How to Choose the Best Type of Medicare Plan for You

When it’s time to choose a Medicare plan, it’s easy to get overwhelmed. There are quite a few different types of Medicare plans to choose from. Once you choose what type you want – you still have to choose a plan! Making the right choice is important because it may not be easy to change plans if you change your mind.

The Annual Enrollment Period (October 15 through December 7) is when anyone can make changes, and for some people, it’s the only time. If you make the wrong choice, you might have to wait a whole year before you can change again (unless you qualify for the OEP or have a SEP).

Which Types of Medicare Plans are Best for Me?

To figure out which Medicare plan is best for you, ask yourself the following questions:

What specific medical services do I need coverage for (ex: lab tests, blood work, surgery, chemotherapy, dental, etc.)?
How much room do I have in my budget? Am I able to pay a little more to have more benefits?
Do I qualify for savings (apply for Medicaid, Medicare Savings Programs, and LIS)?
Would I rather pay more on a monthly basis and pay very little when I visit the doctor, or is it better to pay a small amount every month but risk having higher copayments?
Who are the doctors and other providers who I want to be covered in my plan?
What prescriptions do I need coverage for?

Medicare Plan Finder Tool — Click to start searching for Medicare Plans

Types of Medicare Plans

There are four main types of Medicare plans to consider when you begin your Medicare plan search. Start by comparing Original Medicare, Medicare Advantage, Prescription Drug Plans, and Medicare Supplements.

Keep in mind that you cannot have Medicare Advantage and a Prescription Drug Plan at the same time. You also cannot have Medicare Advantage and a Medicare Supplement plan at the same time.

Which plan or combination of plans works best for you?

Original Medicare: The original Medicare program. Comprises of Part A (hospital coverage) and Part B (medical coverage).
Medicare Advantage: A private plan that you can purchase once you have Original Medicare. Can add additional benefits such as hearing, vision, dental, fitness, etc. Can include a prescription benefit.
Prescription Drug Plans: Another type of private plan that you can purchase once you have Original Medicare. Usually only includes a prescription benefit.
Medicare Supplements (Medigap): Another type of private plan that you can have in addition to Original Medicare. Adds more financial coverage, like for copayments and deductibles. This type of plan would also require you to have a stand alone part D drug plan.

Choosing a Medicare Advantage Plan

So, did you decide to go with Medicare Advantage? Great! Now, there are a few types of Medicare Advantage plans that may be available for you. First, ask yourself whether or not you need a large network and whether the freedom to see any doctor is important to you. Then, read through these important differences:

HMO Plans (Health Maintenance Organization) – You’ll select one primary physician. In some cases, you may only receive coverage for that one doctor (unless he or she refers you to a specialist). Requirements may vary based on your plan.
HMO-POS Plans (Point-Of-Service) – You’ll select one primary physician, but you’ll have the freedom to visit any specialist in your network for your other needs. You will be charged a fee for visiting specialists.
PPO Plans (Preferred Provider Organization) – You can see any doctor, but your costs will usually be lower if you choose one that is in your network.
PFFS Plans (Private Fee-For-Service) – You will not need referrals or a primary physician, but you’ll have to pick a doctor that accepts your PFFS plan.
SNP (Special Needs Plans) – Designed for those who are eligible for both Medicare and Medicaid, live in a nursing home, or have a chronic illness or disability.
MSA (Medical Savings Account) – Works like a tax-free savings account for your medical bills. Medicare will deposit money into your HSA. You can use that account to pay for medical expenses.

How do I Pick a Medicare Supplement Plan?

If you’ve decided that you want a Medicare Supplement plan, you’ll want to start by selecting the plan letter that corresponds with the coverage you need. Use the chart below for reference.

Once you’ve made that decision, you may have a few different carriers available in your area to choose from (some smaller cities may not have several options available).

Our Medigap Plan Finder Tool is a great place to start.

2020 Medigap Comparison Chart — 2020 Medigap Plan Comparison Tool

How to Find Medicare Plans in My Area

Finding Medicare Plans in your area just got easier. Our Medicare Plan Finder tool can help you not only see what is available, but see which options may be best for your unique needs.

You can enroll by yourself, or you can meet with a licensed agent (for free) who can walk you through the process to make sure you don’t make any mistakes. The licensed agent can also talk to you about a variety of different types of plans in your area and answer all your questions.

This unbiased approach is a great way to get the help you need when selecting a Medicare plan.

To set up your free meeting with a Medicare Plan Finder licensed agent, call 844-431-1832 or click here.

What Can You Do During the Medicare Annual Enrollment Period?

Watch this brief video first!

Annual Enrollment Period… Explained

Did you know that there are five different Medicare enrollment periods throughout the year? Not everyone will be eligible for every period, but everyone who has Medicare is eligible for the Annual Enrollment Period.

Be sure to keep track of each enrollment period so that you know when it’s your turn to make changes. Don’t go months with a bad plan just because you missed your enrollment period!

What/When is the Annual Enrollment Period?

The Annual Enrollment Period runs from October 15 through December 7 of each year. This is the time when all Medicare beneficiaries are eligible to make changes, which will go into effect on January 1 of the following year. It does not apply to people who have not yet enrolled in any form of Medicare coverage. If you’re enrolling for the first time, you’ll have an “Initial Enrollment Period.” You can use the AEP later to make changes if you don’t like the choices you made during your IEP.

Changing Medicare Plans After the Annual Enrollment Period

There are a few other times throughout the year when you may be eligible to make changes.

The Initial Enrollment Period (IEP) is for those enrolling in Medicare for the first time. If you are aging into the program, this will begin three months before your 65th birthday and end three months after. If you become eligible due to disability, your IEP will depend on your disability status or diagnosis.

The General Enrollment Period (GEP) is for those who missed their IEP. It runs from January 1 through March 31. If you enroll during the GEP, your coverage will begin on July 1. You may face a late enrollment penalty fee for not enrolling during your IEP. If you want to enroll in Medicare Advantage during the OEP, you can do that between April 1 and June 30, or you can wait for the AEP.

The Special Enrollment Period (SEP) is not one specific time frame. You may qualify for a “temporary” SEP if you have a special circumstance that results in a loss of coverage, such as losing a job with coverage or moving to an area where different plans are available. You will likely have 30 days following the event to make a change. Some circumstances, like having a disability, can make you eligible for a different type of SEP. If you are disabled or have low-income and have a special needs plan, you can change plans once per quarter for the first three quarters of the year.

How can I get a SEP for Medicare?

