Medicare Part C is the home for Medicare Advantage plans, which basically provide coverage for the 20% of costs not covered by traditional Medicare Parts A and B. In the previous blog, we discussed the benefits of an MA plan and the decisions you should consider before signing up with one of the private insurance companies that offers them.
As with most things in life, MA plans are not free! Part of your decision-making should be looking at the cost of premiums and the amount of co-pays and deductibles a plan charges.
The suppliers of MA plans are free to set their own co-pays and deductibles. By law, they have to offer the same benefits but what you pay for them can differ. Medicare pays the companies for each person who enrolls in an MA plan. It is a fixed fee, not based on the amount of coverage the person has.
When you speak with a potential MA provider, you will want to know:
What is the charge for its monthly premium? (This will be in addition to what you pay for Part B.)
How are premiums charged, i.e., based on age, based on a group rate?
Is there a deductible?
What are the co-pay charges in network and out of network?
If Part D is included, is there a separate charge for that?
What is the plan’s limit on annual expenses (both deductibles and co-pays)?
As we said in the last blog, C stands for complicated. If you have questions or concerns about Part C coverage, I am here to help.
Now, here is a little bit about Medigap.
Like Medicare Advantage, Medigap is not a government program, it is administered by private companies. It is designed to cover out-of-pocket expenses not covered by traditional Medicare. It is an alternative to Medicare Advantage, i.e., you can’t have both.
Medigap policies cover specific geographic areas, so you would enroll in one only in your area. You can receive care outside of the area unless you have chosen Medigap Select, which does not provide coverage outside your service area.
Also, Medigap has different sign-up regulations. You must sign up within six months of signing up for Part B. The policy is renewed automatically every year. It is not impossible, but is difficult, to switch from Medigap to either Medicare Advantage or back to just traditional Medicare.
You will pay a monthly premium for Medigap. Premiums vary by company. There are ten Medigap policies that offer different benefits (A, B, C, D, F, G, K, L, M, N). Medigap does not cover Part D prescription drug costs.
We advise investigating every aspect of Medicare Advantage and Medigap plans before you buy. Better shop around! Fine the plan that fits your needs.