Medicare, Medicaid, Life and Health Insurance/Medicare
I won't be 65 until next summer, but had several questions, I hope you don't mind.
If I went with a original Medicare (part A and B) and visited or even moved out of state, I'm assuming I could see any Dr. who takes Medicare, whereas if I went out of state with a Medicare Advantage plan (part C), it would be considered out of network and cost a lot more?
I currently have private health insurance and pay a $25 Dr. co-pay. Do you know just approximately how much Dr. co-pays are when you have original medicare vs an advantage plan? I didn't see anything about that.
If someone gets part D for Rx's, do they have to pay a monthly premium PLUS a co-pay for the prescription? And just in general, do most people have original medicare, parts A and B, with part D for Rx's, or do most have an advantage plan that includes Rx's?
Looks like my big decision will come down deciding between original Medicaid, parts A and B and adding D, versus a medicare advantage plan; not sure which would be better. Thanks
ANSWER: Hi Lee, thank you for your question. It requires an 'educational' answer. There is another way which you did not mention, which is Medicare Supplement Insurance. Most of my clients have this as it allows you to travel or move and depending on the plan you choose might not have any copayments.
As you mentioned, Medicare is primary and the supplement pays after Medicare, giving you the freedom to see any Dr. or facility that bills Medicare and pay little or nothing at all.
Plain Medicare currently has a $147 deductible which must be paid under Part B, then you are responsible for 20% of services. Medicare Advantage plans will vary from area to area, but Dr. copayments are usually considerably less, but of course they mandate a provider network.
The national average for Part D plans is around $33 and yes there are copays for your meds. If you enroll in a Medicare Advantage plan the Part D is included. If you choose a Medicare Supplement, you will need a stand alone Part D plan.
I can assist you further as I am licensed in Colorado, feel free to look me up.
I hope this helps you.
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QUESTION: Thanks Cindy for the info. Do all Advantage plans require seeing a provider within their network? I don't go out of state much, so don't know how much of a consideration that should be for me. And from what I read, Advantage plans are less expensive than a supplement and include Rx's. Do you help people choose Advantage plans or just supplements?
So many options/choices I'll need to make and deal with, I hate it. For when the time comes to decide, can you give me your contact information and also tell me what you charge to help people choose what they need? And do you represent a particular insurance company or act more as a 'broker'? I'm sort of leery about all the insurance companies out there. Thanks
Lee, all Medicare Advantage plans have networks that you must stay in. Supplements give you the freedom to see any doctor that accepts Medicare. In my experience, if you pay less up front, you pay more later and vice versa. Turning 65 gives you the opportunity to get the best insurance you possibly can, you can always downgrade later, but you can't upgrade if your health doesn't allow it.
As a broker in Sacramento, CA I can assist you for all these things we talked about. Google me.