To qualify to change plans once every quarter for the first three quarters of the year, you must:

Be a member of a Medicare Savings Program or Medicaid
Be part of SPAP (State Pharmaceutical Assistance Program)
Be enrolled in a SNP (Special Needs Plan)
Be in a Medicare Savings Program or LIS (Extra Help)

To qualify for to change plans once following an event, you must:

Move to a new service area that has different plan options available
Involuntarily lose your coverage
Find a contract violation with your plan
Lose or gain a job where you are enrolled in employer benefits
Move into or out of a medical facility
Leave imprisonment
Suddenly gain or lose Medicaid eligibility
Suddenly gain or lose Medicare Savings Program or LIS eligibility
Have been automatically enrolled in Part D

OEP vs. AEP

OEP is not the same as AEP. During AEP, you can make a lot of different changes to your coverage. During OEP, you can only do one of the following:

Switch from one Medicare Advantage plan to another
Change from a Medicare Advantage plan with prescription drug coverage to Original Medicare + Part D
Switch from Medicare Advantage to Original Medicare (can also add Part D)

What can I do During the AEP?

During AEP, you can make a number of different changes to your coverage, like:

Enroll in a Medicare Advantage plan
Switch to a different Medicare Advantage plan from what you had
Drop your Medicare Advantage plan and have only Part A and Part B
Add a Part D prescription drug plan
Change to a Medicare Advantage plan with a prescription drug benefit
Change from a MAPD (Medicare Advantage Prescription Drug Plan) to a Medicare Advantage plan without prescription coverage
Change from one Part D plan to another
Drop your prescription drug coverage and return to Original Medicare only

You can also add or remove Medicare Supplement (Medigap) coverage, but keep in mind that you can enroll in Medicare Supplements during any time of year. Enrollment periods to not apply to Medicare Supplement plans. However, if you enroll in Medigap any time past your Initial Enrollment Period, underwriting may apply, leaving you with higher costs than you could have had if you enrolled sooner.

Click here to use our Medigap Plan Finder tool at any time.

Why the AEP is so Important for Medicare

The ability to make these changes every year is more important than you may realize.

Even if you think you’re happy with your plan, plans are allowed to change their benefits and costs every year. Your plan can add or remove benefits and make cost adjustments as they need to. At the same time, new plans are continually entering (and leaving) the market. It’s a good idea to take a look and see if there is a better plan for you each year.

Licensed agents are required to go through a training and certification process before they can sell to you. They are usually trained on what’s going on in the area that they sell in. They may be able to tell you about plans that you haven’t even heard about before, and they can help you sort through your options. It does not cost anything to meet with a Medicare Plan Finder licensed agent.

Can you Auto-Renew Medicare?

In most cases, you do not have to renew your plan each year. Your Medicare coverage will automatically continue as long as you want. The only reason your plan wouldn’t renew is if that specific plan itself leaves your service area or leaves Medicare.

However, that does not mean that you shouldn’t review your coverage each year. Have your finances or your healthcare needs changed? Has your plan changed its benefits or costs? Ask these questions every year to make sure you’re still getting the coverage you need.

What’s new in 2020?

There are a few 2020 Medicare changes that may affect what you want to enroll in this year:

Medigap Plan F and Plan C are going away
The “Donut Hole” is closing
As of 2018, plans can cover durable medical equipment
As of 2018, plans can cover non-emergency medical transportation
As of 2018, plans can cover telehealth
As of 2019, you may be able to change your Medicare Advantage plan during the OEP

How to Make Medicare Plan Changes

You can enroll in a new Medicare Advantage plan by getting help from a licensed agent. If you haven’t enrolled in Original Medicare yet, be sure to do that first by contacting Social Security either online or at 1-800-772-1213. You can also visit your local Social Security office.

To get in touch with a licensed agent in your area, click here or call 844-431-1832 (TTY 711). You can also go straight to our Medicare Plan Finder tool.

How do I Check my Benefits for Medicare and Other Programs?

Have you recently performed a healthcare benefits check up? Are you missing out on the benefits that you qualify for? They can be hard to keep track of when there are so many out there. There are benefits available for everything from your health to the food on your table, and they all have different eligibility requirements. Thankfully, there are tools out there that can help you keep track. One of our favorites is benefitscheckup.org.

What is My Benefits Checkup?

BenefitsCheckUp is a free financial and healthcare benefits check up tool offered by the National Council on Aging. They scan over 2,500 federal, state, and private benefits programs for eligibility standards to keep their tool up-to-date. When you visit benefitscheckup.org and click on “Find My Benefits,” you’ll get results for all the programs that you might be eligible for based on your:

Zipcode
Gender
Birth year and month
Monthly gross income (including your spouse, if applicable)
Marital status
Veteran status
Race/ethnicity (optional)

Your report will reveal what programs you may be eligible for, which can include (but is not limited to):

Adult daycare
Adult education
An Alliance for Accessible Hearing Care (AUDIENT)
Donated Dental Services (DDS)
Elderly Nutrition Program/Home delivered meals
Foreclosure prevention
HUD Public Housing or Section 8
Legal assistance
Low Income Home Energy Assistance Program (LIHEAP)
Medicaid
Medicare
Medicare Savings Programs
Program of All-Inclusive Care for the Elderly (PACE)
Retirement benefits
Social Security
State Children’s Health Insurance Program (SCHIP)
Supplemental Nutrition Assistance Program (SNAP)
TRICARE
Tax credits
Transportation benefits

Who is the National Council on Aging?

The NCOA, or National Council on Aging, partners with governments, businesses, and nonprofit organizations to support aging adults. NCOA’s mission is to “improve the lives of millions of older adults, especially those who are struggling.” They accomplish this by finding ways to help seniors make more money, save more money, participate in healthy social programs, remain in their communities, and fight fraud, waste, and abuse.

How to Check my Health Benefits

You can check your health benefits online, but there are a few different ways to do that depending on what health benefits you have. If you have marketplace health insurance, go to healthcare.gov, then complete these steps:

Log into your account
Click on your name in the top right corner
Select “My applications & coverage”
Under “Your existing applications,” select your completed application

Once you get there, you’ll see a summary of your health benefits. If you need more information, you can also call your health insurance company.

Check my health benefits — Check My Health Benefits | Healthcare.gov

How do I Check My Medicare Status?

To check your Medicare enrollment status online, visit Medicare.gov at this link. Enter your information, then click “continue.” You will need your Medicare card for your Medicare number. You won’t be able to continue until you’ve answered all the questions.

