Understanding Your Medicare Options
May 12, 2020
Email US
Click to Email Us
Original Medicare vs. Medicare Advantage
Original Medicare (Part A and Part B) is the federal plan that provides hospital and medical insurance coverage to those who qualify. For the basics of your health care, it works well. You get easy access to most of the care you need, with minimal paperwork and widespread acceptance by doctors and medical facilities.
But, even though Original Medicare is intended for older adults, it does not cover many of the health issues that become more critical as we age - like prescription drugs, vision, hearing and dental. And it may leave you open to financial burdens that dont fit your budget.
So its no wonder that the Medicare Advantage category is growing rapidly as our country gets older. (Enrollment in Medicare Advantage plans has tripled since 2004*).
Medicare Advantage plans (also known as Medicare Part C) are contracted with the federal government to provide Medicare coverage. These plans must provide all the benefits that Original Medicare offers, and often include additional benefits for more complete health care coverage. And because they operate as managed care programs, Medicare Advantage plans can provide all this coverage, and limit your financial risks as well.
Coverage you cant get from Medicare
Most Medicare Advantage (MA) plans include prescription drug (Medicare Part D) coverage for your medication needs. Look for plans that have low or no copays on widely used generic drugs, and offer additional savings on higher cost prescriptions at in-network or preferred pharmacies.
Dental, vision and hearing issues can become more prevalent as we age, and coverage for these important conditions can be key to maintaining a healthy, functional lifestyle. These benefits are often included in MA plans; the coverage can vary from plan to plan, so try to find one that can help offset the costs of big-ticket items like hearing aids, glasses and dentures.
Protecting your finances
Because incomes often become limited or fixed at the same time health issues increase, Medicare Advantage plans can be a good financial solution as well.
With deductibles, copays and co-insurance, Original Medicare generally covers only 80% of medical expenses. Youd be responsible for the other 20%. Keep in mind there is no limit on this expense, so a chronic health condition or extended hospital stay can be financially devastating.
Medicare Advantage plans cover many of the out-of-pocket costs that Original Medicare does not; you pay little (or nothing) of that remaining 20%. And, while you still must pay your Medicare Part B premium, many MA plans offer coverage with no additional plan premium. In any case, MA plans have maximum out-of-pocket limits, so you know exactly what your potential financial liability looks like.
(In 2019, the average out-of-pocket limit for Medicare Advantage enrollees is $5,059*.)
Make sure that you use doctors, specialists, hospitals and services that are in your plans network to keep your coverage affordable and take the utmost advantage of your Medicare Advantage membership.
Do your research.
Once you become eligible, youll need to enroll in Medicare and choose a health plan. Then, every year, the Annual Election Period (October 15 December 7) allows you to change your coverage, so thats a good time to review your current health, financial situation and Medicare options to make sure that you still have the plan thats right for you. You can find out more at www.medicare.gov.
*Kaiser Family Foundation
https://www.kff.org/medicare/fact-sheet/medicare-advantage/
_______________________________________
Editors Note: This article was contributed by PA Health & Wellness.
