When you reach age 65, you have to make one of the most important decisions of your life: which Medicare plan you want to sign up for. Many people make the mistake of thinking that Medicare is a free blanket that everyone automatically gets at a certain age, but nothing could be further from the truth. Making the wrong choice could create all manner of problems for you in terms of coverage and expenses. Read our guide to choosing between traditional Medicare vs. Medicare advantage, and how a Medicare attorney can help you plan for your future.
The Two Kinds of Medicare
There are essentially two different kinds of Medicare: Traditional and Advantage. Traditional Medicare (also called Medicare Part A and B) gives you a choice of doctors and providers that accept coverage, while Medicare Advantage (Medicare Part C) acts like a PPO or HMO, providing a network of providers from whom you must choose.
Traditional Medicare provides hospital coverage as well as medical coverage and in 2016, costs an average of $104.90 every month. You have a deductible as well as coinsurance for services rendered, with no out-of-pocket maximum. This level also does not include prescription coverage, unless you add Medicare Part D, which increases your premium. Because there are no out-of-pocket maximums, many people opt for supplemental coverage to make up the difference.
This is the Medicare that automatically kicks in if you are currently paying Social Security when you turn 65. You get this plan automatically unless you choose to opt out. In addition, with traditional Medicare you have a much wider list of options as to who provides your healthcare.
Medicare Advantage is provided by private insurance companies that Medicare approves, rather than by Medicare itself. Because it behaves like a PPO, you need to use doctors and providers approved in your plan’s network.
The average cost for Advantage is around the same as for Traditional Medicare, plus an additional premium that could range from $30 to $60 or higher for your additional coverage. Depending on your play you may have a copayment or coinsurance for services. Drug coverage may also be included.
The key to Medicare Advantage is that it behaves much more like the insurance you likely had before retirement.
How to Decide
Deciding between Traditional Part A and B Medicare and Medicare Advantage Part C can be a very daunting choice for many seniors. They’re not sure which, in the long run, will cost more and which will provide better coverage. While it is possible to switch from one to the other, there can be complications, particularly for those requiring care for an ongoing condition.
This is why it can be very helpful to have the services of a qualified Medicare attorney who is specialized in planning for the future. If you live in Cuyahoga County in Ohio and are in need of more information or advice regarding which Medicare plan is best suited to you, call Stano Law today for an evaluation of your future Medicare planning needs.