Once you know the different parts and options, the next step is putting together coverage that suits your health and wellness needs. You cannot have a Medicare Supplement policy if you have Medicare Advantage plan. Medigap, or Medicare Supplement is extra coverage you can purchase to cover the costs original Medicare (Parts A and B) doesn’t cover (i.e., the remaining 20%). Prescription coverage is offered separately for those who have Parts A and B, but typically is included with Part C plans. Part D plans can have a deductible, copayments or coinsurance amounts due each time a prescription is filled at a pharmacy. Part D benefits, and the premium, could be included in a Part C plan. Part D (prescription drug coverage) offers insurance for prescription medications. HMO plans require you to use network providers for your care to be covered (except for emergency/urgent care). Health Maintenance Organization (HMO) – You select a primary care physician (PCP) who will assist you with coordinating your care. However, it may cost more to get care from out-of-network providers except for emergency/urgent care. Preferred Provider Organization (PPO) – PPO plans provide you with the flexibility to obtain care wherever you are since they include in-network and out-of-network coverage. If you choose a Medicare Advantage plan, you still have to pay your Part B monthly premium. They typically have a low or no-cost premium. They also can include additional services like, vision, dental, over-the-counter items, and fitness. Part C (Medicare Advantage) plans, offered privately through health insurance companies, must cover everything Parts A and B cover, and most include Part D prescription drug coverage. You pay an annual deductible and 20% coinsurance. Part B covers doctor’s visits, preventive services, urgent and emergency services, medical equipment and supplies, X-rays and outpatient care. There is typically no monthly premium if you’re eligible. Part A covers in-patient hospital care, skilled nursing care, home healthcare, and hospice care. Or find a doctor with our online tool, which allows you to search by location.Frank Fernández is the senior vice president of government programs at Capital Blue Cross. Looking for a primary care physician? UH offers online appointment scheduling for select UH physicians and specialties, including primary care. “It takes a lot of time to find the perfect plan for your individual needs.” Related links “Get as much information as you can as soon as you can,” Dr. University Hospitals offers a Medicare selection class through its Center for Lifelong Health’s Age Well, Be Well program. “It's a lot to sort through and everybody’s needs are different.” “I had a patient on insulin and the plan she chose did not pay adequately so there were a lot of unexpected out-of-pocket expenses,” she says. Your doctors can help with your decision-making by bringing their experience and lessons learned from helping other patients.

Ask your primary care physician and the medical specialists you see about specific medical conditions you have and how Medicare coverage affects them.Investigate Medigap insurance and what these private policies cover.Learn about the various copays and deductibles associated with parts A and B.Research the expenses Medicare covers, as well as those not covered.Compare the four parts of Medicare and decide which options best match your personal medical needs.It’s a good idea to get to know these four parts and what each covers, Dr. Medicare is divided into four parts, often called the ABCDs. The first step is understanding the various parts of Medicare and what they do.

It can be confusing, but down the line the more education you have, the better off you will be.” Understand Medicare’s ABCDs

“I would suggest that people start looking at what's available right after their 64th birthday,” she says. Although you can’t sign up for Medicare benefits until age 65, it's important to begin researching your options long before lighting all those candles on your cake, says internal medicine and gerontology specialist Kathleen Rogers, MD.Īmong the first decisions are when to start using Medicare.

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