Medicare Insurance Plans


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When you reach your 60s, you start to think about what your health insurance will look like after retirement. Medicare contains different types of plans, and each plan has its unique benefits. You will have several Medicare insurance plans to choose from when you approach age 65. Additionally, you might not be 65 but have other characteristics or factors in your life that make you eligible for Medicare plans.

Original Medicare

Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) make up Original Medicare. This Medicare insurance plan is available to those 65 and older, but the federal insurance program is also open to disabled people and those with end-stage renal disease.

Is Part A free? You can qualify for premium-free Medicare Part A based on your earnings or those of your spouse, parent, or child.

If you are 65 or older and are eligible for monthly Social Security or Railroad Retirement Board cash benefits, then you may have premium-free Medicare Part A. Individuals who pay a premium for Part A must complete an application to enroll through the Social Security Administration within a specified timeframe. These people must also enroll, if not already done so, in Part B.

Medicare Advantage

Part C is known as Medicare Advantage. Some refer to it as MA plans for short. Medicare-approved private companies sell these Medicare Advantage policies to the public. These plans are alternatives to Original Medicare’s Part A and Part B and have extra benefits that Original Medicare does not cover.

There remains a strict set of regulations private companies must follow to offer this type of coverage. Yet, they can decide on eligibility rules from year to year. You might qualify for an insurance company’s MA plan for one year but be disqualified from the plan the following year.

Part D

Prescription drug plans are helpful for many Medicare enrollees. Part A and Part B do not cover this service, but you can enroll in a separate plan, Part D, for Medicare drug coverage. If you have Medicare Advantage, your MA plan may already offer prescription drug coverage. Each Medicare Part D plan contains a formulary known as a list of drugs covered. Plans can feature brand-name and generic prescription drugs. Numerous plans list their covered drugs in tiers based on the costs of each medicine.

Medicare Supplement Insurance Plan (Medigap)

Original Medicare beneficiaries often pay out-of-pocket costs in copays, coinsurance, and deductibles. Private insurance companies design Medicare supplement plans to fill in the gaps in coverage left open by Part A and Part B. The government standardized each Medicare supplement product to hold the same general benefits regardless of where you live and which insurance company sells the policy. Letters represent each of the different policies: Plans A, B, C, D, F, G, K, L, M, and N. Plans C and F are no longer available to the public if you turn 65 on or after January 1, 2020, and for some people under age 65.

Medicare Cost Plans

Private insurance companies may offer Medicare Cost Plans for limited areas of the country. These policies combine features from Original Medicare and Medicare Advantage. In 2019, the federal government discontinued Medicare cost plans in much of the nation. However, you can still inquire if they are available in your location.

Demonstrations and Pilot Programs

The Centers for Medicare & Medicaid Services (CMS) also conducts research studies to test new configurations for Medicare coverage, payment, and quality of care in demonstration and pilot programs. Participation in these experimental studies is available at a specific time for select places and people.

Program of All-Inclusive Care for the Elderly (PACE)

PACE is a federal program for those 55 or older who require nursing home-level care. Applicants must live in the PACE service area and be able to live safely in the community with PACE’s assistance. This Medicare and Medicaid program assists individuals with their healthcare needs in the community instead of going to an assisted living facility or nursing home. The PACE program’s care covers all Medicare and Medicaid services and additional services that improve and support an individual’s health as determined by PACE workers. Applicants with Medicaid do not pay a monthly premium. Those with Medicare but do not qualify for Medicaid must pay a premium for Medicare Part D medicine and a monthly premium for PACE’s long-term care.

Whatever Medicare insurance plan you need, contact Empower Brokerage at (888) 539-1633 and ask to speak with one of our friendly licensed agents for a Medicare review.

If you found this article insightful, please read another intriguing piece about understanding ACA health insurance.

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About Joey Hinojosa

Joey Hinojosa graduated with a bachelor's degree in broadcast journalism and a master's degree in mass communications. He began working at Empower Brokerage in early 2022 and enjoys being creative in his writing, photography, videography, animation, and other projects.

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