The premiums and coverages vary, and you must realize the differences.
Medicare’s open enrollment period runs from October 15 to December 7. If you are enrolling in Medicare for the first time, give yourself plenty of time. You may discover that it is much more complex than an employer-sponsored group health plan.1
Medicare takes a little time to understand. As you approach age 65, familiarize yourself with its coverage options, costs, and limitations.
Certain features of Medicare can affect health care costs and coverage. Some retirees may do okay with original Medicare (Parts A and B), others might find it lacking and decide to supplement original Medicare with Part C, Part D, or Medigap coverage. In some cases, that may mean paying more for health care than you initially figured.
How much do Medicare Part A and Part B cost, and what do they cover? Part A is usually provided with no charge; Part B is not. Part A is hospital insurance and covers up to 100 days of hospital care, home health care, nursing home care, and hospice care. Part B covers doctor visits, outpatient procedures, and lab work. You pay for Part B with monthly premiums, and your Part B premium is based on your income.1
It’s best to prepare for the copays and deductibles linked to original Medicare. In addition, original Medicare does not cover dental, vision, or hearing care, nor prescription medicines or health care services outside the U.S. It pays for no more than 100 consecutive days of skilled nursing home care. These out-of-pocket costs may lead you to look for supplemental Medicare coverage as a way of paying for extended care.1
Medicare Advantage (Part C) This is why so many retirees decide to buy Medigap policies or enroll in comprehensive Medicare Advantage (Part C) plans—they recognize the shortcomings of original Medicare. The downside of Part C plans is that you are restricted to the doctors in their networks. Original Medicare allows you to choose any doctor that accepts Medicare (though it is smart to have a Medigap policy as well).
You can freely switch from one Medicare Advantage plan to another in the open enrollment period; you can also enroll in one without having to go through underwriting. If you want to move from a Part C plan back into original Medicare, you may not be able to supplement Parts A and B with a Medigap plan right away because underwriting will be required.3
Medigap policies help Medicare recipients with some of these copays and deductibles. Sold by private companies, these health care policies can pay a share of certain out-of-pocket medical costs (i.e., costs greater than what original Medicare covers for you). You must have original Medicare coverage in place to purchase one. The Medigap policies being sold today do not offer prescription drug coverage.2
Part D plans cover some (but certainly, not all) prescription drug expenses. Monthly premiums are averaging $32.74 this year for these standalone plans, which are offered by private insurers. Part D plans currently have yearly deductibles of less than $500.3,4
Creating a Medicare strategy is integral to your retirement preparation. Should you try original Medicare for a while? Should you enroll in a Part C HMO with the goal of managing your overall out-of-pocket health care expenses? There is also the matter of eldercare and the potential need for interim coverage if you retire prior to 65. Discuss your concerns about Medicare in your next conversation with your financial professional.
Whether you are enrolling in Medicare for the first time or considering a change in coverage, it is vital to understand these matters. If you have questions, visit Medicare.gov or ssa.gov/medicare for more information.
Citations
- cnbc.com, August 26, 2020
- medicare.gov, September 16, 2020
- medicare.gov, September 16, 2020
Citations.
- Medicare.gov, August 13, 2020
- Medicare.gov, August 13, 2020
- CNBC.com, August 6, 2020
- Medicare.gov, August 13, 2020