Other Articles You May Like
Navigating Medicare: A Comprehensive Information Guide with MediConnect
Navigating Medicare: A Comprehensive Information Guide with MediConnectAre you turning 65 soon or approaching eligibility for Medicare? Understanding your healthcare options is crucial for ensuring you receive the coverage you need. With Medicare being a cornerstone of healthcare for millions of Americans, its essential to familiarize yourself with its information. At MediConnect, our Medicare advisory firm, were here to help you find the plan that works best for you.What is Medicare?Medicare is a federal health insurance program primarily designed for people who are 65 or older. However, it also covers certain younger individuals with disabilities and those with end-stage renal disease. It consists of different parts, each providing coverage for specific services:1. Medicare Part A: Hospital insurance that covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.2. Medicare Part B: Medical insurance that covers outpatient care, doctor visits, preventive services, and some home health care.3. Medicare Part C (Medicare Advantage): A private insurance alternative to Original Medicare (Part A and Part B), often including prescription drug coverage and additional benefits like vision, dental, and wellness programs.4. Medicare Part D: Prescription drug coverage available through private insurance companies approved by Medicare.Understanding EnrollmentEnrolling in Medicare can be a straightforward process if you understand the information for your options and the timing of key decisions: Initial Enrollment Period (IEP): Typically, this is a seven-month period that begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65. General Enrollment Period (GEP): If you missed your Initial Enrollment Period, you can enroll during the General Enrollment Period, which runs from January 1 to March 31 each year. However, late enrollment may result in penalties. Special Enrollment Period (SEP): Some individuals may qualify for a Special Enrollment Period due to specific life events, such as moving, losing employer coverage, or qualifying for additional assistance programs.Making Informed Choices with MediConnectChoosing the right Medicare coverage depends on various factors, including your healthcare needs, budget, and preferences. At MediConnect, our Medicare advisory firm, we take the information you give us to offer personalized guidance and expertise. Helping you make informed decisions: Coverage Needs: Our team will work with you to assess your healthcare needs, including prescription medications, doctor visits, and any specialized care requirements. Costs: Well help you understand the premiums, deductibles, copayments, and coinsurance associated with each Medicare option to determine the total cost of coverage. Provider Networks: Well explain the differences between Original Medicare and Medicare Advantage plans, helping you choose the option that aligns with your provider preferences. Prescription Drug Coverage: Our experts will evaluate your prescription drug needs and compare Part D plans to find the one that best covers your medications at the lowest cost.Additional ResourcesNavigating the complexities of Medicare may seem daunting, but youre not alone. Here are some resources to give you additional information along the way: Medicare.gov: The official Medicare website offers comprehensive information, including plan comparisons, enrollment guidance, and eligibility criteria. State Health Insurance Assistance Programs (SHIPs): These programs provide free, personalized Medicare counseling and assistance to help you understand your options and make informed decisions. Medicare Plan Finder: Use this tool on Medicare.gov to compare Medicare Advantage plans, Part D prescription drug plans, and Medicare Supplement Insurance (Medigap) policies available in your area.As you approach Medicare eligibility, remember that MediConnect is here to support you every step of the way. Our Medicare advisory firm is dedicated to helping you find the coverage that meets your unique needs and preferences.By understanding the various parts of Medicare, enrollment periods, and factors to consider when choosing a plan, you can make confident decisions about your healthcare coverage. Let us guide you through the process and ensure you have the peace of mind that comes with comprehensive Medicare coverage tailored to your individual requirements.
Avoiding Common Estate Planning Mistakes: A Message from Jeff Bellomo
Greetings, I trust this message finds you in good health and high spirits. In my years as an elder law and estate planning attorney here at Bellomo & Associates, Ive had the privilege of guiding families through the intricacies of planning for the future. Today, I want to share some insights on common estate planning mistakes, drawing from the experiences of those Ive had the honor of assisting. Its human nature to postpone tasks, especially those that involve contemplating the future. However, delaying your estate planning can have significant consequences. Whether youre an income-generating couple, a seasoned individual considering nursing home care, or a young family with dreams to protect, procrastination can rob you of the peace of mind that comes with a well-thought-out plan. No two families are the same, and neither should their estate plans be. Cookie-cutter approaches often neglect the nuances that make your situation unique. As your trusted advisor, I emphasize the importance of personalized solutions. Your plan should reflect your values, aspirations, and the legacy you wish to leave behind. Life is dynamic, and so are your circumstances. Marriage, births, career shifts, and even unexpected health challenges can reshape your priorities. Failing to update your estate plan accordingly can lead to unintended consequences. Regular reviews ensure that your plan remains a true reflection of your current life stage and desires. Discussing end-of-life matters can be uncomfortable, but its a crucial step in ensuring your wishes are understood and respected. Communicating openly with your loved ones about your estate plan can prevent misunderstandings and provide clarity during challenging times. In the age of online resources, its tempting to try a do-it-yourself approach to estate planning. However, the potential pitfalls of DIY plans can far outweigh the perceived cost savings. Professional guidance ensures that your plan complies with legal requirements and considers intricate details that may be overlooked. To those of you who resonate with these considerations, I extend an invitation to join us at our next estate planning workshop. Its not just an opportunity to learn about common mistakes but also a chance to connect with others who share similar concerns. Bring your questions, share your stories, and lets navigate the path to a secure future together. Remember, estate planning is not just a legal process; its a journey toward safeguarding what matters most to you. I look forward to meeting you and exploring the important next steps in creating a plan that reflects your unique legacy. To a future of informed decisions and lasting legacies, Jeff BellomoWe offer FREE WORKSHOPS every week! Click here to register!
