Monthly Archives: November 2015

How To Choose A Medicare Plan-Part 2

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In Part 1 of How To Choose A Medicare Plan we explored the pros and cons of Original Medicare and Medicare Supplement plans.  In Part 2 we explore the other path, Medicare Advantage plans.  If you are new to Medicare, you must choose one of these two paths.  With these two articles, our intent is to give you enough information to decide for yourself which path is right for you.

Medicare Advantage Plans

Medicare Advantage plans are health insurance plans that replace your Medicare Part A and Medicare Part B with a private insurance policy from a private, for-profit insurer.  They come in many different forms but are usually either HMO’s or PPO’s.  They often include a Medicare Part D prescription drug plan as part of the Medicare Advantage package.  Medicare Advantage Plans are also referred to as Medicare Part C.

If you choose a Medicare Advantage plan you must still pay your Medicare Part B premium that is automaticallyMedicare Enrollment Maze deducted from your Social Security check.  However, instead of those funds going to Medicare, they are redirected to your Medicare Advantage insurer. 

Medicare Advantage plans are required to be actuarially equivalent to Medicare Part A plus Medicare Part B.  What that means is that over large groups of people the medical expenses of the population in total should be approximately equivalent to the medical expenses of those people with Original Medicare Part A & B.  Simply put, “actuarially equivalent” means very little to the individual as individual experiences will vary greatly depending on the plan and their medical needs.  In addition, Medicare Advantage is not equivalent to Original Medicare plus a Medigap plan.  Original Medicare plus a supplement (any supplement) offers more coverage and freedom of choice but comes with a higher premium.

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How to Choose A Medicare Plan-Part 1

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    Rather than present this How to Choose A Medicare Plan guide in one large article, this will be a two-part series.  This, the first article, will review how you should approach learning about Medicare and a process to follow in making your choices. We will also review Original Medicare and Medicare Supplement policies.   In part 2 we will look at Medicare Advantage plans, including some basic features of Medicare Advantage and the pros and cons of choosing a Medicare Advantage plan over Original Medicare.

     In each part we have linked to other articles we have written that provide more detail on the subject. Readers are encouraged to at least peruse those links for more information. By the end of this two-part guide, you will have a good grasp on Medicare and the choice within Medicare that is best for you.

How to Choose A Medicare Plan – Part 1

It is estimated that 10,000 people turn 65 every day in this country, and that staggering pace will continue until the year 2030.  While not everyone needs to deal with Medicare at age 65 because they maintain employer healthcare and delay retiring, the number of people who must learn how Medicare works and make decisions regarding their Medicare choices is the highest it has been since Medicare began back on July 01 of 1966.  This article is meant to help those new to Medicare learn how to choose a Medicare plan and be comfortable with their decision.

Whenever I give webinars about Medicare, one of the first subjects I talk about is how to choose a Medicare plan, or any health insurance plan and be confident in your decision. The process doesn’t start with picking up the Medicare & You guidebook to study all the features Medicare.  It doesn’t start with learning about the pros and cons of keeping Original Medicare vs. moving to a privately run Medicare Advantage plan.  No, the first step in finding the right health insurance plan for you is much more personal.  The first step is answering for yourself and your spouse a simple question; why do you have health insurance? Or, what do you want your health insurance to do for you?

This is a personal question.  There is no right or wrong answer.  Every one of us, or every couple will respond differently to the question.   Those people who start this process with their own answer to that question tend to have a much easier time and be more confident in their decision than those who start by trying to understand the details of Medicare.

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