Your Insurance … with Michele Campbell: As you near retirement age, learn the ins and outs of Medicare plans

Medicare Supplements are not HMO or PPO plans

By Michele Campbell

Michele Campbell

Are you turning 65 or just now retiring? Many folks who have continued working past the age of 65 are now considering retirement, especially now that we are all getting vaccinated and many will be returning to their respective workplace. You might be feeling a little overwhelmed with all the information out there. 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 or $170.10, but can be higher based on your income.  Check what your Part B premium will be on Medicare.gov. This will give you a better idea of what your costs are for retirement planning. 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 plans are. With these plans, you pick a Primary Care Physician, who belongs to a network. 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.

There are PPO Medicare Advantage plans available and they could be a good option if most of your doctors are in network.

If all of your doctors are out of network, it’s not such a wonderful option as the out of network benefits aren’t that great. If this is the case, then use a Medicare Supplement plan.

With Medicare Advantage plans, most have deductibles and copays as you use the plan. Sometimes there are no copays, such as for preventative services, you don’t pay anything.  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 plans do not cover medication, so you’ll need to add a Part D plan also. There is a lot more detail that goes into these plans, but this is a good start to compare the differences.