Medicare open enrollment runs from October 15th - December 7th, 2020
As Seniors, you need to think about how Medicare will cover your health care needs, your first major decision should be whether you want to enroll in original Medicare through the government or select a Medicare Advantage plan which is offered through private insurance companies.
If you choose original Medicare your coverage will include Part A (hospital care).
Part B (doctor visits, rehab, lab tests and other outpatient services) and Part D (prescription drugs) you can choose to add also and enroll separately.
If you decide to go with Part C, a Medicare Advantage plan a private insurer will generally bundle together parts A and B and almost always D into one comprehensive plan.
Covered Care
Under original Medicare, you can choose any primary care doctor and specialist who accept Medicare. You don't need a referral to see any medical provider and you don't have to worry about your doctor leaving a network.
The Kaiser Family Foundation says approx. 93 percent of primary physicians participate in Medicare. Which means the doctor you are currently seeing most likely accepts Medicare and you won't have to change doctors.
With a Medicare Advantage plan you will join a private insurance network, similar to what you probably had at work.
The most common ones are health maintenance organizations (HMOs) and preferred provider organizations (PPOs). You would have a primary care physician who would direct your care and would need a referral to any specialist.
HMOs tend to have more restrictive choices of medical providers than PPOs.
Costs
With original Medicare the federal government sets the premiums, deductibles and coinsurance amounts for Part A and Part B. Your generally responsible for 20% of medical costs. The government sets maximum deductible rates for the Part D prescription drug program.
Because Medicare only pays 20% most -people purchase a supplemental – or Medigap – policy to help with out-of-pocket costs.
With a Medicare Advantage plan you would still pay the government-set annual Part B premium and sometimes an additional premium for the MA plan. But instead of paying the 20 percent coinsurance amount for doctor visits and other Part B services, most MA plans have set copay amounts for a physician visit, and typically that means lower out-of-pocket costs than original Medicare. MA plans also have an annual cap on out-of-pocket expenses.
Where you live
With original Medicare you can access care anywhere in the United States as long as the provider accepts Medicare.
Medicare Advantage plans are based around networks of providers that are usually self-contained in a specific geographic area. So, if you travel a lot or have a vacation home where you spend a lot of time, your care may not be covered if you go to out-of-network providers, or you would have to pay more for care.
Very Important!
Original Medicare offers nursing home care for a temporary time period under certain circumstances - Not all Advantage Plans do - please verify this before choosing an Advantage Plan. This could cost you $350/day or more if you need temporary nursing care after a hospital stay.
for more information visit - Medicare.gov
