How To Pick The Best Medicare Plan

The Main Course: Medicare Part B

The premiums in question are for Medicare Part B, which pays for physician services, diagnostic tests, physical therapy and other outpatient care. The standard Part B monthly premium is projected to rise to $148.50 in 2021, up from $144.60 this year. That base premium gradually increases depending on income because of Medicare surcharges, also known as income-related monthly adjustment amounts. Rates and income thresholds for Part B are set by the federal government and typically announced toward the end of the year for the following year.

• 7 Things Medicare Doesn’t Cover

Part B, along with Part A, which covers inpatient care at a hospital or skilled nursing facility, are the meat and potatoes of Medicare coverage. Most people dont pay a Part A premium because theyve been funding it through payroll taxes during their working years.

The two parts together sound comprehensive but, in fact, leave gaping holes in coverage, with prescription drugs, hearing aids and routine dental, vision and foot care not included. Whats more, when Part B kicks in, it only pays for 80% of medical costs, leaving you to shoulder the remaining 20%, and thats after any copayments and deductibles. Part A pays for all hospital costs only for the first 60 days and thats after a $1,408 deductible. If you have catastrophic needs, it can get very expensive, says Jim Blankenship, author of A Medicare Owners Manual: Your Guide to Medicare Benefits and a certified financial planner in New Berlin, Ill.

How To Find The Best Medicare Part D Drug Plan

A CR analysis found huge price differences on plans within ZIP codes, sometimes even at the same pharmacies. Here are tips on how to save hundreds on your drugs each year.

When Damian Birkel, 66, fills his prescriptions each month at his local pharmacy in Winston-Salem, N.C., he has the pharmacist run more than a dozen of his meds through his Medicare drug coverage plan, called Part D, and pays cash for three more. For those, he uses GoodRx, a company that provides discount coupons.

The owner of a small consulting firm, Birkel says using the discount coupons is the only way he can afford meds not covered by his plan. In fact, the $500 he saves with the coupons is enough to cover his 2021 Part D monthly premiums. So far, he says hes fairly satisfied with the arrangement.

But now he and his wife are among the roughly 48 million Americans enrolled in a Part D plan who must decide by Dec. 7, 2021, whether to reenroll in the same plan for next year or shop for a new one.

Because much can change from year to year, its not as straightforward a decision as it might seem.

For one thing, deductibles and monthly premium charges can go up. For another, the drugs a plan coversand how well it covers themcan also be different, says Frederic Riccardi, president of the Medicare Rights Center, a nonprofit group that counsels individuals on finding Medicare plans and advocates for pro-consumer Medicare policies.

Best For Easy Application: Mutual Of Omaha

Mutual_of_Omaha

Mutual of Omahas application process couldnt be simpler. The front page details each different Medicare Supplemental Plan it has available, and it never navigates away from that page during the comparison process.

• Easy, clean website with reviews available on the same page

• Simple comparison process that only requires gender, date of birth, and ZIP code

• Household discount available

• Multi-step process to pay online

• Limited extra benefits other than the household discount

Mutual of Omaha prides itself on simplicity. It offers an easy-to-read chart for services covered under Medicare Supplement Plan G. It also allows you to create an account or apply as a guest, allowing faster comparisons. Applying with either type of account requires information from your Medicare card, your social security number, and your medications to allow for an accurate estimate. You also can save your application and return to it later, but you will have to create an account to do so.

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Best Medicare Advantage Plans 2021

We researched all major Medicare insurance companies and their 2021 Medicare Advantage plan offerings, ultimately selecting the 6 best Medicare Advantage plans.

• Highest CMS star ratings in states served
• $0 deductible with every plan
• $0 monthly premium option in many plans
• Only serves 9 states

For the past 5 years, Kaiser has been ranked as the best overall Medicare Advantage plan in J.D. Powers annual survey2. Kaiser offers numerous extra perks, such as wellness coaching, transportation to medical appointments , gym access and support groups. Kaiser wins our No. 1 spot for its top-notch customer service, extensive benefits, and user-friendly online tools.

• Nearly 2.5 million members will have no monthly premium for 20213
• National plan availability
• 3 types of Special Needs Plans offered
• Limited online resources

With 26% of all Medicare Advantage enrollees receiving their coverage through UnitedHealthcare4, its the largest Part C provider in the country. Because of its size, UnitedHealthcare is able to offer both rate stability and a broad range of plans for every budget and lifestyle.

• Numerous health and wellness benefits
• Mail delivery for prescription drugs with some plans
• Resources for managing chronic diseases
• Ranked #1 for customer service
• Humana Honor plan designed specifically for military veterans
• Limited pharmacy options

How To Choose The Best Medicare Plan

Once youve decided on your needs, the next step is finding the perfect Medicare plan for you.

Original Medicare Or Medicare Advantage: The biggest decision youll have to make is determining if youd like Original Medicare or Advantage.

• Original Medicare offers Part A and Part B protection. Youre also eligible for Medigap or Supplemental coverage for less out-of-pocket expenses. Some other features of Original Medicare are:
• You can use any physician accepting Medicare youre not limited to in-network providers.
• Part A costs are usually covered, while Part B is based on your income.

