Medicare Support Decision Guide

This guide will teach you:

  • The basics of the way that the four parts of Medicare work
  • Mistakes most people make when choosing a Medicare supplement and why paying more doesn’t buy more
  • My tried-and-true recommendations for the three best Medicare insurance plans and why I recommend them
  • A bit about Allstar Senior Benefits and how you can benefit from our experience

According to the Kaiser Family Foundation, almost every Medicare beneficiary chooses to enhance Original Medicare with another sort of coverage. [1] Some folks have employer- or union-sponsored coverage, VA health benefits, or another public plan, but most choose between Medicare supplements and Medicare Advantage. I want to help you decide between these two most common options and tell you which three choices I recommend for most of my clients.

The Four Parts of Medicare

Before I discuss different options to enhance your Original Medicare benefits in a sensible and cost-effective way, it’s helpful to briefly summarize the way that Medicare works.

These are the four main parts of Medicare today and some of the gaps in coverage that Original Medicare [2] has:

Part A: Part A is often called hospital insurance, as it mostly deals with inpatient stays. Most Medicare beneficiaries don’t have to pay a premium for Part A. In 2017, beneficiaries with only Original Medicare may have a $1,316 deductible per benefit period. Out-of-pocket expenses might also include $329 for hospital stays for days 61 to 90 and $658 for days 91 to 150. Once hospital days have been used up, patients with only Original Medicare are responsible for the entire cost. Hospice care also includes coinsurance or copays.

Part B: Part B typically requires a premium payment. It gets referred to as medical insurance, as it mostly covers outpatient services. With only Original Medicare, patients pay a $183 deductible each year and 20 percent for most covered services. If providers charge more than Medicare allows, they may have to pay these excess charges. Original Medicare rarely covers services outside of the United States.

Part C: Part C consists of Medicare Advantage plans that beneficiaries can choose to provide them with Part A and B benefits. Most of today’s Medicare Advantage members choose HMOs, which restrict them to plan networks for almost all healthcare needs. You might also find PPOs, POS, and PFFS plans. These can offer somewhat more flexibility but at a higher cost. In any case, expect to pay copays and deductibles that aren’t capped until they reach the yearly out-of-pocket maximum. These maximums could be as high as $3,000 to $6,000 each year. Some Medicare Advantage plans also include Part D drug benefits.

Part D: This is the prescription coverage that beneficiaries can sign up for. Stand-alone Part D plans have separate premiums, but this sort of coverage may already be included in a Part C plan. Each plan has its own list of covered drugs, so it’s important to make sure that your own medications are well covered or covered at all.

Read This Before Choosing Medicare Advantage Plans

If you believe a lot more people have been choosing Medicare Advantage plans lately, you’re probably right.

Just hold on before you follow the herd that might be attracted to low- or even zero-monthly premium plans. There are some disadvantages to Medicare Advantage that might make you regret this decision.

Click here to read the full Medicare Support Decision Guide.