When a person turns 65, it’s good to know that Medicare is available to them. Of course, not all seniors are alike. They have different health concerns and conditions. As such, finding the best Medicare plan is always an individual choice.
If you are looking for a Medicare plan, there are many to choose from. Finding the right one, however, often depends on your personal income, needs, and priorities, and requires some careful consideration.
Here are your options:
Traditional Medicare
Original Medicare includes Part A (hospitalization) and Part B (necessary medical and preventive services). Its key benefit is that you can choose any doctor who accepts Medicare. Part A includes inpatient care in a hospital, as well as skilled nursing facility care, hospice care, and home healthcare. However, it does not include custodial or long-term care.
What’s more, Part A coverage under Traditional Medicare depends on state and federal laws, Medicare’s national coverage decisions, and coverage decisions that are made by companies in each state that process Medicare claims.
Part B Medicare services refer to medical supplies and services necessary for a physician to diagnose and treat a medical condition. Preventive services include procedures designed to prevent illness, such as a flu shot or tests that diagnose a condition during its early stage, when treatment is most effective. Most preventive services are free of charge as long as they are rendered by a provider who accepts Medicare.
Part B Medicare also covers ambulance services, limited outpatient prescription medications, and inpatient and outpatient mental health services, as well as medical equipment, such as hospital beds, wheelchairs, canes, crutches, walkers, lifts, and blood sugar monitors. If you need equipment, you pay 20 percent of the Medicare-approved cost, as well as a deductible, and the plan only pays for these items if your doctor and equipment supplier is enrolled in Medicare. Part B does not cover other items and services, such as dentures and most dental care, eye exams related to obtaining a prescription for glasses, hearing aid, routine foot care, and acupuncture.
Medicare Advantage
Medicare Advantage (Part C) is a bundled alternative to Traditional Medicare that includes all the benefits of Original Medicare and usually a few additional benefits, such as cost help with dental, hearing, and vision care. These plans are offered by private insurers, and availability depends on your location.
In addition to Part A and Part B benefits, most Medicare Advantage plans cover prescription drugs (Part D). You may have lower out-of-pocket costs with a Medicare Advantage plan than with Traditional Medicare, but you usually need to choose from doctors within the plan’s network.
In terms of Part D coverage, Medicare Advantage plans vary in the specific drugs they cover. Also, drugs are classified in “tiers,” categories based on the number of required copayments. Your cost will depend on which medications you take and whether you use a pharmacy within your plan’s network.
Medigap
Offered by private companies, Medigap provides supplemental insurance coverage of healthcare that Traditional Medicare does not include. It helps with copayments, deductibles, and coinsurance. Whereas Medicare Advantage is an alternative to Traditional Medicare, Medigap is a supplement to traditional Medicare. Therefore, you must be enrolled in Traditional Medicare to enroll in Medigap.
The Best Medicare For You
The disadvantage of Traditional Medicare is that it may cost you more than having a Medicare Advantage plan.
The advantages of a Medicare Advantage plan include having all-in-one coverage that often includes prescription drugs and extra benefits, such as dental care, that Traditional Medicare doesn’t provide. Also, you have an annual cap for out-of-pocket expenses. Once you reach the limit, the plan will pay the full allowed amount. Plus, the premium for some Medicare Advantage plans is $0. Some plans also help pay part or all of the Part B premium.
If you are living on a low income or are unable to spend more on health insurance to pay Medigap premiums, a Medicare Advantage plan may be a more affordable choice than Traditional Medicare.
Medicare For Seniors in Miami, Florida
As a provider of senior-focused healthcare services in Florida, we at Palm Medical Centers believe you and your loved ones should receive all the assistance you are entitled to. As part of our commitment, we not only accept Medicare Advantage plans, Medicaid, and Commercial Plans from most major healthcare insurance providers, but also we have dedicated patient relations outreach representatives who can help you with Medicare application and plan selections.
To learn more, call Palm Medical Centers today at (833)500-PALM (7256) or send us a message now. With 26 clinics located throughout Central and South Florida, there’s bound to be a Palm Medical Centers location nearby to serve you.
