Do your Medicare options seem overwhelming? Well, there is a reason for the abundance of options - there are about 6.45 million Indiana residents, and over one million of them have Medicare! Every person’s health care and financial needs are different, and not everyone will fit into the same health insurance plan. At Medicare Plan Finder, we are dedicated to helping you discover the right plan for your individual needs.
Original Medicare coverage is the same nationally, but insurance plans are allowed to offer their own set of benefits inside Medicare Advantage and Medicare Supplement plans. There are two parts to Original Medicare (Part A and Part B). Once you’ve enrolled in Original Medicare, you can choose to add on a Part D (prescription drug) plan, or you can enroll in an Indiana Medicare Advantage or Medicare Supplement plan.
Part A is the Original Medicare part that covers hospital services, nursing homes, hospice, and some home health services. This includes semi-private hospital rooms, meals, and in-hospital drugs. It does NOT include extra items like fully private hospital rooms and personal care items. Most people will have premium-free Part A, but those who have not worked and paid Medicare taxes for most of their lives will face a premium of up to $437 per month in 2019.
While Part A is responsible for hospital-related services, Medicare Part B provides coverage for doctor visits. This includes your yearly wellness visits, lab tests and x-rays, some medical equipment, mental health treatment, and even ambulance transportation if necessary. In 2019, most people will pay a premium of $135.50 for Part B. Some people will see an adjusted rate due to high or low income. Most people will also see a deductible of $185 per year.
Parts A and B do not provide prescription drug coverage (with the exception of drugs used within hospitals), so you’ll need to select a Part D plan or another private plan that includes prescription drug coverage. Part D plans have premiums that range anywhere from $20 or less per month all the way up to $80 per month. Every Part D plan will have its own formulary, or list of covered drugs.
If Parts A, B, and D do not provide enough coverage for you, or if you’re looking for a cheaper or different option, Medicare Advantage (MA) may be right for you. Even though MA plans are still government-regulated, they are offered by private insurance carriers, meaning they have a bit more freedom to add additional benefits. MA plans can include items like dental, vision, hearing, and even fitness benefits.
Most Medicare Supplement plans, otherwise known as Medigap plans, do not provide additional coverage like Medicare Advantage plans do. Instead, they provide coverage for your other Medicare costs, like your Part A and B premiums and deductibles. Another benefit to Medigap plans is that while Medicare Advantage plans typically have strict networks of doctors you can visit, Medigap plans generally allow you to see any doctor who accepts Medicare.
Anybody age 65 or older is eligible for Medicare (you can start applying three months before your 65th birthday). If you are not old enough but have been diagnosed with either ESRD (End-Stage Renal Disease) or ALS (Lou Gherig’s Disease), you can still qualify for Medicare. Additionally, if you receive Social Security disability benefits, you will be automatically enrolled into Medicare when you reach your 25th month of benefits.
Indiana Medicare costs will depend on the plan you choose. If you stick to Original Medicare, most people will have premium-free Part A, $135.50/month for Part B, and a Part D plan premium. This usually amounts to less than $200 per month, but keep in mind that your costs can go up and down based on your income and employment history. You may also have additional out-of-pocket costs, like co-payments and deductibles that you must hit. If you select a Medicare Advantage or Medigap plan instead, you’ll have different costs. Some Medicare Advantage plans have $0 premiums, but high deductibles and co-payments. A benefits advisor can help you figure out which option is best for you and your budget.
In short, yes! If you qualify for Medicare but also meet the income requirements for Indiana Medicaid, you can receive benefits from both programs. In this case, you can enroll in a type of Medicare Advantage plan called a DSNP (dual-eligible special needs plan). DSNPs usually allow Medicaid to cover your Medicare costs, so it’s almost like getting additional benefits at no extra cost.
Most people will be automatically enrolled in Medicare Part A upon turning 65. If you are not automatically enrolled, you can apply through the Social Security website or by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778). Alternatively, if you worked for a Railroad, call the Railroad Retirement Board for benefit information at 1-877-772-5772 (TTY 312-751-4701).
If you think you want additional benefits, like in the form of a Medicare Advantage or Medigap plan, it’s best to speak with an agent who can offer you plans from several different companies. In that case, you should either call Medicare Plan Finder at 833-438-3676 or complete this form to request a call.
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