Supporting Seniors in Quitting Smoking
Quitting smoking is one of the best decisions a senior can make for their health. Smoking poses severe risks, especially for older adults, but quitting can lead to significant improvements in eye health and overall well-being. If you have a senior loved one who smokes, be prepared to support them as they give up the habit. The Impact of Smoking on SeniorsSmoking affects everyone's health, but the impact is even more critical for seniors. It exacerbates conditions like heart disease, stroke, and respiratory issues. The risk of developing some types of cancer also increases significantly with prolonged smoking.Specific Effects on Eye HealthSmoking can damage the eyes. It raises the risk of cataracts and age-related macular degeneration, which can lead to blindness. Maintaining good eye health is essential for seniors to continue enjoying their independence and quality of life.Overall Benefits of Quitting Smoking at Any AgeIt's never too late to quit smoking. The health benefits begin almost immediately. After quitting, blood pressure drops, and lung function improves. Long-term benefits include a lowered risk of heart disease, stroke, cancer, and eye diseases. Quitting smoking adds valuable, healthy years to a senior's life.How Caregivers Can HelpQuitting smoking is tough for anyone, but it can be especially challenging for seniors who may have smoked for many years. Nicotine addiction, established habits, and the fear of change are barriers that caregivers must understand and address. Fortunately, there are several practical ways caregivers can assist.Creating a Smoke-Free EnvironmentCaregivers can start by making the home smoke-free. Remove ashtrays, lighters, and cigarettes. Encourage the senior to replace smoking habits with healthier activities.Encouraging Healthy Habits and RoutinesPromote healthy habits like walking, exercising, or engaging in hobbies. Physical activities can help reduce cravings and improve overall health.Providing Distractions and Alternative ActivitiesHelp seniors find alternative activities to occupy their time and mind. Puzzles, reading, gardening, or spending time with family and friends can serve as excellent distractions from the urge to smoke.Emotional Support and EncouragementEmotional support is crucial for seniors trying to quit smoking. Knowing that someone believes in their ability to quit can make a tremendous difference. Celebrate every small victory, whether it's one smoke-free day or a week. Small rewards can motivate seniors to keep going.Being Patient and UnderstandingUnderstand that quitting smoking is a process. Be patient and offer a listening ear without judgment.Resources for Smoking CessationNational resources like the National Cancer Institute's Quitline (1-800-QUIT-NOW) provide free support and valuable information. Guide seniors in accessing these resources. Help them schedule appointments, join online communities, or download helpful apps.Encourage seniors to talk to their healthcare providers about quitting smoking. Doctors can offer medical advice, prescribe medications, and refer them to support programs.Let Us Help You Foster Senior HealthQuitting smoking brings immense benefits for seniors, enhancing their health and quality of life. Caregivers can help and encourage their loved ones through this challenging process. If you have a senior loved one who needs more help at home, including support as they stop smoking, contact Senior Helpers Fort Collins. We're here to support families in Fort Collins, Englewood, Littleton, Lone Tree, and Longmont through professional senior care services. Let's work together to help our seniors lead healthier, happier lives.