If you are new to Medicare, you have a fundamental choice to make – enroll in Original Medicare or opt into a Medicare Advantage plan. It is very important that you understand the pros and cons of both types of coverage.
Original Medicare (also known as Parts A & B) is a fee-for-service program. Most consumers supplement this government benefit with a private Medicare Supplement (also called Medigap, with Plan G becoming the preferred plan for 2020) policy as well as a Part D plan for their prescription drugs. A Medicare Supplement policy may cover some services that are not included under the standard Medicare Parts A and B as well as some out-of-pocket costs such as:
- Co-insurance costs for care at skilled nursing facilities
- The Part A deductible
- Foreign travel emergency care
If you choose a Medicare Supplement policy, you will pay an additional monthly premium. You won't need prior authorization to use specialists or to get second opinions. The monthly premium is paid to the insurance company which eliminates the headache of paying multiple fees for various services like lab fees, imaging/x-rays, inpatient procedures, outpatient procedures, and many more.
A Medicare Advantage Plan (Part C), on the other hand, takes the place of original Medicare Parts A and B. These plans work more like group insurance. They are sold through approved, licensed insurance companies and may have an additional monthly premium. Often, Medicare Advantage plans include prescription drug coverage as well as services that original Medicare does not such as health/wellness programs, dental care, vision care, gym memberships, and personal emergency alert systems. Medicare Advantage plans may be offered using an HMO, PPO, or private fee for service. This could limit a person's ability to use doctors and hospitals and may require prior authorization to use specialty services.
Therefore, it's important to work with an independent agent from The Coleman Agency. Insurance companies offer plans based on your geographic location. The zip code and county that you live in, dictates the specific plan that your eligible to enroll into coverage. Agents from The Coleman Agency will educate you on all the different plan designs, embedded ancillary benefits, carrier networks, and drug coverage formularies. The agents with The Coleman Agency will also spend time getting to know you, ask you what's important to you for your medical needs, and conduct a comprehensive needs analysis.
Call us today to schedule a in home consultation with one of our experienced Medicare Experts.
The Coleman Agency is contracted with many carriers offering plans from UnitedHealthcare, AARP Medicare Complete, Humana, Cigna-HealthSpring, Blue Cross and BlueShield of North Carolina, Blue Cross and Blue Shield of South Carolina and Aetna.