Check my Medicare Benefits — Check Medicare Status | Medicare.gov

How to Check Medicare Eligibility Online

You can qualify for Medicare by:

Turning 65
Getting diagnosed with ALS
Getting diagnosed with ESRD
Entering your 25th month of SSDI

To check your Medicare eligibility online, go to Medicare.gov at this link and complete the series of questions. It is important that you answer them accurately to find out if you are eligible.

Check Medicare Eligibility Online | Medicare.gov

When you’re done, you can click on the button that says “Eligibility & Premium Calculator Home” at the bottom, and then click on “Calculate my premium” to find out what your Part B premium will most likely be.

Check Medicaid Status Online

Checking your Medicaid status online isn’t quite as easy as Medicare because Medicaid is different in every state. Your state might have its own application portal where you can track the status of your application and find out more about your benefits. You can also visit your local Medicaid office (usually a Social Security building or another government office) or call to check your application status, but know that it could take a few weeks.

How do I Check Medicaid Eligibility?

Checking your Medicaid eligibility will be different in each state as well. Medicaid eligibility is based on your income and ability to pay for your healthcare services, but each state’s income limits are slightly different due to the cost of living and other factors. Check with your state’s page, here, to find out if you might be eligible.

How to Check my Financial Benefits

Checking your financial benefits is easy with today’s online tools. Health benefits aside, the major welfare benefits are TANF, SNAP, EITC, Supplemental Security Income, and housing assistance.

Social Security benefits can begin when you retire. To be eligible for Social Security retirement benefits, you must have worked for at least ten years. The longer you’ve worked, the higher your benefit can be. For example, if you wait until you are age 70 to retire, your benefit may be higher than if you retire at age 62.

If you don’t qualify for Social Security retirement benefits, you might instead qualify for SSI, or Social Security Income. To qualify for SSI, you must be either blind, disabled, or over the age of 65, and you must have limited income and resources. Qualifying for SSDI (Social Security Disability Income) is different. SSDI eligibility is based on means, severity, and work. That means you must have low income due to your disability/inability to work substantially, a severe disability, and must be incapable of working and earning a livable income. If you receive SSDI for at least 25 months, you may also qualify for Medicare (even if you re under 65).

What Tax Benefits do I Qualify for?

There are lots of different types of tax benefits out there. The best way to make sure you’re not missing out on any tax benefits is to meet with a tax accountant before you file each year. Retirees might qualify for the tax credit for the elderly and disabled. To qualify, you must be:

Age 65 or older at the end of the tax year
A legal U.S. citizen or resident alien (or married to one)
Earning less than:
- $17,500 if single
- $20,000 if married but only one spouse qualifies
- $25,000 if married
- $12,500 if married but living and filing separately

How do I get Income Assistance Through TANF?

TANF stands for Temporary Assistance for Needy Families. TANF is not a government handout. It promotes job preparation and job hunting, helps to reduce unprepared pregnancies, and encourages healthy marriages. TANF is both federal and state-based, similar to Medicaid.

The government has a TANF budget every year that is divided among the states. Each state then has the ability to determine how much each state is allowed to give out and can adjust the eligibility standards.

Check with your state’s Health and Human Services office to find out if you’re eligible. Many states have TANF applications built into their Medicaid applications, so you can apply for both programs at the same time.

Collecting Unemployment After Retirement

Some states have different requirements. For the most part, if you are not retired and lose your job after age 62, you can apply for unemployment. You may be able to receive Social Security and unemployment at the same time. However, if you are retired/over 65, you may not be able to collect unemployment. You’ll have to rely on your senior tax break and your Social Security retirement benefits instead.

Other Benefits you Might be Eligible for

Government assistance can extend far beyond healthcare and income. You may be eligible for meal assistance, free or low-cost housing, and more!

What Veterans Benefits am I Eligible for?

You can qualify for VA (Veteran’s Affairs) healthcare benefits as long as you served the full period for which you were called to active duty or at least 24 continuous months. If you served prior to September 7, 1980, the time period limit may not apply to you. It also may not apply if you were honorably discharged.

You can qualify for TRICARE if you are a uniformed or retired uniformed Service member or family member, a National Guard/Reserve member or family member, a survivor, a former spouse, a Medal of Honor recipient, or otherwise registered in the Defense Enrollment Eligibility Reporting System (DEERS).

You may also be able to qualify for disability compensation, memorial benefits, pension, home loans, education, job training, life insurance, and more.

What Housing Benefits am I Eligible for?

Public housing options tend to be a bit limited, so the eligibility standards can be strict. Eligibility depends not only on your income and citizenship status but also on whether you are elderly or disabled or if you have dependent kids. Eligibility can change based on where you live, so it’s best to contact your local PHA (Public Housing Agency) and fill out an application.

How do I Check Eligibility for SNAP Benefits?

SNAP eligibility depends on your location and household income. You must apply for SNAP in the state that you legally reside in. Use this website to find your local office (click on your state) to apply for SNAP.

Can I get Meals on Wheels?

Meals on Wheels operates through different local programs throughout the nation. Each programs’ eligibility requirements are slightly different, but for the most part, you will need to be homebound and over the age of 60 (some people under 60 may be able to qualify). Some people may be able to get Medicare Advantage plans that offer Medicare meal delivery services through Meals on Wheels.

Superfoods for seniors and medicare eligibles — Meal Delivery Services

How else can I Check my Benefits?

There are several ways to check on your current benefits and to see what you’re eligible for. We encourage anyone who is receiving benefits to check with a licensed agent who understands health insurance programs. You can also visit your local Social Security or other government offices to ask about benefits in person.

We also recommend that you find a great lawyer and a great accountant. Benefitscheckup.org can tell you if you might qualify for free or low-cost legal assistance.

These websites offer benefits checks::

Why Should I use a Licensed Agent?

Using a licensed agent to check your benefits and find out what you’re eligible for can prove to be extremely useful. Licensed agents are often familiar with the rules and regulations set in place by both the federal government and your state. Additionally, they are often able to help walk you through the application process for benefits.

We have licensed agents available who can sell Medicare Advantage, Medicare Supplements, Medicare Part D, and sometimes more. To get started, click here or call 844-431-1832.

Original Medicare vs. Medicare Advantage

The Annual Enrollment Period is quickly approaching and starting October 15, you will be able to switch Medicare Plans. Which do you favor in the battle of Medicare vs Medicare Advantage? If you’re not quite sure, we’re here to help! By understanding the basic principles of each, you will be better prepared to make that decision.

