Ask the right questions
Know the answers before buying into a plan
WHAT ARE THE DIFFERENT PARTS OF MEDICARE?
Medicare Part A provides coverage for hospital expenses, such as inpatient stays, hospice care, some at-home health services, and stays in skilled nursing facilities.
Part B covers other medical expenses, including doctors’ visits, various types of therapy, and part-time assistance from health aides or skilled nurses.
Medicare Part C, commonly referred to as “Medicare Advantage,” is a combination of Parts A and B. There are also Medigap plans that provide supplemental insurance coverage, but individuals cannot have both Medicare Advantage and Medigap.
Lastly, there’s Medicare Part D, which is available for prescription drug coverage.
WILL I SAVE MONEY BY SWITCHING TO MEDICARE?
For those on employersponsored health plans, the average deductible amount for single coverage is $1,644, and less than half of people on employer plans are satisfied with the choice of provider networks available. There are also more out-of-pocket costs for hospital admission and outpatient surgery under employer healthcare plans.
Medicare premiums tend to increase slightly year over year, but Medicare offers greater coverage options, covering 93% of primary care doctors nationwide. The standard premium for Medicare Part B was $148.50/month in 2021, up from $144.60/month in 2020. However, thanks to a short-term spending bill enacted by the federal government last October, the increase for 2021 was limited to 25% of what it would otherwise have been.
WHAT COVID-19 PROVISIONS DOES MEDICARE COVER?
COVID-19 tests, antibody/ serology tests, and telehealth visits have all been covered during the pandemic, and Medicare also provides 100% coverage for the COVID-19 vaccine for all beneficiaries. When you visit your provider to receive the vaccine, you should not be charged an office visit fee or any other fees if that was the only service performed.
WHEN DO I HAVE TO DECIDE?
Medicare’s annual enrollment period begins on Oct. 15 to Dec. 7, during which time all those with Original Medicare, Medicare Advantage or Part D prescription drug coverage can switch plans. There is an additional opportunity for individuals enrolled in Medicare Advantage or prescription drug plans to switch to a five-star rated Medicare Advantage plan between Dec. 8 and Nov. 30.
WHERE CAN I TURN IF I HAVE MORE QUESTIONS?
The best place to start is your Human Resources department, as they’ll be able to explain and compare the options available to you. A few other useful resources are Medicare.gov and State Health Insurance Assistance Programs (SHIPs), both of which are government-supported. If you need more help, there are also private Medicare plan selection services that can assist you in determining which plan best fits your needs and budget.