New to Medicare? Or, maybe you're thinking about switching plans? Medicare is complex, and ensuring you have the right coverage is essential. We're going to break down your options, so you can understand which plan fits your health needs, lifestyle, and budget, to take care of the whole you.
Let's start with the first question: What's the difference between Medicare Advantage and Medicare Supplement plans?
Medicare Advantage plans
Medicare has four parts — A, B, C, and D. Original Medicare makes up Parts A and B. Part C — Medicare Advantage — is available from private insurance companies. Medicare Advantage combines Parts A and B and may even offer prescription drug coverage (also known as Part D). And Medicare Advantage can include additional benefits like eye care, hearing aids or exams, and wellness services. There are different types of Medicare Advantage plans you can enroll in, such as a health maintenance organization (HMO), health maintenance organization point of service (HMO-POS), or preferred-provider organization (PPO). It depends on what's available in your area.
Medicare Advantage plans may also offer:
- Fitness club membership
- Healthy lifestyle coaching programs
- Yearly limit on out-of-pocket costs for covered medical services
- Acupuncture and chiropractic services
- 24-hour nurse line
- Emergency medical care outside the U.S. and more
When can you enroll? For initial enrollment, you have a seven-month window to join. It includes the three months before you turn 65, your birthday month, and the three months after your 65th birthday.
If you already have a Medicare Advantage plan, you can switch to another Medicare Advantage plan during the Annual Enrollment Period, which runs from October 15 to December 7 of each year. You may also be able to purchase a Medicare Supplement plan if you choose. It's important to shop during this time period to avoid late penalties
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Medicare Supplement plans
Medicare Supplement, also known as Medigap, is an insurance plan that helps supplement Original Medicare. It helps pay some of the health care costs that Original Medicare doesn't cover (like copayments, coinsurance, and deductibles), also referred to "gaps" in Medicare coverage. There are ten types of plans you can choose from: A, B, C, D, F, G, K, L, M, and N.
Here are a few more highlights of Medigap plans:
- You can see any doctor that accepts Medicare
- No referral is needed to see a specialist
- 100% of Medicare-approved chemotherapy treatments are covered
- Plans never change and are guaranteed renewable
- Some versions have no yearly out-of-pocket risk
- Emergency medical care outside the U.S. is covered
Remember: Original Medicare doesn't cover everything. In fact, there may be a deductible, copayments or coinsurance costs for Part A services and it only covers 80% of Part B services. That's where a Medicare Supplement plan comes in. It can help cover some of your out of pocket costs which can really add up.
How do you enroll? The best time to enroll is during your Medigap Open Enrollment Period. This period lasts for six months and begins on the first day of the month in which you're both 65 or older and enrolled in Medicare Part B.
It's important to know that a Medigap plan is different from a Medicare Advantage plan. Medicare Advantage plans offer Medicare benefits, while Medigap plans supplement your Original Medicare benefits.
Which plan is right for you?
Amy Capomaccio is a health care writer at Aetna with experience in senior wellness, Medicare, Medicaid, and commercial health care. When she's not practicing new mindfulness techniques, Amy is spending time outdoors and traveling. Amy hails from Wakefield, MA and has a degree in Advertising and Public Relations from the University of Tampa.
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