What is Medicare?

Medicare is operated under the federal government and covers a variety of health care expenses and provides benefits for seniors over 65 as well as those with Social Security benefits or certain health conditions. There are many parts, policies, and new standards associated with Medicare. We get it – it’s confusing! It’s important to understand the history of Medicare Part A B C D, because AEP is right around the corner!

Part A covers inpatient and outpatient care at hospitals, nursing homes, hospice care, and home health services. Part B covers doctor visits and ambulance rides. Most beneficiaries receive Part A for free. Most people pay the same rate for Part B coverage, but a small number of beneficiaries may have income-adjusted premiums.

Original Medicare allows beneficiaries to go to any provider that accepts Medicare, which is over 900,000 physicians nationwide! This means that no matter which Medicare provider you visit, the costs will stay the same. This is ideal for beneficiaries who travel often or want doctors in different locations.

If you are enrolled in Original Medicare, you are able to enroll in a Medigap plan. Medigap plans provide financial benefits for an extra monthly premium. This can include help paying your copayments, coinsurance, and deductibles. Additionally, some of these Medigap plans cover prescription drugs. However, if your plan does cover prescription drugs, you cannot purchase a separate drug plan.

History of Medicare

National health coverage wasn’t even discussed until President Roosevelt in 1912. He ran on a platform that included providing health coverage to anyone who needed it. Flash forward to 1945 when President Truman took office. Within seven months, he called for a national health fund that would be available to all Americans.

Truman fought hard, but it took another 25 years before anything went into effect. In 1965, Lyndon B Johnson signed legislation that provided benefits for seniors over 65. As of 2018, the Centers for Medicare and Medicaid Services (CMS) estimate that over 58.5 million people benefit from Medicare. As more policies and new standards go into effect and technology creates healthcare innovations in this industry, Medicare will continue to evolve.

Medicare Part A B C D

Medicare is broken into specific parts and each part is unique. Original Medicare consists of Parts A and B. Part A covers inpatient hospital fees, hospice care, and home health services. Part B covers doctor services, outpatient care, and physical therapy.

Most beneficiaries receive Part A for free and Part B is covered by a monthly Medicare premium. Beyond Original Medicare, there are Parts C and D. Part C is Medicare Advantage (MA).

MA plans combine Part A (hospital fees insurance) and Part B (medical insurance) and usually prescription drug coverage. Part D is a standalone plan that is purchased separately on top of Original Medicare. It can help cover the cost of prescription drugs.

What is Medigap?

If you are enrolled in Original Medicare, you are eligible to purchase a Medigap plan. What is Medigap? Medigap plans help pay some of the cost that Original Medicare does not cover. This can include copayments, coinsurance, and deductibles. Medigap plans generally don’t cover vision or dental care but may include prescription drug coverage. They are sold by private insurance companies. You cannot be enrolled in a Medicare Advantage plan and Medigap, so it’s important to compare and evaluate your budget and needs.

Pros and Cons of Medicare

Some people love Medicare, and others don’t care for it.

Why Medicare is Awesome

Premiums: If you worked for most of your life, you won’t have to pay any premium for Medicare Part A!

Healthcare Innovation: Medicare has increased healthcare innovations in the medical market tremendously. Thanks to Medicare, millions of Americans suddenly have access to health coverage they otherwise would be unable to afford. Millions of dollars have been invested in healthcare innovation and development!

Medicare “Rules:” CMS has steady Medicare rules that help prevent fraud, waste, and abuse. Without breaking the Medicare Rules, Medicare agents and plans can’t take advantage of you!

Why Some People Dislike Medicare

Hospital Fees: Even with the help of Medicare, hospital fees can still cost a pretty penny. Medicare beneficiaries typically pay 20% of the total fee. Additionally, Medicare typically does not have a cap. This means that if you have a series of health issues within a year, you may be spending more than you originally budgeted.

Prescription Drug Coverage: Medicare does not cover prescription drugs. If you are looking to purchase drug coverage, you will need to purchase separate prescription drug coverage through Medicare Advantage or Part D.

Limitations: Original Medicare provides the same health coverage for everyone. There is no personalization or choosing the exact benefits you want, unless you enroll in Medicare Advantage. If you are seeking more than basic health coverage, an MA plan could be perfect for you.

What is Medicare Advantage?

The history of MA plans is relatively short compared to Original Medicare. Just like Medicare, MA plans have benefits for seniors over 65 and certain disabled persons. These plans are rising in popularity and may be the best option for you!

Medicare Advantage plans can allow you to have a monthly premium for all your additional benefits, like dental, vision, and prescription drugs. There is no hassle with sending payments for multiple plans. Some MA plans may offer a lower deductible in exchange for a higher monthly premium. This is a great option for healthy seniors and other Medicare eligibles. With MA plans, you only pay for the services you use rather than paying a higher upfront cost.

The History of the Medicare Advantage Program

Medicare Advantage plans were not offered until 2003. Since then, enrollment has tripled to 19 million beneficiaries according to the Henry J Kaiser Family Foundation. Medicare Advantage plans are available through private insurance companies and must cover the same benefits as Original Medicare. However, many MA plans offer extra benefits like vision and dental coverage and even SilverSneakers®. These plans have a set network of providers you must choose from, but don’t worry! There are many different networks and plans available.

Medicare Advantage (Part C) Popularity

According to the Henry J Kaiser Family Foundation, enrollment has tripled to 19 million beneficiaries since 2003. Medicare Advantage plans are available through private insurance companies and must cover the same benefits as Original Medicare. However, many MA plans offer extra benefits like vision and dental coverage and even fitness programs like SilverSneakers®. These plans have a set network of Medicare providers you must choose from, but don’t worry! There are many different networks and plans available.

Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are the most popular plans among Medicare Advantage.

HMOs:

An HMO, or Health Maintenance Organization, has a closed provider network. You’ll have to select one primary provider for most of your healthcare needs. HMOs may require you to get a referral for more severe injuries or illnesses.

PPOs:

PPOs, or Preferred Provider Organizations, allow you to see any doctor, but staying in your network you will save you money. Additionally, they don’t require referrals and like HMOs, they often cover Part D supplements.

Medicare Advantage plans have one monthly premium. There is no hassle with sending payments for multiple plans. Some MA plans may offer a lower deductible in exchange for a higher monthly premium. This is a great option for healthy seniors. With MA plans, you only pay for the services you use rather than paying a higher upfront cost.