Youll have to pay coinsurance, premiums, and deductibles however, Medigap can help absorb these costs.

• Medicare Advantage offers Part A, Part B as well as additional benefits such as prescription, dental, vision, and hearing coverage and even fitness club memberships. You are not eligible for Medigap Supplemental plans. Some additional Medicare Advantage considerations are:
• You have to see in-network providers, which is problematic if you want to select your own doctor.
• It offers low-cost premiums, deductibles, coinsurance, and copays.
• There is an annual limit to out-of-pocket expenses.
• Medicare Advantage is offered by private insurance companies and regulated by the federal government

Free Medicare Insurance Comparison – Save up to 30%

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Know When You Have Guaranteed

You typically have guaranteed-issue rights during your Medicare Supplement Open Enrollment Period. This is your one-time chance to have the best Medicare Supplement Insurance plan availability.

However, after that period, you may be able to get Medicare Supplement insurance with guaranteed issue in a few limited situations, like if you disenrolled from your Medicare Supplement Insurance plan to enroll in a Medicare Advantage plan for the first time, then changed your mind within a year.

Hopefully, you now have a better idea of what to consider as you find the best Medicare Supplement Insurance plan for your needs, budget, and preferences. Want to get started now? Take a look at plan options in your area by entering your zip code below!

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. All plans are not available in all areas and are subject to plan limitations and applicable laws, rules, and regulations. The general information in this article is not intended to fully explain any specific plan. Please see the official plan documents for more complete information about any specific plan.

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Medicare Plus Medigap Supplemental Insurance Policies

About 58% of the 62 million older adults and people with disabilities who receive Medicare benefits choose Original Medicare, Parts A and B, which cover hospitals, doctors, and medical procedures. About 81% of these beneficiaries supplement their insurance with Medigap , Medicaid, or employer-sponsored insurance, and 48 million also pay for a stand-alone Medicare Part D prescription drug policy.

Medicare Supplement Insurance, or Medigap plans, are not connected with or endorsed by the U.S. government or the federal Medicare program.

While this may be the more expensive option, it has a few advantages. Both Medicare and Medigap insurance plans cover you for any hospital or doctor in the U.S. that accepts Medicare, and the great majority do. There is no need for prior authorization or a referral from a primary care doctor. Coverage includes the entire U.S., which may be important for anyone who travels frequently or spends part of the year in a different locale. This option is also attractive to those who have particular physicians and hospitals they want to use.

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Choosing A Medicare Advantage Plan

Medicare Advantage Health Plans are similar to private health insurance. Most services, such as office visits, lab work, surgery, and many others, are covered after a small co-pay. Plans might offer an HMO or PPO network and all plans place a yearly limit on total out-of-pocket expenses. Each plan has different benefits and rules. Most provide prescription drug coverage. Some require a referral to see a specialist while others do not. Some may pay a portion of out-of-network care, while others will cover only doctors and facilities that are in the HMO or PPO network. There are also other types of Medicare Advantage plans.

Selecting a plan with a low or no annual premium can be important. But it’s also essential to check on copay and coinsurance costs, especially for expensive hospital stays and procedures, to estimate your possible annual expenses. Since care is often limited to in-network physicians and hospitals, the quality and size of a particular plans network should be an important factor in your choice.

Consider Premiumsand Your Other Costs

To see how a Medicare Advantage Plan cherry-picks its patients, carefully review the copays in the summary of benefits for every plan you are considering. To give you an example of the types of copays you may find, here are some details of in-network services from a popular Humana Medicare Advantage Plan in Florida:

• Hospital stay$100 per day for the first 4 days
• Emergency Room $120 copay
• Diagnostic radiologyup to $100 copay
• Lab Servicesup to $50 copay
• Outpatient x-raysup to $50 copay
• Outpatient surgery up to $100 copay

As this non-exhaustive list of copays demonstrates, out-of-pocket costs will quickly build up over the year if you get sick. The Medicare Advantage Plan may offer a $0 premium, but the out-of-pocket surprises may not be worth those initial savings if you get sick. The best candidate for Medicare Advantage is someone whos healthy, says Mary Ashkar, senior attorney for the Center for Medicare Advocacy. We see trouble when someone gets sick.

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Do I Want The Flexibility To See Any Doctor

Finding the right doctor is an important part of your health care journey. So if youre considering a Medicare Advantage plan, you should know that some require you to see primary doctors and specialists in their network. Others will allow you to choose any doctor, but at a higher cost. Youll need to weigh whether sticking with your current doctors, even if they arent in the network, is more important than the benefits you may get from an in-network provider. Often the network allows for better coordination of care between doctors, which can help you better manage your health care.

In contrast, Original Medicare is a national plan that doesnt restrict which doctors you can see, as long as they accept Medicare. For instance, if you live six months of the year in New Jersey, and the other six in Florida, youll still be able to see doctors in both places. Since those doctors may not all be part of the same network, it might be harder for them to share information about your care, leaving you to do more of the legwork. And generally, Original Medicare doesnt limit how much you pay for covered medical care each year. Learn more about how a Medicare Supplement can help you with additional expenses.

