When it comes to Medicare choices, failing to plan may be planning to fail

For Immediate Release – October 19, 2021

The choices can seem dizzying, the words confusing, but taking the “I’ll think about it tomorrow” approach to Medicare planning can spell trouble. Beginning at age 65, Medicare is the primary way by which most people will meet their healthcare needs in retirement. Avoid costly mistakes and side-step pitfalls by learning about Medicare plans sooner rather than later. A quick review of some key elements of Medicare will help you get started.

You qualify for Medicare if you are 65 years of age or older or are under 65 and have one of a select group of illnesses or disabilities. Most people must enroll in Medicare sometime between the three months before and after their 65^th birthday month if they are not already receiving retirement or disability benefits from Social Security.

The first and arguably most important decision to be made is whether to obtain coverage from Original Medicare or through a Medicare Advantage Plan.

“There are many things to think about when considering the right Medicare coverage for you. It’s important that each person takes the time to consider their needs, like prescription coverage, health issues, monthly budget, and find a plan that works best for them,” Terra Mullins, director of community outreach for Health Alliance, said. “It’s not a one size fits all situation with Medicare coverage, just because a plan has been good for your friend or neighbor, doesn’t mean it will fit your needs.”

Let’s see how the two options compare.

Original Medicare

Federally-funded health insurance program.
Original Medicare includes Part A (hospital coverage) and Part B (physician and outpatient services). Coverage for Part D (prescription drugs) is purchased separately.
Most participants receive Part A coverage for free, but everyone pays a premium for Part B coverage.
Participants do not get coverage for things like routine dental, vision or hearing services.
No yearly cap on out-of-pocket expenses.
Medicare Supplement/Medigap policy can be purchased to help keep out-of-pocket costs down.

Medicare Advantage plan (also known as Medicare Part C)

Replaces Original Medicare and it’s offered and managed by private insurance companies approved by Medicare.
All-in-one plan that bundles Part A, Part B and often Part D coverage.
Often includes additional coverage for routine vision, dental and hearing services plus extra wellness and care coordination benefits.
May also cover benefits like transportation to doctor visits, coverage for fitness activities and over-the-counter drugs.
Participants pay their Part B premium for their Medicare.
Monthly premiums with some plans start at $0/month
Yearly limit on out-of-pocket costs for medical services.
Cannot be combined with Medicare Supplement/Medigap policies.

“Medicare Advantage plans focus on keeping members healthy, not just supporting them when they’re sick,” Krystal Revai, MD, associate chief medical officer at Health Alliance, said. “Health Alliance™ Medicare Advantage plans provide tools and support for members to stay on track and achieve their health goals. Plus, many plans include coverage for additional benefits like dental and hearing which are important to maintaining overall health.”

Before you have to choose your Medicare path or accept automatic enrollment into a plan, do your homework. Whether you choose Medicare original or go with an all-in-one Medicare Advantage plan, like those offered by Health Alliance, the focus should be on your health and wellness needs and which option offers you coverage for the things that matter most to you.

Whether you are shopping for a plan, assisting a family member with their Medicare journey, or are already a Health Alliance member, you can find more information about Medicare plans and enrollment at HealthAlliance.org/Medicare. Medicare Open Enrollment is October 15- December 7, 2021.

Remember, in the words of Thomas Edison, “Good fortune is what happens when opportunity meets with planning!”