Pros and Cons of Medicare Advantage

Why Medicare Advantage Plans are Awesome

Premiums: KFF reported that half of Medicare Advantage beneficiaries in 2019 pay no premium at all, and most others pay between $20 and $100.

Out-of-pocket Max: Although you pay a premium with both Original Medicare and Medicare Advantage, MA plans may offer a lower deductible in exchange for a higher monthly premium. Also, MA plans have a limit for your out-of-pocket costs, saving you even more in the long run!

Prescription Drugs: Prescription drug coverage is often included in Medicare Advantage plans. This allows you to bundle your health coverage – saving you money and creating more convenience for you!

Unexpected Benefits: Some Medicare Advantage plans even include cool benefits like gym memberships!

Flexibility: There is a broad range of Medicare Advantage plans out there, so you may be able to choose between a few options to get the one that’s right for you.

Why Some People Don’t Like Medicare Advantage Plans

Limited Networks: There is usually no nationwide coverage with Medicare Advantage plans. This can be an issue if you frequently travel within the US. Additionally, your network may require that you only see specialists that your doctor refers you to.

Price Fluctuation: The specifics of your Medicare Advantage plan varies per provider. You may still be required to pay copays and coinsurance fees. Additionally, your Medicare premiums and copayments may change each year.

Medicare Advantage vs. Medigap

When comparing Medicare Advantage vs Medigap, it’s easy to get confused. Medigap can only be purchased alongside Original Medicare. You cannot have a Medicare Advantage and Medigap plan at the same time. Medigap plans cost an additional monthly Medicare premium, but they help fill the cost gaps in coverage – this means less out of pocket costs for you.

Medicare Advantage vs Medigap prices can vary. If this is something you’re interested in, it’s important to compare policies.

Medicare Plan Finder — medicareplanfindertool.com

Difference Between Medicare and Medicare Advantage

What is the difference between Medicare and Medicare Advantage? It is easy to confuse the two. The main difference is that while Original Medicare is the federal program, Medicare Advantage plans are privately owned. Medicare Advantage plans still have to follow all the rules determined by CMS (Centers for Medicare and Medicaid Services), but they are able to offer benefits that the federal program cannot. med

How to get Medicare Advantage

Does a Medicare Advantage plan look attractive to you? Did we grab your attention? AEP is coming soon!

From October 15 to December 7, anyone with Medicare can make changes to their plans. If you’re interested in purchasing a Medicare Advantage plan or hearing more about how to get covered, complete this form or call us at 844-431-1832 to arrange a free, no-obligation appointment with an agent and get covered today.

*This blog was originally published on September 20, 2018, and updated on July 28, 2019.

Get Middle Tennessee Dental Care with Medicare and Interfaith Dental

Nashville and Middle Tennessee residents don’t have to suffer from a lack of affordable dental coverage. In 1994, Dr. Tom Underwood founded Interfaith Dental with the help of the Nashville Dental Society and the Outreach Commission of West End United Methodist Church.

Interfaith Dental makes it possible for low-income families to access the dental care they need without having to pay full price.

Low Income Dental Clinics in Middle Tennessee

Middle Tennessee has quite a few public health clinics, and many specialize in dental care for low-income families and individuals. We work closely with Interfaith Dental, located both in the Fesslers Lane/Elm Hill Pike area of Nashville and near the St. Thomas Rutherford Hospital campus in Murfreesboro. Below are some of the low-income dental clinic options you have in Middle Tennessee.

Interfaith Dental Clinic (600 Hill Ave., Nashville, TN 37210)
Lentz Public Health Clinic (2500 Charlotte Ave, Nashville, TN 37209)
Main Street Clinic Nashville (905 Main St., Nashville, TNc 37206)
Matthew Walker Clinic (14th Avenue North, Nashville, TN 37208)
Downtown Homeless Clinic Nashville (526 85th Ave. South, Nashville, TN 37203)
Southside Family Clinic (107 Charles E. Davis Blvd., Nashville, TN 37210)
Vine Hill Dental Clinic (601 Benton Ave., Nashville, TN 37204)
Meharry School of Dentistry Clinic (1005 Dr. DB Todd, Jr. Blvd, Old Hospital 3rd Floor, Nashville, TN, 37203)

How to Find a Low-Income Dentist Near You

Not located in Middle TN? That’s ok – there are plenty of low income dentists throughout the country. This government website is operated by the Bureau of Primary Health Care, a part of the Health Resources and Services Administration. You can use their tool to find a federally-funded community health center that offers dental services.

Additionally, you can search through the American Dental Association or the American Dental Hygienists’ Association to find supervised, low-cost care that is part of the training program for dental students. Your care will be supervised by licensed and experienced dentists.
If you have Medicare, we can help you make sure you have the best Medicare plan to get you the dental services you need and help you find the best dentist that accepts Medicare.

Who is Interfaith Dental (IFD)?

Interfaith Dental is a low income dental clinic with a mission to “create a healthier community by providing transformational oral health care for those experiencing poverty.” They envision a Middle Tennessee community where every resident “has the opportunity to achieve and sustain a healthy smile,” regardless of income status.

When it began in 1994, IFD only had two chairs and one employee, operating out of the West End United Methodist Church basement. By 1998, they were able to move their operation to 1721 Patterson Street (just off West End, near the St. Thomas Midtown campus).

In 2012, they opened another clinic in Murfreesboro, expanding their reach into Rutherford County. In even bigger news, this past year (2019), the clinic was able to expand into a new office at 600 Hill Avenue (near the Fesslers Lane/Elm Hill Pike intersection).

They’ve come along way from their two-chair operation, now owning 26 state-of-the-art dental operatories.

How to Become an Interfaith Dental Patient

Since the Interfaith Dental Clinic offers such low-cost dental care, there is an application process before you become eligible for services. To be eligible, you must be legally considered low-income (living below the poverty line), uninsured, and suffering from a devastating dental disease.

To get more information or to schedule your first appointment, call 615-329-4790 for the Nashville office, or 615-225-4141 for the Murfreesboro office.

Your Interfaith Dental journey will begin with a phone questionnaire. You’ll be asked for some basic information which will determine if you are eligible for Interfaith Dental Clinic services and what services you need.

