How To Choose A Medicare Plan

resources Jun 22, 2022

So you worked all of your life and always had health insurance which was provided to you by your employers.  Most people will remember that you paid a certain amount per paycheck and the rest was covered by your employer to see any physicians that were in your specific health plan.  Now you realize you have nothing once you don’t work.  It’s really scary but prior to retiring you will have decisions to make that can and will affect the rest of your life.  So the first thing you have to decide on is whether you will fall into Medicare or Medicaid.  There are financial responsibilities with Medicare which do not occur with Medicaid.  Medicaid has very strict income requirements you need to meet to be approved.  If you don’t meet the financial requirements for Medicaid then your option will be Medicare.  Medicare can be very confusing when making the right decision.  I would like to explain a few things that may be of assistance to you.


Medicare A & B is offered to you when retiring. Medicare A is often referred to as hospital insurance, and Medicare B is used for all your doctor visits, your bloodwork, and your tests.  You will have to pay for standard Medicare.  First you must meet your deductible for 2022 which is $233.00.  There is also a monthly fee of $170.10 per month for 2022.  The government will kindly take your monthly payment right out of your social security check.  After you meet your deductible, Medicare will pay 80% of the costs involved with your visit.  The most important thing to take out of this discussion is when making appointments for yourself or your loved one, always ask if they participate with Medicare so your financial obligation will be less.  With the standard Medicare plan you also will need to purchase a supplement plan to cover the other 20% costs that Medicare does not pay.  You can compare all the supplement plans to see which will work best for you.


Medicare D is the plan you will need to choose for the monthly medications you need.  When selecting this plan you refer to Medicare D plans and enter the particular medications you take, and it will give you the plans that work best for you and the pharmacies that accept the plan.

Medicare C is a Medicare Advantage plan also known as Managed Medicare.  It resembles an all inclusive versus an ala carte.  Sometimes it costs more for the ala carte but you get to choose what you want and when you want it, and the all inclusive where everything is included but control is placed on what you can choose from and when.  Even referencing the alcohol that is included is what they want you to have as opposed to selecting the top shelf.   With a managed plan the company decides which doctors you can see so the physician you have been seeing for the last 40 years may not be in your plan.  They also have some control on which facilities you can go to and for how long you can stay there.  The other major component of the managed plans is the written referral you have to obtain from your primary physician when you want to go to a specialist (ex. Urologist or Cardiologist).  And even then the list that accepts your plan may be very small.  Of course these plans look very appealing to seniors that may be on a tight monthly budget, because they make vision care and dental care included in their plans.


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