Individuals insured by Medicare Parts A (hospital costs) and B (medical and physician expenses) should not depend only on Medicare for their medical needs. Medicare has deductibles and only pays 80 percent of eligible costs once the deductible is met. A high, catastrophic medical bill might leave you with a significant amount of medical debt to pay off. There are two techniques that you may employ to keep these significant, prospective losses under control. Let’s take them one by one and look at them in more detail:
Underwriting Isn’t Necessary
Underwriting is not necessary if you apply for coverage within six months of your 65th birthday or when you join in Medicare Part B, whichever is later. There are also specific guaranteed enrollment periods available in circumstances when an insured’s previous coverage is terminated due to no fault of the insured’s own. Individuals who need more medical treatment seem to be happier with Medicare supplement plans, despite the fact that these plans give little or no coverage for normal dental, vision, hearing, or preventive care.
Medicare Advantage Plans
While these plans are a component of Medicare (Part C), they operate in a very different way than original Medicare combined with a supplement plan. For starters, no claims are sent directly to Medicare. Medicare Advantage plans are private-fee-for-service plans, which means you interact directly with the insurance company. The advantage plan is in charge of processing all of your medical claims. These insurers are supported by Medicare since they are covering your medical bills.
There are certain pros and downsides to these sorts of schemes. One benefit is the cheap cost of the premiums. The majority of options are substantially less expensive than a conventional Medicare supplement plan—some even have no monthly fee. In addition, there is no medical underwriting necessary to obtain one of these policies. Despite the fact that the plans must cover all medical treatments that are generally covered by Medicare, most Medicare supplement plans provide certain extra benefits such as dental, eye, and hearing exams, as well as preventive check-ups.
The value of these additional benefits varies greatly from one insurer to the next. The co-pays and out-of-pocket payments that are left for the insured to bear are the only significant drawback of these plans. While the out-of-pocket payments are restricted to a maximum level, these charges may be significant when compared to having them paid in full by a standard supplement plan. Simply said, these pans are most effective for those who are in excellent health and need just little medical treatment.
Which plan is the best fit for you? All of this is dependent on the amount of medical costs that you spend each year. If your out-of-pocket spending in a Medicare Advantage plan exceed the premium for a standard supplement plan in a given year, you would have been better off paying for a supplement plan. This is a significant choice that should be given careful attention as well as the counsel of an experienced broker.
