The Medicare options for 2018 are wide open. Regardless, you need to obtain them as soon as you become qualified. Although windows are always open, some of them will close very quickly. Then, if you sign up later, you will have fewer options. Worse, you will pay more. The choice you make could help you save hundreds of dollars a year.
Acting now is vital. Unfortunately, it becomes complicated, despite the effort of the government to simplify the program. Most enrolees will have to face a lot of options. Furthermore, the plans would change every year. Hence, if you have the wrong plan, you could be spending hundreds of dollars year after year.
When deciding which option to make, you should consider, not just your financial situation but also your healthcare needs. Often, your preferences change as you age. If your needs change, you need to pick a different coverage. People adjust their coverage every year. And experts recommend it.
What are the options available to you in 2018?
Original or Advantage
New enrollees will have to face this big first decision, whether to go for Original Medicare or Advantage.
The Original Medicare has two parts. Part A is coverage for hospital stays while Part B covers all doctor visits, outpatient services, laboratory work and preventive care.
For most people, Part A is free. The only part you have to pay is for the Part B, which is $134 per month. Now, if you choose to deduct your premium from Social Security checks, you can do it so that you will have to pay $109 per month. Then again, your premium rate would increase if your income is higher than a certain threshold.
Although Part A is free, both parts involve deductibles and copays.
Is there a Part C?
In 1997, Congress created Medicare Part C or the Medicare Advantage when private insurers began offering HMOs and PPOs. Part C includes Part A and B coverage from insurance companies that are Medicare-approved.
Under this plan, however, it uses a network of healthcare providers. If your doctor is not in the system, you do not have to change, but you will have to pay a higher cost.
So which plan to choose: original or advantage?
Both have pros and cons. Parts A and B provide more options for doctors and hospitals. Furthermore, there is no need for referrals for a specialist and the federal government set the premiums, instead of a private company. Thus, you can expect lower premiums than the Advantage has to offer. Then, your coverage is not limited only to your local region.
But the Original Medicare’s monthly premiums are higher than the Advantage, especially if you need supplement plan. If you are suffering from a serious medical condition, the out-of-pocket expenses are higher than in the Advantage plan. Plus, you will need a separate program to cover prescription drugs and other health expenses.
Part C or Medicare Advantage, on the other hand, offers separate drug and supplemental policies. Plus, some of its plans can cover vision, hearing and dental expenses. Then, the programs have lower cost sharing compared to the Original Medicare.
But because Part C has a network of healthcare providers, going to a doctor that is out of the system means you must pay more. And you also need to obtain referrals just to see a specialist. Then, if your plan shuts down, you should find new coverage.
Resolving the gaps in Medicare coverage
Even though Medicare options are useful for your healthcare needs, there are gaps that you need to consider.
So, in 2003, Congress approved the Medicare Part D. It is a low-cost plan that covers prescription drugs. But you must enroll in it as soon as you become eligible. If you sign up for it after a certain period, you need to pay the penalty.
Unfortunately, Part D has various plans. Thus, you must be smart in considering your coverage every year. You must change it, especially if you require different medicines.
It is also vital to understand that there are still costs that you need to shoulder, even if you have Medicare. For instance, if you need to undergo treatment and require a stay in the hospital for 70 days, the first 60 days of hospital stay is covered by Medicare Part A. But there is a deductible for every hospital stay. The deductible in 2017 was $1,316.
In Part B of Original Medicare, you need to shoulder the 20 percent copay when you visit a doctor or opt for a particular medical procedure.
If you have insurance from your previous employers or military, the overall costs would be minimized. You can also choose Medicare Savings Programs that can help in paying for those expenses not covered by Original Medicare.
However, if you cannot enroll in those plans but you are enrolled in Original Medicare, you could purchase a supplemental insurance or also known as Medigap.
What is a supplemental insurance?
Also known as Medigap, supplemental insurance will pay for the out-of-pocket expenses that Parts A and B do not cover. These would include any hospital deductibles, plus the 20 percent coinsurance of doctor visit.
Even if you have a preexisting condition, you are guaranteed to receive this coverage during the initial enrollment period. The coverage is also nationwide, just like Original Medicare. Because the government standardizes the rates, it is easy to compare them all.
Unfortunately, supplemental insurance will have an average premium of over $2,000 a year. It is also difficult to switch plans when you are enrolled in another plan. Then, if you failed to sign up when you become eligible, the plans will have higher rates. Worse, you will be denied coverage. It also does not cover prescription drugs. Thus, you must still obtain a Part D plan.
Because there are several Medicare options in 2018 available, it is ideal that you conduct an in-depth shopping. You can use an online tool that lets you shop for a plan by simply entering your preferences and information. From there, you can easily compare the plans that are perfect for your healthcare needs.