Aside from learning how Medicare works one of the more difficult aspects of the process is deciding how to insure yourself on Medicare. Once original Medicare A & B are in place you will need to decide how you want to insure yourself. There are two options as illustrated below:
Choosing Medicare Insurance.
Basically Medicare Supplements and Medicare Advantage Plans have different program designs. When you buy a Medicare Supplement plan you are still enrolled in Original Medicare which is insurance provided by the federal government itself. Medicare pays the majority of the bills and the supplement, carried by private insurance companies, pays some or all of the deductibles and coinsurance depending on the plan, associated with Medicare Parts A & B. To this you would then add a stand-alone Prescription Drug Plan (PDP) to cover your prescriptions.
When you buy a Medicare Advantage Plan, you move completely into a private health insurance plan. That means you are no longer insured by Original Medicare provided by the government, the private insurance pays the majority of the bills and you pay a coinsurance or copayment per visit.
Medicare supplements are offered by private insurance companies to help cover some or all of the costs associated with original Medicare. These plans, A, B, C, D, F, G, K, L, M, & N, offer various levels of coverage and are standardized nationwide that means the benefits in a Plan F do not vary from company to company but they do charge different prices for that Plan F.
Using this option means that the federal government provides the basic hospital and medical coverage and then you purchase a Medicare Supplement from a private insurance company to pay some or all of the costs associated with that basic coverage. With these plans you typically pay more up front in premium but little or nothing on the back end when receiving care, depending on the plan.
What Doctors can I see?
You may see any doctor who participates in the Medicare program and is accepting new patients. As a tool, there are no geographical limits on where you received care covered by your Medicare supplement policy, as long as care is received in the states. However, some policies do offer coverage of some emergency care outside the states.
When do I join?
The first six months of your eligibility for Medicare part B is your open enrollment Period. During this time you may choose any of the standardized Medicare supplement plans and your acceptance in the plan is guaranteed. In Maine this is true even if you are under age 65 and on disability. The insurance company may not consider your health history when setting rates for Medicare supplement. However Maine community rating state which means everyone pays the same rate for Medicare supplement plan regardless of age or health.
How much does a Medicare supplement cost?
As stated earlier, Medicare supplements are standardized nationwide so the coverage is identical from one company to another based on which a plan you select. As a general rule the more generous the benefits the higher the premium.
Can I change coverage later?
Medicare supplements are not subject to the lock-in period like the prescription drug plans or Medicare advantage plans which can only be changed during the annual enrollment (AEP).