Monday, May 25, 2015

Does Medicare cover expenses the same as my health insurance?

Although Original Medicare is comparable to traditional health insurance, there are some very important differences that many people are not aware of. For example,

1.     Each Part of Medicare has its own separate deductible. Part A covers you in the hospital, Part B covers medical expense outside the hospital, and Part D covers your prescription costs.

2.     In general, Part B pays 80% and you pay 20% of the Medicare-approved amount for the doctor or health care provider services. The Part B deductible also applies.

3.    Original Medicare does not limit the amount you may have to pay out of your pocket for your share of medical services each year.

4.    Deductibles for Part A are not tied to a calendar year like traditional health insurance. It’s tied to a benefit period that starts when you go to a hospital and ends when you haven’t received hospital care for 60 days in a row.

5.    Original Medicare doesn't cover prescriptions unless you pay extra to purchase Part D coverage. 

Your share may be different if you choose a Medicare Advantage Plan (Medicare Part C) instead of Original Medicare. Advantage Plans are offered by private insurance companies but regulated by the government. They must provide the same coverage as Original Medicare and will often offer additional benefits such as an annual cap on out-of-pocket expenses, prescription drug coverage, vision and dental coverage, health club memberships and more. Some Medicare Advantage plans cost nothing more per month than original Medicare, while others come with a higher monthly premium. Contact me and I can help you find the Medicare Advantage Plan that meets your health care needs and budget.

For more answers to your questions on Medicare, please join me for my class, Getting Started with Medicare. This is an opportunity for you to gain a basic understanding of Medicare, Medicare Advantage Plans and Medicare Supplements. For a list of all my upcoming classes, visit my website at (Pre-registration is required. These events are only for educational purposes and no plan specific benefits or details will be discussed.)

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