Next, the Patient Care Coordinator that you speak with will tell you when the next “Application Day” is. On that day, you’ll come into the office to complete your application. Both the Nashville and Murfreesboro locations have the same office hours in 2019, which are:

Monday through Wednesday, 8 AM to 4 PM
Thursdays, 1 PM to 7:30 PM
Fridays, 8 AM to 12 PM

Be sure to bring the following items with you on “Application Day”:

Current Year Tax Return
Two current pay stubs for anyone working in your household.
- If you are paid in cash, provide written documentation from your employer on a business letterhead that contains the business name, address, phone number, and owner information as well as your hire date, hours worked per week, pay rate, and hourly income.
- College students, bring your class schedule
- Work training program participants, bring proof of enrollment.
65+, provide social security/pension/retirement proof of income.
Proof of address (utility bill, bank statement, etc.)
TN driver license
Referral from medical professional, social worker, or employer (if you have one)

Due to high demand, there may be a waiting period for your services. There are a limited amount of applications that are handed out on a first-come, first-serve basis every month.

While walk-ins are generally not accepted, please call Interfaith Dental if you have a dental emergency. Some emergency services are offered on a first-come, first-serve basis.

What to Expect from Your First Interfaith Dental Appointment

At your first Interfaith Dental Clinic appointment, you’ll begin by meeting the team members. Then, someone will sit with you to review your medical and dental history and discuss all of your dental concerns.

Interfaith Dental care is comprehensive – they want to know how your dental health has affected your career, your family, and even your self-confidence. Is your goal to have a beautiful smile again, or to eliminate pain? Your care providers will hear all of your concerns and follow up with the best possible care.

The next step of your first appointment is a series of full diagnostic X-rays and oral exams that will help the doctors determine a treatment plan. Phase one will usually include fillings, cleanings, and extractions, and phase two will include crowns, root canals, and even partial dentures, if necessary.

If that sounds like a lot, it’s because it is. Your first appointment with Interfaith Dental can take up to two hours, in some cases – so be sure to allow that much time out of your day.

Interfaith Dental Office | Middle TN Dental Care for Low-Income People — *Photo of an actual Interfaith Dental operating room, per* *https://interfaithdentalclinic.com/about/tour/*

Medicare Dental Coverage in Middle Tennessee

Original Medicare only covers dental services when they are part of a hospital stay.

For example, if you go to the St. Thomas emergency room with a fractured jaw and need emergency dental care in the hospital, those services may be covered by Medicare Part A. However, common dental services and treatments such as annual exams, cleanings, root canals, dentures, implants, etc. are not covered by Original Medicare.

To get Medicare dental coverage, you’ll need to either enroll in a private, individual dental plan or a Medicare Advantage (Part C) plan. Medicare Advantage plans, even though they are Medicare health plans, are operated by private insurance companies, which allow them to add benefits that the Original Medicare program does not cover. This can include not only dental benefits but also benefits like fitness programs, vision, meal delivery, etc.

Medicare Plan Finder and Interfaith Dental, Bringing Change Together

Medicare Plan Finder works with Interfaith Dental by helping their patients fill the gaps in their dental coverage. Interfaith Dental is not always able to provide free or very low-cost care. For example, there may be times where a $10,000 dental procedure costs $5,000 at Interfaith Dental. You’d still be paying $5,000 less than if you went to a regular dentist, but that $5,000 may be more than you can handle. At Medicare Plan Finder, we try to match you up with a low-cost insurance plan that can cover those extra out-of-pocket costs.

Start by scheduling your appointment at the Interfaith Dental Clinic located nearest to you. Call 615-329-4790 for the Nashville office, or 615-225-4141 for the Murfreesboro office.

Then, if your doctor determines that you need a series of procedures that you can’t afford (even with Interfaith Dental’s help), give us a call at 844-431-1832. We can help you determine whether or not you are eligible for Medicare (did you know you don’t have to be 65?). If you’re eligible, we’ll help you find low-cost coverage so that you can go back to Interfaith Dental to get the services you need.

Essential Medicare Benefits for All Medicare Plans

Prior to 1965 when Medicare was created, people over the age of 65 found it almost impossible to be covered by private health insurance companies after retirement. Original Medicare is the program the government created to cover essential medical needs like hospital stays and doctor visits. There are two parts: A and B.

The term Medicare has expanded since the 1960s to include other important services and programs in order to help people be as healthy as possible. Now, private health insurance companies can sell “Medicare Advantage” plans, often known as Part C. “Extra” Services such as vision insurance, hearing coverage and physical fitness programs typically fall under Part C.

Medicare 101 Course — Sign up for the free Medicare course

Does Medicare Count for Minimum Essential Benefits?

The Affordable Care Act originally required that everyone have a health plan with the minimum essential benefits, which included:

Ambulatory outpatient services
Emergency services
Hospitalization
Pregnancy/maternity/newborn care
Mental health and substance abuse services
Prescription drugs
Rehabilitative services/devices
Lab services
Preventive/wellness services
Pediatrics (including dental and vision for kids)

If you had Medicare, you would have met the minimum essential benefits requirement. The federal government dropped the requirement that you have a minimum coverage level under the Affordable Care Act (also known as ACA or Obamacare) in 2019. However, certain states still impose penalties.

You meet minimum coverage requirements if you have coverage under Part A, Parts A and B together, or a Medicare Advantage plan (Part C). If you’re covered by any one of those plans, you will not have to pay the penalty for not having health insurance. If you were only enrolled in Part B, you would not meet the government-mandated minimum requirements.

What Does Medicare Cover?

When people talk about Medicare benefits, they are referring to Original Medicare plans. However, specific plans cover different things, and not all plans have the same coverage. Here’s what Original Medicare plans cover:

Preventive care
Annual wellness appointments
Doctor visits
Telehealth
Mental health
Ambulance transportation
Home health (limited)

Original Medicare plans do not cover prescription drugs – except in limited cases, such as for oral cancer medications. Most prescription drugs require a Medicare Part D coverage or certain Medicare Advantage plans.

Difference Between Part A and Part B

Medicare Parts A and B fall under Original Medicare. Part A is Medicare hospital insurance, and it covers hospital visits and stays. It does not cover ambulance transportation. (That’s included in Part B.) Part B covers doctor’s appointments, telehealth, mental health, preventive care, annual wellness visits, ambulance transportation, and limited home health.

Medicare Health Benefits

If you need more coverage than what Part A and Part B provide, you’ll want to look towards a Medicare Supplement plan or Medicare Part C. Part C plans can include:

Dental
Vision
Hearing
Fitness classes and gym memberships
Non-emergency transportation, such as trips to the doctor’s office
Meal delivery
And more!

