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Getting ready for Medicare enrollment on October 15th can be a shock once you begin to dive in and try to decipher the Medicare plan options.
A lot of people would simply love to ask which plan is best, pick it and move on…but it’s not that simple…not even close.
So, what is the best Medicare plan for seniors?
Unfortunately, there is no universal best choice for a plan. What you or a loved one will end up picking will depend on the following factors:
- Do you currently have any medical coverage?
- How often do you require medical attention?
- How much can you afford to pay each month coverage and prescription drugs?
- How important is your choice of healthcare providers?
- Does your current doctor accept the plan you’re choosing?
- What’s more important, cost or coverage?
- Do you travel frequently?
These questions are important as you choose between the two type of Medicare Plans – Original Medicare and Medicare Advantage.
Original Medicare consists of two parts, Part A and Part B.
How much you pay depends on your income and current coverage. Part A is free for most people, but Part B will cost you – anywhere from $100-$150 per month.
Again, this is all income dependent, so if you’re income is over a certain level, your premium will cost more per month.
In addition, there are copays and deductibles involved with both parts, so plan accordingly.
That brings us to Medicare Advantage plans, or Medicare Part C (detecting a pattern yet?)
Medicare Advantage plans are offered by private insurance companies approved by Medicare, giving you Part A and B coverage.
The Medicare Advantage plans give you access to a network of health care providers, and perhaps even doctors out of network, but expect higher costs.
Which Medicare Plan Is Best?
So which is the best Medicare plan for seniors? Again, it depends on what you’re looking for and some of the answers to the questions above.
Orignal Medicare typically offers more choices of hospitals, doctors and specialists. These plans are covered by the government, so they won’t go out of business and premiums are set each year by the government, not private insurance companies.
Sounds pretty good right? Not so fast, Original Medicare can actually cost more than Part C (Advantage) if you need a Medigap Plan (Part D for prescription drugs).
And that’s starts us down the rabbit hole. Adding Medigap plans for prescription drugs can get complicated, compounded by the fact that Original Medicare HAS NO OUT OF POCKET SPENDING LIMIT. So if you have serious medical complications, you could face high out of pockets costs.
That brings up to Medicare Advantage Plans (Part C). These plans basically cover all your medical needs, incorporating drug and supplemental coverage with the other items Part A and B cover.
As a bonus, some of these plans can also cover vision, dental and hearing issues.
These plans usually have lower cost sharing than Original Medicare and allow a primary care doctor to coordinate your healthcare.
Great, Part C is the way to go, right?
Again, not so fast. Part C or Medicare Advantage plans can have higher premiums than Part B. These plans do sometimes move or shut down, forcing you to go shopping for a plan again.
Medicare Advantage plans also require referrals for specialists visits, if if that specialist or a medical professional is out of network, you’re simply going to pay more.
In the end, it’s best to sit down, write out what’s important to you in a Medicare Plan, then shop your options for BOTH plans, Original Medicare and Medicare Advantage. Understand what your budget is, how important it is that you see certain doctors and what your costs are going to be with Original Medicare and any gaps you need to fill with Medigap plans covering prescription drugs and offering supplemental help with deductibles and other out of pocket expenses.