This page outlines the plan options and why each may be a fit for you. When it comes to Medicare coverage, you have three options:
- Original Medicare only
- Original Medicare plus the purchase of a supplement (or Medigap policy) through a private insurance company
- Enroll in a Medicare Advantage plan (usually an HMO or PPO) through a private insurance company. This combines all the parts of Medicare in one plan.
Original Medicare Consists of Parts A & B. The benefits and your basic costs are outlined below. This is by no means comprehensive; we are just showing the basics to give you an overview of the Parts of Medicare and what is covered.
Keep in mind there is no out-of-pocket cap or limit to your expenses when you have Original Medicare only. This is just one reason many people choose to supplement Original Medicare, or receive Medicare through a Medicare Advantage Plan.
Medicare Part A
- Hospital insurance (covers inpatient hospital visits).
- Without a supplement, you must pay a deductible of $1316 for a hospital visit (per benefit period), in 2017.
- Part A helps cover skilled nursing facility stays, hospice and home health care.
- If you or your spouse paid medicare taxes while working, you should not have to pay for Part A.
Medicare Part B
- Medical Insurance (everything other than hospital visits).
- Covers doctor visits, outpatient services, radiology, labs, and more.
- Without a supplement, you pay an annual deductible of $183 (in 2017), then 20%.
- You must pay a monthly premium for part B.
Medicare Supplement Insurance
Do you have an existing family doctor that you would like to continue seeing, or would like to be able to go to a specialist without a referral?
If it is important to you to be able to see your existing family doctor, change doctors at any time, or see a specialist without a referral, a Medicare Supplement may be right for you.
Medicare supplement premiums are usually costlier than Medicare Advantage plans. If budget restrictions aren’t a concern, you may consider a Medicare Supplement.
If choosing a particular doctor is not that important to you, you might consider Medicare Advantage. In many cases you trade the freedom of Original Medicare for an HMO network. However, many of these plans can give you the peace of mind of predictable co-pays, and preventive care within an established network of doctors, specialists, and hospitals.
If you prefer more freedom to choose but like the lower premium of a Medicare Advantage, you may consider a Medicare Advantage PPO.
If you still feel strongly about having the freedom of a Medicare Supplement, and want to save on premium, a high deductible plan F might be for you.