In the first episode we reviewed each part of Medicare. In this episode we’ll review your options to ‘bundle’ the parts of Medicare.
You may have heard the term ‘Original Medicare’. Original Medicare refers to Part A, hospital coverage, and Part B, medical coverage. Everybody who is eligible for and ready to enroll in Medicare enrolls in these two parts. Enrolling in Original Medicare is a requirement for enrolling in an Advantage plan or a Supplement plan.
With your enrollment in Original Medicare, you have the option to add additional coverage. This comes in two forms to choose between: either an Advantage plan, or a Supplement plan with an added drug plan. So you will either enroll in: Part A + Part B + an Advantage plan, OR you’ll enroll in Part A + Part B + a Supplement + Part D. Of course, you don’t have to purchase additional coverage…you could just roll with Original Medicare and pay the leftover costs yourself, but that’s not very common.
Let’s say you go the Advantage route. You would be enrolled in Part A, Part B, and the Advantage plan. While you are enrolled in Part A and Part B, your experience of using your insurance would be through your Advantage plan. You would have an annual deductible, copays and coinsurance, and an annual out of pocket maximum. Where you can seek medical care would be subject to in and out of network requirements defined by your Advantage plan, and the plan is entitled to subject you to prior authorization requirements. An Advantage plan will usually include prescription, dental, and vision coverage as well.
The other option is to enroll in Part A, Part B, a Supplement, and Part D. In this case, Parts A and B would cover their respective costs of medical care, and the remaining costs would go through your Supplement plan for additional coverage. Prescription costs (not covered by Part A or B!) would go straight through your Part D plan. Supplement plans are accepted anywhere that accepts Medicare and services are not subject to prior authorization requirements. Supplement coverage does not cover dental or vision coverage.
Remember, everybody gets Part A and Part B. Then you choose between Advantage or Supplement coverage. So now you know your two major options, but there is more to consider when making the decision between the two! You’re probably wondering what is the cost of either option, we’ll cover that in episode three!
