Your Insurance . . . with Michele Campbell: Learn about different Medicare plans

There are various plans but the most popular plans are Plan G and N.

By Michele Campbell

Michele Campbell

Many Gilroy residents have continued working past the age of 65 and might be feeling a little overwhelmed with all the information out there regarding retirement and Medicare. Here is a quick overview.

Original Medicare = Part A & B

These are the only parts that are provided by the government. If you’ve worked 40 quarters, which equals 10 years, then Part A should be free. Part B has a standard rate of $148.50, but can be higher based on your income. You can check what your Part B premium will be on Medicare.gov. Once you know this number, you will get a better idea of what your costs are for planning. Many people are surprised about this cost and haven’t planned well enough. Once you’ve enrolled in Medicare Parts A & B, then you can purchase either a Medicare Advantage plan or a Medicare Supplement plan along with a Part D prescription drug plan.

Part C is a Medicare Advantage plan

Typically these are HMO plans and the more rural you are, the less available these are. These plans are considered Managed Care, where you pick a Primary Care Physician, which belongs to a network. Once you’ve picked your doctor and start using the plan, you have to get referrals to see specialists. If you choose to go out of network, then you won’t have any coverage with the HMO’s.

With Medicare Advantage plans, most have deductibles and copays. Sometimes there are no copays, such as for Preventative Services, you don’t pay anything. For bigger ticket items, like in-patient hospital visits, outpatient surgery, MRI’s, etc., you typically have larger copays. For smaller cost items, like X-rays and lab work, they can be $0 or small copays. Most Advantage plans include a Part D drug plan, so you’ll satisfy that portion that Medicare requires that you have.

Medicare Supplements are not HMO or PPO plans

Supplements are secondary to Medicare. The supplement can pay your deductibles and coinsurance that Medicare doesn’t pay. There are various plans but the most popular plans are Plan G and N. These do not cover medication you pick up at a pharmacy, so you’ll need to add a Part D drug plan. There is a lot more detail that goes into these plans, but this is a good start to compare the differences. To learn more, join our free webinars.