Many people will find that Original Medicare benefits cover most of their needs as they age, but it’s important to consider the quality of life that can be obtained when you have access to a gym or have taxi fare to get to the doctor. We can’t think of anything more important than your health and well-being, and a Part C plan can provide the additional benefits you need to be healthy and happy.

Meeting with a licensed agent for Medicare

Medicare Advantage

While you aren’t required to enroll in Medicare Part C, it is a valuable asset for most people. Medicare Parts A and B cover only the most basic needs for health care. There are thousands of Medicare Advantage plans to choose from, and a qualified professional can help you sort through them and find one that suits your needs.

Medicare Advantage plans are private health insurance plans that cover every service Original Medicare covers. Advantage plans are often used along with government-run plans to ensure the patient has coverage for what he or she needs, which can include dental, vision, and even meal delivery.

Medigap

Medigap policies cannot be used in conjunction with Medicare Advantage. Medicare supplements pick up where Original Medicare falls off. Medigap plans can help with coinsurance, co-payments, and deductibles. These plans are strictly for financial coverage, and not health coverage.

How to Get More Benefits

If you need coverage for things that don’t fall under the Original Medicare umbrella, you need to know a few things before you enroll. Medicare Advantage (Part C) and Medicare Supplements (also called Medigap) can serve different needs, and either can be beneficial depending on your circumstances.

The Initial Enrollment Period (IEP) consists of the six months surrounding your 65th birthday and your birthday month. This is important to know because you must select a policy in that timeframe in order to be covered. If you do not enroll in Medicare Advantage during that time, the only other time you can do that is during the Annual Enrollment Period (AEP), which is every year from October 15 through December 7.

While most people who wish to make changes to their health insurance or get new coverage must enroll during the AEP, the Special Enrollment Period (SEP) allows people – even those younger than 65 – to enroll if they are diagnosed with specific, chronic health conditions. If you qualify for the SEP, you can add or change coverage once per quarter during the first three quarters of the year. Some people may have limited special enrollment periods that surround qualifying events. For example, if you move to a new service area where different plans are available, you may be granted a temporary (typically 60 day) special enrollment period.

Get Essential Medicare Health Benefits

A comprehensive Medicare plan can help you live your best life. If you’re ready to enroll in Medicare benefits and need assistance in selecting the right plan for you, we can help you find a plan that fits your budget and lifestyle. Call us at 844-431-1832 or contact us here today.

How Medicare and Medicaid Work Together

Medicaid helps lower the cost of Medicare for more than 12 million dual-eligibles. In fact, Medicaid is the nation’s largest public health insurance program for people with low income and covers more than 1 in 5 Medicare enrollees. Are you eligible? Here is everything you need to know about Medicaid, Medicare, eligibility, costs, and savings programs.

What is the difference between Medicare and Medicaid?

Medicare and Medicaid can be easily confused, but they are two separate government-operated programs. Medicare is a federal program that provides health coverage for seniors over 65 and other Medicare-eligibles, regardless of your income. Medicaid is a state and federal program that provides health coverage for those with low income. However, if you are dual-eligible, you are eligible for both Medicare and Medicaid. This allows you to expand your network to include Medicaid doctors and decrease your out-of-pocket healthcare costs.

Those who are over 65 and those who receive SSDI (Social Security Disability Insurance) are eligible for Medicare.

Medicaid eligibility is different in every state and is largely based on income level. Though this varies by state and marital status, if you know that you are under the Federal Poverty Level, there’s a good chance that you qualify for Medicaid.

Can you Have Medicare and Medicaid?

If you are dual-eligible, that means you’re eligible for both Medicare and Medicaid. That can mean that you are both low-income and over 65, both low-income and on dialysis for ESRD, or any other qualifier listed below.

When you have both Medicare and Medicaid, Medicare will cover you first. Your Medicaid will serve as sort of a backup plan when you need more coverage than Medicare can provide.

People who are eligible for both Medicare and Medicaid may qualify for a Dual-Eligible Special Needs Plan, or DSNP. DSNPs often come with very low or $0 premiums, and Medicaid often covers the resounding copayments. DSNPs are not available in every area, and each plan can be a bit different, so be sure to ask your agent.

Dual-eligible beneficiaries are sometimes eligible for a Medicare Savings Program (MSP) as well. An MSP can help you pay for your Medicare premiums. You’ll also be enrolled in Extra Help, a program that helps you pay for your Medicare prescription drug costs. You may hear Extra Help referred to as LIS, or Low-Income Subsidies.

Bonus: if you are eligible for both Medicare and Medicaid, you have a Special Enrollment Period (SEP). That means that you don’t have to wait for the Annual Enrollment Period (AEP) to enroll or make changes to your plan.

Smiling Senior at Doctor | Medicare Plan Finder — Get the care you need from Medicare and Medicaid

Medicare and Medicare Eligibility Check

Ready to find out if you are eligible for Medicare? Do you fall into any of the below categories?

I am over the age of 65 or will be turning 65 within the next few months.
I have ESRD (End-Stage Renal Disease/Kidney Failure) and am receiving dialysis treatment.
I have Lou Gehrig’s disease (amyotrophic lateral sclerosis or ALS).
I have received Social Security Disability Income for over 24 months.
I receive retirement/disability income from the Railroad Retirement Board.

Note that to qualify, you also must be a U.S. citizen.

Medicaid eligibility is going to depend largely on what state you live in. While Medicare is more federally regulated, Medicaid is mainly state-regulated. For example (2018), in Tennessee, a family of four can qualify for Medicaid with an income of less than $32,718 annually. However, in New York, a family of four can only qualify for Medicaid with an income of less than $32,319.

Some of the groups that most commonly pass the Medicaid eligibility check are U.S. citizens like:

Those under 21 with low income
Pregnant women with low income
Low-income parents of minors
Low-income women undergoing breast or cervical cancer treatments
Those who receive Social Security benefits
Individuals who live in nursing homes or receive other long-term care and require financial assistance

If you think you are eligible, you can access the Medicaid Application for every state from the Healthcare Marketplace website.

Medicaid Doctors and Costs

A great way to find providers in your area who accept Medicaid is by using an online search tool like “DocSpot.” From DocSpot, you’ll enter your city, your type of coverage (Medicaid), and the type of doctor you are looking for. DocSpot will populate results for you where you can read reviews and pick Medicaid doctors in your area that you can schedule an appointment with.

If you have both Medicare and Medicaid, you can expand your doctor network to also include those who accept Medicare. If you have Medicare Advantage (a Medicare plan offered by private companies instead of the federal government), you’ll want to use your plan’s website to search for a provider that accepts your coverage.

