At 65, Original Medicare Part A and B come from the government and are the same throughout the country. Part B has a premium based on income which is paid through the Social Security office and together, they cover hospital and medical needs. However, both parts have deductibles and Part B has coinsurance costs creating big gaps in coverage.
Since health care expenses tend to increase with age and Original Medicare alone does not cover all expenses, decisions need to be made as to how you wish to have your extra Medicare costs covered: Original Medicare with a Medicare Supplement and Part D Rx policy OR a Medicare Advantage policy.
Medicare Supplement insurance plans are identified by letters. Plans A through N are designed to go with Original Medicare Parts A & B. These plans are Federally-standardized: all insurance companies must offer the same coverage plans, so there is no difference in coverage from one company to another. Premiums vary among insurance companies as well as the company’s service and experience. For a set premium, they cover most copays and deductibles. They also allow you to choose a doctor or travel anywhere in the country and be covered.
These Med Supp or “gap plans” need to be combined with Part D Rx plans (PDPs). These are private health plans that contract with Medicare to provide prescription drug benefits only (and no other benefits).
As an alternative, Medicare Advantage plans are private health plans such as HMOs, PPOs, POSs, or PFFSs (Private Fee for Service) plans that contract with Medicare to provide additional benefits that offset some of the costs from deductibles and copays in Medicare Part A & B. In most cases, these plans also include Medicare prescription drug coverage. There are copays, deductibles and network limitations that require you to go to a doctor in the insurance company’s Medicare provider directory.
Whether you are looking for a freedom of choice or a network plan, you can apply as early as three months before your birthday month with coverage starting the 1st day of your birthday month.