New To Medicare?
Considering a Switch to Medicare Advantage?
Choosing the Right Coverage for You
If you’re new to Medicare and aren’t sure where to begin, or if you’re considering a switch to a Medicare Advantage plan, you’re not alone. Most people just starting out find all of the different Medicare options to be a bit confusing or even overwhelming. The good news is, what makes Medicare confusing also makes it great. You have so many coverage options to choose from, and you get to choose the one that works best for you and your individual health care needs. To be able to select the perfect Medicare plan for you, it’s best to start by learning the basics of Medicare and from there, evaluating the options that truly make sense for your unique situation.
Enrolling in Medicare
When you first become eligible for Medicare, you have a seven-month window in which you may enroll, beginning three months prior to your 65th birthday and ending three months after. In the Medicare world, this is called your Initial Enrollment Period (IEP). During your IEP, you may enroll in Medicare Parts A and B as well as sign up for a Part D plan or an all-in-one Medicare Advantage Plan (Part C).
Switching Medicare Plans
You can also enroll in a Medicare Advantage plan for the first time (or switch from Original Medicare to Medicare Advantage) during the Annual Enrollment Period (AEP) between Oct. 15 and Dec. 7 of each year, for coverage beginning Jan. 1.
In addition, you can switch Medicare Advantage plans (or switch from a Medicare Advantage plan to Original Medicare) between Jan. 1st and March 31st of each year. However, you are not able to switch from Original Medicare to a Medicare Advantage plan during this time.
Option 1: Original Medicare
To start off, let’s take a look at Original Medicare, or Parts A and B. Part A is known as hospital insurance, and Part B is known as medical insurance. Together, Parts A and B cover around 80% of your medical costs. This leaves you responsible for the remaining 20%, and 100% of the cost of prescription drugs as well as benefits like vision and dental.
Option 2: Join an all-in-one Medicare Advantage Plan
For an all-in-one plan that offers comprehensive coverage, many choose a Medicare Advantage plan. These plans cover all the things Original Medicare does and may cover the remainder of what Original Medicare doesn’t. In addition, many Medicare Advantage plans include Part D prescription drug coverage and valuable extras like transportation assistance, fitness, and chiropractic benefits for no or low copays, depending on the plan.
Also, some Medicare Advantage plans, like Stanford Health Care Advantage, offer low premiums and low copays. They also include a built-in safety net that puts a limit on the amount you will have to pay out of your own pocket each year for covered medical expenses.
Option 3: Add a Part D Prescription Plan to Original Medicare
To pick up where Original Medicare leaves off, one option is to purchase a private stand-alone Part D prescription drug plan. These plans are offered by private insurance companies, and the monthly premium for these plans can vary based on how much they cover. Though this option will help cover some of the cost of prescriptions, it still leaves you exposed for the 20% that Original Medicare doesn’t cover.
Option 4: Add a Part D Prescription Plan and a Supplement to Original Medicare
To cover that 20% Original Medicare doesn’t cover as well as prescription drugs, some people purchase a Part D plan and a Medicare supplement. Supplements can be expensive though, and you will be paying multiple premiums to multiple companies each month.
Protecting Your Savings
Which Medicare coverage option you choose directly impacts the amount you pay out of your own pocket and when you have to pay. To explain this, many use a pay now vs. pay as you go analogy. The option you choose also plays a big part in your overall financial risk because certain options protect your savings more than others.