Your Medicaid, Medicare, and Medicare Advantage costs will all depend on your financial status and the type of plan you select.

Medicaid Prescription Drug Costs

Technically, prescription drug coverage is an optional federal Medicaid benefit. Since Medicaid is a state-based program, all states determine their own prescription drug coverage. Currently, all U.S. states provide outpatient prescription drug coverage to eligible Medicaid beneficiaries. Depending on your state, you will receive either free or heavily discounted prescription drugs when receiving Medicaid benefits.

Additional Medicaid Costs

Some Medicaid beneficiaries will be required to pay copayments for certain services. It all depends on your income. For example, for non-institutional care (such as a doctor’s office visit), anyone at 100% of the federal poverty level will have to pay a copay of $4.00. Anyone whose income is 150% above the federal poverty level will have to pay 20% of the costs. Keep in mind that the federal poverty level can change every year and also takes into account the number of people living in your household.

Medicare Extra Help Application

If you have Medicare but do not qualify for Medicaid, fear not! You may still qualify for financial assistance in another form: Medicare Extra Help.

Medicare Extra Help, otherwise known as LIS (Low-Income Subsidies), helps you cover your prescription drug costs that Medicare does not cover. To qualify for Extra Help, you must first have Original Medicare (Part A and Part B). You cannot have savings, investments, and real estate that total more than $28,150 (or $14,100 if you are single).*

Access the Medicare Extra Help Application here.

*These numbers are subject to change every year.

Medicare Savings Program Application

Even if you do not qualify for full Medicaid benefits or if you don’t qualify for Medicare Extra Help, you can still qualify for a Medicare Savings Program. There are four Medicare Savings Programs:

Qualified Medicare Beneficiary (QMB)

Pays for Medicare Part A and B premiums, deductibles, coinsurance, and copayments. Also makes you eligible for Medicare Extra Help. To qualify for QMB, you:

Cannot exceed individual monthly income limit of $1,032
Cannot exceed married monthly income limit of $1,392
Cannot exceed individual assets limit of $7,560
Cannot exceed married assets limit of $11,340

Specified Low-Income Beneficiary (SLMB)

Pays for Medicare Part B premiums. Also makes you eligible for Medicare Extra Help. To qualify for SLMB, you:

Cannot exceed individual monthly income limit of $1,234
Cannot exceed married monthly income limit of $1,666
Cannot exceed individual assets limit of $7,560
Cannot exceed married assets limit of $11,340

Qualifying Individual (QI)

Pays for Medicare Part B premiums. Also makes you eligible for Medicare Extra Help. To qualify for QI, you cannot have Medicaid and you:

Cannot exceed individual monthly income limit of $1,386
Cannot exceed married monthly income limit of $1,872
Cannot exceed individual assets limit of $7,560
Cannot exceed married assets limit of $11,340

Qualified Disabled & Working Individuals (QDWI)

Pays for the Medicare Part A premium if you are working, disabled, and under 65 OR if you lost your premium-free Part A when you went back to work. You must not be receiving state medical assistance. You also:

Cannot exceed individual monthly income limit of $4,132
Cannot exceed married monthly income limit of $5,572
Cannot exceed individual assets limit of $4,000
Cannot exceed married assets limit of $6,000

Access the Medicare Savings Program Application here.

Medicaid Application

Think you are eligible for Medicaid? You can apply either online through the Health Insurance Marketplace or through your state Medicaid agency. To use the Health Insurance Marketplace Medicaid Application, click here.

Each state has its own Medicaid Application on its own Medicaid website. It may be a good idea to meet with an agent first so that you can get help with your application.

Are you eligible for Medicare and Medicaid?

If you’re not sure whether or not you are eligible for Medicare and Medicaid, we can help. Give us a call and we’ll ask you a series of questions to help you find out if you’re eligible.

If you are eligible, we can send an agent to your home to help you sort through your health care options. Another perk of being eligible for both Medicare and Medicaid is that you can receive a Special Enrollment Period, meaning that you can make changes to your coverage during any time of the year and don’t have to wait for the Annual Enrollment Period in the fall.

Our agents are licensed to sell plans from multiple different carriers, so they can help you pick the plan that truly works best for you.

To get started, give us a call at 844-431-1832 or click here.

This post was originally published on March 15, 2018, and was updated on September 28, 2018, and updated again on April 3, 2019.

How to Sign Up for Medicare

An estimated 70 billion baby boomers are nearing retirement, and over 10,000 boomers are turning 65 every single day. If you’re new to Medicare, we can help you understand how to sign up for Medicare and answer your questions about coverage, benefits, qualifications, fraud, and privacy.

How to Sign Up for Medicare

If you currently receive Social Security benefits, you’ll be automatically enrolled in Medicare Part A when you turn 65. You will need to opt into B, and it will be automatically deducted from your monthly Social Security check. However, if you do not receive Social Security benefits, you will need to enroll yourself. You can enroll in Original Medicare (Parts A and B) online, by phone, or by visiting your local Social Security office.

Do you have to sign up for Medicare when you are 65?

The standard age for Medicare eligibility is 65. However, this does not mean you are required to enroll on your 65th birthday.

If you wish to enroll in Medicare when you become eligible, you can enroll anytime during your initial enrollment period. This period begins three months before your 65th birthday and ends three months after. If you choose to postpone enrollment, you may be subject to a late-enrollment penalty. This can result in a 10% Part B premium increase for every year you were eligible but did not enroll. Plus, you will have an additional penalty of 1% the national based Medicare Part D monthly premium for each month you did not enroll in prescription drug coverage.

Medicare Coverage and Benefits

Original Medicare consists of Parts A and B. Part A covers inpatient hospital fees, hospice care, and home health services. Part B covers doctor services, outpatient care, and physical therapy. Most beneficiaries receive Part A for free, but pay a monthly Part B Medicare premium. Beyond Original Medicare, there are Parts C and D, Medicare Advantage and prescription drug plans.

What is Medicare Advantage (Part C)?

Medicare Advantage plans, sometimes referred to as “Part C,” are available through private insurance companies. They cover the same benefits as Original Medicare, but most offer extra benefits like vision, hearing, dental, and even fitness programs like Silver Sneakers.

Medicare Advantage plans have one monthly premium, and you only pay for the services you use rather than paying a higher cost upfront. You may want to enroll in Medicare Advantage instead of Original Medicare alone. If MA is not right for you, consider Medigap.