Are you still unable to gauge which Medicare coverage will work great for you? To understand this, let’s first discuss why we need Medicare coverage.
Medicare refers to any insurance plan offered by the Federal Government to cover the necessary medical aid depending on your plan. Adults over the age of 65, dialysis patients, and young people with any physical impairment can benefit from it. A modest fee is charged.
Once you have decided to be a part of this program, you have two ways to go around: either an Ordinary & Advantage Medicare plan or Medicare Supplement Insurance Plan. But how to decide between the two. Let’s talk about it.
Ordinary & Advantage Medicare Plan
With an Ordinary Medicare plan, you can consult a doctor directly without any referral. This type covers Plan A and B. Plan A includes hospital care, whereas plan b includes medical care like ambulance services and some medical equipment.
To avail of Plan B services, you will need to pay20% of the cost affiliated with your Medicare services at the start of each year, called co-insurance. There’s a separate plan, Plan D, for you if you want drug coverage.
Then there’s an alternative to this coverage, named Medicare Advantage, offered by the private sector. It provides Plans A and B services (sometimes plan D as well) with a different set of rules along with a few other benefits that come under plan C. The services include overseas emergency medical coverage, dental, eye, and hearing treatment as well. You must have an Ordinary Medicare plan to enroll in this program and see whether you come under their service area.
Medicare Supplement Insurance Plan
This type of plan covers all your Ordinary Medicare services and the deductibles coverage, the extra cost needed for your Medicare coverage. However, it does not account for the services not provided by Medicare. You may get access to emergency medical aid while traveling to another country with additional charges on plan B.
You need to be aware that Medicare Supplement Insurance plans are only applicable to Ordinary Medicare, not with Advantage Medicare plans.
Comparing Medicare, Advantage Medicare, and Medicare Supplement Insurance Plan
1. In terms of facility provider
With Ordinary Medicare, you can easily consult any specialist or a hospital that provides Medicare facilities without any permit, but that’s not the case with Advantage Medicare. Sometimes you can only consult doctors that come under your plan, and you need a referral every time you consult a specialist.
2. In terms of cost
If you are part of an Ordinary Medicare plan, you need to pay for plan B services (co-insurance). Moreover, if you choose to add plan D, you may have to pay an annual deductible and copayments or coinsurance. Whereas, Medicare Supplement Insurance Plan (Medigap) covers your co-insurance and deductibles.
With an Advantage Medicare plan, you may be required to pay out-of-pocket charges in addition to a monthly payment for plan B.
You can upgrade your Ordinary Medicare plan to Medigap to get cover for co-insurance and out-of-cost expenses.
3. In terms of coverage
Ordinary Medicare covers necessary treatments provided by most Medicare-affiliated facilities, but not supplementary services such as routine checkups, dental care, and so on. To cover your prescription drug coverage, you must apply for Plan D.
Advantage Medicare covers all the expenses that Ordinary Medicare covers, as well as additional routine services that Ordinary Medicare does not cover. Plan D is usually included as part of an insurance package. Medigap does not account for extra routine services and drug coverage like Ordinary Medicare.
There is no right or wrong when it comes to selecting a Medicare plan. You must weigh the advantages and disadvantages of each to choose which will be perfect for you. If you currently have an Ordinary Medicare plan, you can be upgraded to Medicap if necessary.