My Medicare--What’s Best for ME?

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My Medicare--What’s Best for ME?

Medicare open season is approaching and that means you are soon going to be able to enroll or change your coverage. Especially for those turning 65 this year, you need to investigate what the Medicare options are and what’s best for you.

So What Does Medicare Cover?

Medicare has different parts you can purchase.

PART A covers hospital care, skilled nursing care, hospice, and some home health care. Premiums are based on Social Security credits, so those with more than 10 years of work history get this part for free. You will also have to pay copays and deductibles, so you will have out of pocket costs.

PART B covers outpatient care, preventative care, and doctors visits. Part B premiums are set to rise this year, by up to 52%. This part will also have copays, deductibles, and coinsurance.

PART C is the Medicare Advantage plan. It substitutes for parts A and B and has similar coverage. The Advantage plan has limits on out of pocket expenses, but at the same time usually has higher copays and coinsurance. The network of doctors and hospitals you have access to also tends to be more limited, however the plan does sometimes cover dental and vision services, which parts A and B do not.

Part D covers prescription drugs.

In addition, many private insurance companies offer Medigap insurance, to cover additional types of care which traditional Medicare does not. The premiums on Medigap vary greatly depending on the provider, your age, gender, health, and other factors.

Then What’s Best For Me?

There is much to consider when choosing a Medicare plan. First of all, you need to be honest about your health. What kind of care will you need? Those who are young and healthy may find the Advantage plan to be the cheapest option.

What is your family medical history? If you know you have a predisposition for certain health problems, you need to consider even though you are healthy now, you may not be in the future. In which case, it may be better to elect for traditional Medicare parts A, B, and D and then purchase additional Medigap insurance. Medigap may give you access to a wider network of physicians and hospitals, and may not require you to have medical operations approved by the insurance company as traditional Medicare does.

Be honest about your financial situation. Can Medigap fit into your financial plan? If so, it may be the best option. Medicare parts A and B may be cheaper when looking at premiums, but the out of pocket costs could be a lot. A and B have no limit on what you could pay out of pocket. For example, if you were to be hospitalized for more than 60 days, for each day of the benefit period you would have a $315 coinsurance payment.

Finally, consider other health related costs. One in five will spend at least $25,000 out of pocket on long term care in their lifetime. A room in a nursing home can cost up to $70,000 annually. Medicare does NOT cover long term care.

You need to carefully consider your Medicare plan. Know your options. Consider your finances, health, and potential future health related costs before making any decision on what plan is best for you. Being knowledgeable of your options, and reflective of your own situation, will help you make the right choice.

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