Medicare covers many of your healthcare needs. Medicare works with approved private companies that provide healthcare and prescription drug coverage.
The Medicare plan that you choose affects many things like cost, benefits, doctor choice, convenience, and quality.
Your Medicare plan choices include:
The Original Medicare Plan
This is a fee-for-service plan that covers many healthcare services and certain drugs. You can go to any doctor or hospital that accepts Medicare. When you get your healthcare, you use your red, white, and blue Medicare card. The Original Medicare Plan pays for many healthcare services and supplies, but it doesn’t pay all of your healthcare costs. There are costs that you must pay, like coinsurance, copayments, and deductibles. These costs are called “gaps” in Medicare coverage. You might want to consider buying a Medigap policy to cover these gaps in Medicare coverage. You can also add prescription drug coverage by joining a Medicare Prescription Drug Plan.
Medicare Advantage Plans
Medicare Advantage Plans are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered healthcare through that plan. This coverage can also include prescription drug coverage. Medicare Advantage Plans include:
- Medicare Health Maintenance Organization (HMOs)
- Preferred Provider Organizations (PPO)
- Private Fee-for-Service Plans
- Medicare Special Needs Plans
To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. These plans may cover more services and have lower out-of-pocket costs than the Original Medicare Plan. Some plans cover prescription drugs. In some plans, like HMOs, you may only be able to see certain doctors or go to certain hospitals to get covered services.
Medicare Prescription Drug Plans
Medicare prescription drug coverage is insurance that covers both brand-name and generic prescription drugs at participating pharmacies in your area. Medicare prescription drug coverage provides protection for people who have very high drug costs or from unexpected prescription drug bills in the future.
You may sign up when you first become eligible for Medicare (three months before the month you turn age 65 until three months after you turn age 65). If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments. If you don’t sign up when you are first eligible, you may pay a penalty.
Want More Information About Medicare?
Area IV Agency offers free, unbiased help for people in the West Central Indiana area to make decisions about their Medicare health insurance coverage. Our counselors are certified through Indiana’s State Health Insurance Assistance Program (SHIP).
Area IV Agency provides expert SHIP counseling through phone or face-to-face appointments. Our counselors are available Monday through Friday, 8:00 a.m. to 4:00 p.m.