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Managing Out-of-Pocket Medicare Costs

Managing Out-of-Pocket Medicare Costs

Original Medicare Parts A and B do not cover 100% of your health care costs. In general, you are responsible for:

  • A monthly Part B premium (Part A is premium-free for most people)
  • An annual Part B deductible
  • 20% of the Medicare-approved amount for outpatient services covered by Part B, such as doctor visits
  • Deductibles, co-insurance, or co-payments when you receive inpatient services covered by Part A
  • Prescription drug costs

 

Luckily, there are two ways you can get help:

  1. Choose a Medicare Advantage Plan

Medicare Advantage (Part C) is an alternative to Original Medicare Parts A and B. It’s a different way to get your Medicare benefits.

Medicare Advantage plans are offered by private insurance companies and every plan must include all the benefits provided by Original Medicare Parts A and B.  Plus, many plans include prescription drug coverage and may offer additional benefits such as: dental, vision, and hearing care – all in a single plan.

Coverage and costs are set by each plan. In general, you pay a small co-pay for the health care services you use. Also, Medicare Advantage plans are required to place a cap on the out-of-pocket costs you might have to pay in a year (there is no cap with Original Medicare Parts A and B).

  1. Add Medicare Supplement Insurance and/or a Part D plan

Medicare supplement insurance is supplemental coverage that you can add to Original Medicare Parts A and B. The benefits provided by each plan are standardized by the federal government and help pay for some or all of the out-of-pocket costs not paid by Original Medicare Parts A and B.

Medicare supplement plans are offered by private insurance companies.  In general, they help with your cost sharing for Parts A and B, like deductibles, co-payments, and co-insurance.  They don’t cover things like vision, dental, hearing care or prescription drug coverage.

You can choose to purchase a Medicare Part D prescription drug plan in addition to a Medicare supplement plan to help cover the cost of your prescription drugs. Part D plans are also offered by private insurance companies and charge a monthly premium.

What Will You Choose for 2016?

There is no right or wrong when it comes to Medicare and Medicare-related insurance. You need to decide based on what best fits your healthcare needs. We can help you review your choices and compare costs to best suit your budget.

For more information, call us at 941-405-3900.

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