Heres what you need to know:

Tip: If you travel frequently within the U.S. or plan to spend time away from your primary residence, check your plans network. Be sure youll have access to doctors that participate in your Medicare Advantage plan in the location youll be visiting.

Choose Original Or Advantage

For new enrollees, this is the big first decision. Original Medicare comprises two parts: Medicare Part A, which provides coverage for most costs related to hospital stays, and Medicare Part B, which covers doctor visits, lab work, outpatient services and preventive care.

Part A is free to most people who qualify for Medicare. You need to pay for Part B the standard premium this year is about $134 a month, or $109 a month for most people who have their premium deducted from their Social Security checks. However, the premium rate is higher if your income is above a certain threshold. There are deductibles and copays involved with both parts.

Over the years, as private insurers started to offer health maintenance organizations and preferred provider organizations , Congress decided that Medicare recipients should have this option as well. So in 1997 it created Medicare Part C, or what is known today as Medicare Advantage plans. In these plans, you get Part A and Part B coverage from private insurance companies approved by Medicare. Unlike original Medicare, the plans use a network of health care providers you may be able to see a doctor out of network, but at a higher cost. Some plans charge a monthly premium above the usual Part B premium, and there are potential copays and deductibles, too. These vary according to the plan you choose.

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Best Medicare Supplement Providers

Many health insurance companies offer various Medigap plans, but not all providers issue policies in all 50 states or boast high rankings from rating agencies like A.M. Best. While prices vary by person and location, here are three top insurance providers to consider as you start your search for the best plan for you. Each of them offers coverage nationwide and holds an A.M. Best rating of A- or higher.

What Are My Options For The Best Medicare Supplement Plan

Its important to know that you can only use a Medigap plan if you have Original Medicare . As of 20201 there are eight different Medicare Supplement plans sold to new beneficiaries: A, B, D, G, K, L, M, and N. Each Medicare Supplement plan must include the same standardized benefits regardless of carrier and location.* However, different types of Medicare Supplement plans offer different levels of coverage. . Medigap policies are guaranteed renewable, which meansas long as you pay the premiumthey cant be canceled for health reasons.

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What If You Miss The Guaranteed

Here is some good news for you. After the open enrollment period, you might still get guaranteed-issue rights. Companies give them in a few limited situations. For example, if you disenrolled from your Medicare Supplement Plan to enroll in a Medicare Advantage plan for the first time, but you changed your mind within the first year.

Typically, companies do not offer guaranteed-issue rights after the Medicare Supplement Open Enrollment Period. The sixth-month frame is your best chance for the best Medicare Supplement Plan.

Helpful Tips From Our Experts

Here at Boomer Benefits, we have a few resources to help you with these questions.

First, you can sign up for one of our free New to Medicare webinars. Our agency co-founder, Danielle K. Roberts, goes over all the basics of Medicare in plan and simple terms. You can attend right from your home or office computer. The webinars last about an hour, and she stays to answer your questions afterward.

Second, you can visit our blog post about Medicare Advantage plans vs. Medicare Supplements . We have a handy guide that you can download there to read later on. There are a lot of great tips in here about how to choose a Medicare plan that fits you.

Once youve decided which route works best for you, then you can move on to quotes from insurance companies.

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Where Should You Start

The best place to start shopping for Medicare Advantage plans is on the Medicare.gov comparison tool. After answering a few questions about your location and any financial help you might be receiving from Medicaid, for instance the tool will show you all available plans that meet your criteria.

If you want to see drug costs when you compare plans, you can enter the name, dosage, quantity and frequency for each drug you take regularly and even the pharmacy where you get prescriptions filled. The final list will then be populated with your expected drug costs in each plan. Filter plans by available benefits, plan type, ratings, insurance carrier and drug coverage options. Select up to three plans for side-by-side comparison.

If youre a little overwhelmed by online tools, you can find live human help from State Health Insurance Assistance Programs . Although they can’t give personalized plan recommendations, they can help guide you through choosing a plan. Each state has its own SHIP program find your local program at shiphelp.org.

What Do Medicare Supplement Plans Cover

Each Medigap plan covers basic benefits, such as:

• Coinsurance charges through Medicare Plan A
• Hospice care copayments and coinsurance through Medicare Plan A
• Copayments and coinsurance through Medicare Plan B
• The first three pints of blood needed due to a medical procedure

Most Medicare Supplement plans do not cover:

• Vision
• Private-duty nursing
• Prescriptions**

Also, its important to note that Medigap plans wont start to cover your coinsurance until your deductible is met, unless deductibles are also covered. Plans K and L have annual out-of-pocket spending limits, after which youre covered 100%. While there is no overall best Medicare Supplement plan, you can make the right choice for your priorities and budget. If you need help determining what your best Medicare Supplement plan option is, ask yourself the following questions:

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