Cake. Balloons. Medicare?! Your 65 birthday represents a milestone in your retirement. When you turn 65 itâ€™s your golden opportunity to select a Medicare plan to meet your needs.
Medicare may seem complicated at first glance, but it doesnâ€™t have to be. The help of a knowledgeable SelectQuote agent removes uncertainty when shopping for Medicare. He or she will simplify the process for your current and long-term healthcare needs.
When purchasing your Medicare plan, itâ€™s important to consider the plan premium and the value it provides.
â€œThink about your healthcare long term,â€ advised David Perlberg, a licensed SelectQuote insurance sales agent. â€œThe first time you enroll at 65 is the only time when you can gain Medicare Supplement insurance with no questions asked. If you decide to change your plan down the road, youâ€™ll need to qualify medically for supplemental insurance. Many people canâ€™t get the insurance they desire at that point. Your agent will help you think through future costs when you first enroll, helping you protect yourself from skyrocketing prices later on.â€
The following questions will help you discuss your Medicare options with your insurance agent.
Does Basic Medicare Cover My Needs or Will I Need Additional Coverage?
Basic Medicare includes Parts A and B. Together, Medicare Parts A and B cover items including hospital care, skilled nursing facility care, ambulance services and durable medical equipment.
Basic Medicare may not offer enough coverage. It doesnâ€™t cover everything â€“ often it covers only 80 percent of costs.
Thatâ€™s why many people choose to get a Medicare Advantage plan or a supplemental plan. As you work with your insurance agent, discuss if you need additional coverage for your situation.
What is the Difference Between Medicare Supplement Plans and Medicare Advantage Plans? How Do I Decide Whatâ€™s Best for Me?
Medicare Supplement plans (sometimes called Medigap Insurance) help provide for gaps in coverage. They save you from the high out-of-pocket costs of Basic Medicare. Medigap Insurance pays some or all of the healthcare costs Basic Medicare doesnâ€™t, such as co-payment, co-insurance and deductibles.
Medicare Advantage plans, also known as Medicare Part C, are offered by private insurance companies that contract with Medicare to provide services. This includes HMOs and PPOs. All the benefits of Medicare Part A and Part B are covered but these plans often include prescription drug coverage and have more bells and whistles. They also carry an annual limit on your out-of-pocket costs for medical services. This is not the case with Basic Medicare, where your costs continue indefinitely. This is a major benefit of a Medicare Advantage plan.
Your SelectQuote agent can help you determine the right solution for your specific healthcare needs.
Can I Still Go to My Preferred Doctor, Specialist and Hospital? Â
If a Medicare Advantage plan is the best fit for you, consider whether the plan includes your current doctors, specialists and places for care in network. A SelectQuote advisor can work with you to find a plan that includes your providers. If for some reason your providers are not included, your agent can also help you find a new provider.
Are My Prescriptions Covered?
Prescriptions are not covered with Basic Medicare. This is where Medicare Part D comes in. A Medicare Part D plan helps with the cost of prescriptions. It may also help lower your current costs for prescription drugs and may help protect against higher future costs for your medicines.
Medicare Part D plans can be purchased as a standalone plan to Basic Medicare or coverage can accompany a Medicare Supplement plan. Medicare Part D coverage is often included in Medicare Advantage plans.
However, even with Medicare Part D there are often gaps in prescription coverage. Itâ€™s what Perlberg calls the â€œdoughnut hole.â€
â€œThe cost of prescriptions is the number one shocker I see for people coming off of group insurance,â€ said Perlberg. â€œTalk to your insurance agent about the prescription doughnut hole. Your agent can help you account for gaps in prescription coverage and determine how much you can expect to pay out-of-pocket.â€
What Plans Cover Hearing, Dental and Vision Care?
Some Medicare Advantage plans include hearing, dental and vision coverage. If you are looking into a plan that doesnâ€™t have dental, vision or hearing and those are pieces you are interested in, a SelectQuote licensed sales agent will help you find the coverage you need.
How Do I Use Medicare Coverage? Do I Need to Get Medical Care Approved First?
Coverage works similarly to employer or Exchange provided healthcare insurance. Once youâ€™ve found a provider that accepts your coverage, youâ€™ll gain approval for the cost and be billed out-of-pocket for what is not covered.
How Does My Plan Impact Coverage When Iâ€™m Traveling?
If you plan to travel often in retirement, a Medicare Supplement plan could be a good choice for you. If a doctor or hospital accepts Original Medicare, they are required to accept a patient with a Medicare Supplement plan. A Medicare Supplement plan makes getting covered care easier when traveling than a Medicare Advantage plan, where you’ll need to find an in-network provider.
There is a lot to consider when buying your Medicare plan. Your insurance agent will help you select the best option for your current and future needs. Medicare Annual Enrollment for 2019 coverage started Oct. 15 and runs through Dec. 7. For more information, contact a SelectQuote licensed agent at 1-888-250-3820.
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