Medicare offers many choices for today’s recipients. You probably understand that it covers millions of US seniors and disabled people. And since it was founded about 50 years ago, has become an American institution.
Most US seniors, and some disabled people, qualify for this benefit. Part A does not usually a require a premium, but insured people must only pay a fairly low Part B premium. This Part B payment is usually just withdrawn from social security payments.
Not all services are covered by Part A and Part B. In addition, recipients will have to pay deductibles and copays for some services. This is why private health insurers are also in the market.
They provide Medicare supplements which offer more coverage or benefits. Some people call these plans Medigap, MedSups, or Medicare Supplements. A person who selects on of these supplements will pay a premium to a private insurer, and they will use this coverage in addition to original Medicare.
These medigap plans are standardized with names like Plan A, Plan B, etc. While each health insurance company may compete on price, they really will not compete on benefits since the plans are standardized.
More recently, another type of plan has been allowed on the market. These are called Medicare Advantage (MA) plans. Sometimes these are also called Part C plans. These are also issued by private companies.
Rather than supplementing original coverage, the insured person will only use the MA plan when they seek medical services. The plans are strictly regulated and must provide coverage that is equal to, or better than, the original plan.
Some of these Advantage policies also require copayments or deductible payments, but they limit them. Some also require additional premiums, but some can operate off of the tax contribution, and do not require an additional premium. Some plans will even refund some of the Part B premium that most recipients pay from their social security check.
It is important to understand that supplements and MA plans are very different. One supplements the original plan, while the other replaces it. MA members are still Medicare members, but while they belong to the plan they will use their Advantage plan card for health services, and not their goernment issued card.
Even more recently, Part D plans started providing prescription benefits. You may still pay an additional plan premium every month, but still understand the bulk is government subsidized. Some MA plans include the prescription coverage. Others require a member to purchase a another Part D plan. Part D plans also can include deductibles and copayments, so a member should not expect to totally eliminate prescription drug costs. But they still help keep the cost of medication under control.
Which is the best senior health plan for you, or for somebody you help care for? It is impossible to give one right answer to this question.
The individual’s expectations, health, and location will affect the choice. The budget that an indiivdual has to pay premiums, or to pay copays and deductibles, will also affect the choice. It is important to look for the best plan for an individual, and not to try to find the best plan for everybody.