When you turn your television on to watch your favorite show or catch the news, you more than likely have viewed commercials featuring Joe Namath and J.J. Walker. These two celebrities can be seen daily advertising products that revolve around Medicare. Both Namath and Walker are encouraging you to call a toll-free number to check on your Medicare benefits.
We have had many people come in our office that enrolled in one of these plans. They come to us for assistance because they do not fully understand how their medical coverage works. Many individuals sign up for an Advantage Plan fully believing that the plan will supplement their Medicare. This is simply not the case.
So, what exactly are most commercials such as these recommending? These commercials are wanting you and other Medicare beneficiaries to sign up for a Medicare Advantage Plan. What exactly are Medicare Advantage Plans and are they different from original Medicare?
Original Medicare (Part A and Part B)
Original Medicare and Medicare Advantage Plans (MAPD) are very different. You can NOT have both original Medicare and a Medicare Advantage Plan simultaneously. You will have one or the other for your coverage. A person can NEVER have both working together for medical coverage. Original Medicare is made up of two parts, Part A and Part B. Medicare Advantage Plans are known as Part C.
Let’s first look at original Medicare and how coverage works if you choose this option. Original Medicare (Part A and B) will pay 80 percent of Medicare-covered services. This leaves you paying the remaining 20 percent.
To cover the 20 percent gap, most Medicare beneficiaries will purchase a Medicare Supplement plan. If you have original Medicare (Part A and B) with a Medicare supplement, sometimes called a Medigap plan, you will have little to no out of pocket expenses for your medical care.
With original Medicare (Part A and B), you have access to ANY doctor or provider who accepts Medicare. When I explained this to a client, she looked at me and said, “so my network is the United States”. Yes, basically what she said is true. Another perk of original Medicare (Part A and B) is NO referral is needed from a primary care provider to see a specialist.
If you have original Medicare (Part A and B), you will have to purchase a separate plan for your drug coverage. Without going into much detail, these are referred to as your Part D or your Prescription Drug Plan. These plans are generally very inexpensive.
Medicare Advantage (Part C)
Your other option for coverage will be a Medicare Advantage Plan. Medicare Advantage plans (Part C) are an alternative to original Medicare (Part A and B). Advantage plans (Part C) replace or stand in place of original Medicare (Part A and B). If you sign up for an Advantage plan (Part C) you are replacing your original Medicare (Part A and B) with a private company that will manage your healthcare.
Because Medicare Advantage Plans (Part C) are sold through private insurers, they can offer additional coverage above original Medicare (Part A and B). Additional coverage usually will include dental and vision coverage. Generally, the monthly premiums for an Advantage Plan (Part C) are relatively inexpensive.
You will have fewer choices in terms of doctors and health care providers, because you will be in a network with a Medicare Advantage plan (Part C). You may also be required to get a referral from a primary care doctor to see a specialist. Most Medicare Advantage Plans (Part C) will offer prescription drug coverage. This means a separate plan for medication coverage will not have to be purchased.
*Medicare Supplement (Medigap) Plans – generally a turning 65 female can purchase a plan at a cost of between $70 and $90 monthly. A turning 65 male can purchase a plan at a cost of between $80 and $105 monthly.
Our first priority as an independent agency is to provide you with all of your options for coverage. Secondly, we assist you in understanding these options. It is important to base your decision on what is the best option for you and your medical care.
Belmont Office – 662.454.9800 Tupelo Office – 662.269.8833