There are different ways to get Medicare health benefits.
Original Medicare (traditional fee-for-service coverage by the federal government) alone.
Original Medicare with supplemental insurance, like a Medigap or retiree plan or
A Medicare Advantage Plan
If you are over age 65 then you are most likely eligible to enroll in Original Medicare (Part A and Part B). This is the traditional health insurance program run by the federal government. It allows you to go to almost any doctor or hospital in the country. Original Medicare covers most of the health services that you need. If you have Original Medicare, you can see any doctor or visit any hospital in the country as long as they accept Medicare payments.
Original Medicare does not over prescription drugs and there is no financial protection (out of pocket limit) with Original Medicare.
Medigap – Supplemental Insurance
To fill gaps in Medicare coverage, many people have additional insurance called supplemental insurance. You can get supplemental insurance from an employer or you can buy it from an insurance company in the form of a Medigap policy that specifically fills gaps in Medicare. Click here to learn more about Medigap plans.
Medicare Advantage (Part C)
Some people get their Medicare benefits through a Medicare Advantage Plan. Medicare Advantage Plans are sold by private insurance companies and offer Medicare benefits. A Medicare Advantage Plans can be a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Point of Service (POS) plan, Provider Sponsored Organization (PSO), Private Fee-for-Service (PFFS) plan, Special Needs Plan (SNP), or Medicare Medical Savings Account (MSA). These plans must offer at least the same benefits as Original Medicare, but have different rules, costs, and coverage restrictions. Click here to learn more about Medicare Advantage Plans.
If you have health coverage from current employer or your union when you become eligible for Medicare, your coverage may automatically convert into a Medicare Advantage Plan. You have the choice to stay with this plan, choose Original Medicare, or switch to another Medicare Advantage Plan. Be aware that if you switch to Original Medicare or another Medicare Advantage Plan instead, the employer or union could terminate or reduce your health benefits, the health benefits of your dependents, and any other benefits you get from your company. Talk to your plan before switching to find out how your health benefits and other benefits will be affected. Click here to learn more about working after age 65.
Part D – Prescription Drug Plans
If you would like to get the Medicare drug benefit (Part D), you must choose Medicare drug coverage that works with your Medicare health coverage. If you prefer to have Original Medicare, choose a stand-alone drug plan that just offers drug coverage. Each of these plans are different and cover different drugs, they also negotiate their prices individually so the costs to you can vary widely. Choosing the right drug plan should be done with some assistance from a professional who understands these plans and can help you find the overall least expensive plan. Click here to read more.
Would you like my help?
If you would like to talk to me or schedule a meeting at your home or a nearby meeting place, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message. The best part about working with me is that it will not cost you anything to meet with me to discuss your options or to review the plans that are available. I am paid by the insurance companies in the form of a commission if you enroll in a plan. You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me.
“My goal is to help you and I have found great joy in being able to offer my services to people who need my help.”