copays.
- I like having all my benefits under one plan, including prescriptions, at a low cost.
*if more statements are true for you from this list, a Medicare Advantage plan might be right for you!
Once you decide on a plan type, the rest is easy.
For a medicare supplement, a very high percentage of people pick plan F. Check out my Medicare Supplements Page.
Advantage Plan HMOs often depend on what doctor or hospitals you prefer. For a look at the plans we offer, check out our Medicare Advantage page, or visit Medicare.gov for plan comparisons.
The Best of Both Worlds?
One plan option that offers a little of both is the Anthem Freedom Blue PPO for California. Even though it is still considered managed care (it is a Medicare Advantage Plan), this plan allows you to go to virtually any doctor and specialist of your choice, without a referral, with zero premium, and your drug plan included. Learn more…
I hope this article was helpful!
For questions, comments, or feedback:
Call Pamela Cook
CA Insurance 0G04182
Toll Free 1.888.520.8683
Comment below, contact, or visit our ASK page.
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