Medicare is the national social insurance program that guarantees access to health care for the elderly and disabled. While many Americans would stick to the conventional Medicare benefits, there are other health care options offered by Medicare. Comparing these plans and choosing the best one can be overwhelming, but Medicare has an online plan finder tool, which you can access in just a couple of mouse clicks.
Medicare Traditional Health Care Plans
If you are 65 and older, you are eligible for the Traditional Medicare Plans. Those who are disabled or diagnosed with End-Stage Renal Disease and those with Amyotrophic Lateral Sclerosis can also qualify. The traditional Medicare has two parts Part A and Part B. Part A generally covers for inpatient hospital care and Part B covers outpatient care. Doctor’s visit is included in the Part B coverage. Under the traditional Medicare plans, beneficiaries can see any doctor in the United States that accepts Medicare.
The cost for Medicare Part A coverage depends on whether you worked in the United States for more than ten years. If you do, then the coverage is for free. However, if you don’t, there is a monthly charge that you need to pay. Part B coverage, on the other hand, requires a monthly premium that increases every year.
Types of Medicare Advantage Plans
The federal government instituted the Medicare Modernization Act of 2003 in an effort to reduce remaining cost. It results to a new health care insurance option known as the Medicare Advantage Plan. Anyone who is above the age of 65 and currently has Medicare Parts A and B can qualify for the new plan.
When you enroll in the Medicare Advantage Plans, there are five types of plans that you can choose – the Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), Private Fee-For-Service (PFFS), a Medical Savings Account (MSO), and Special Needs Plans (SNP) plans. Most people prefer HMOs and PPOs. In PPOs, there is a specific network of doctors, to which you can go without having to pay additional costs. If on the other hand, you want a doctor that is out of network, you can still get coverage. However, there are extra costs that you have to pay out-of -pocket.
With Health Maintenance Organizations or HMO, you are not allowed to go out of the network to see a doctor, except for emergency cases. The benefit of PPOs and HMOs is that medication is included in the plan.
Special Needs Plans work almost the same as the PPOs and HMOs because it also covers medication and they have networks of doctors, to which you can go in order to get coverage. The difference is that care is provided for individuals who are in long term care facilities like nursing homes. If you are under the SNPs, you are entitled to receive for both Medicare and Medicaid.
Medicare Supplemental plans
Medicare supplement plans also known as Medigap plans fills the gaps in Medicare. It provides coverage to what the Original Medicare does not cover. Since Medicare can only cover about 60% of your healthcare expenses, it is very handy to have a Medigap in hand.
It offers flexible financial and health security through its ten standardized plan. Since Medigap is offered by private companies, it varies in prices from one insurance company to another.
Like Medicare, Medigap also has open enrollment period which 6 months that starts from the day you turn 65 years old and have Medicare Plan b. This enrollment period is very crucial because it only happens once in your lifetime or else you won’t be able to get a policy or you’ll pay for higher premiums.
Medicare, Medicare Advantage, and Medicare Supplement plan can help you in many ways. It provides several health care benefits to their members. If you want to know more about Medicare Health care options, you can contact the Medicare hotline or visit their official website for further details.