There are two main options for Medicare health insurance: Medigap and Medicare Advantage. These might seem confusing at first. But, not to worry we have found the most important things to know in order to make a decision about health insurance after 65.

Medicare Advantage

Also known as Medicare Part C is actually private insurance approved by Medicare, but Medicare Advantage is a smaller, local network (similar to an HMO or PPO). Not to fear because Medicare Advantage must offer everything that Original Medicare offers, and may even offer more benefits such as Medicare Part D. Original Medicare doesn’t offer prescription coverage (Part D), but many of the providers of Medicare Advantage include it. Also, sometimes Medicare Part B’s premium is waived.

Sounds great! Right? Costs you less than Original Medicare and you might get Rx covered, but you generally aren’t covered if you travel in the U.S., and could have the potential for leaving gaps in coverage open.

Medigap

Also known as Medicare Supplemental. These plans are federally regulated plans so that every Medigap plan must match any other provider’s plan. This is great for you because you don’t have to do a ton of research just compare by price and, of course, company reliability.

But what exactly is it? It’s a separate plan from Original Medicare, and its whole purpose is to fill in the gaps that Medicare leaves open for major financial expenses, if you happen to get sick. You cannot have both Medicare Advantage and Medigap at the same time, and since there are penalties for signing up late for Medigap you want to make sure you have all the information you can gather.

The main thing to know is that it extends coverage for hospitalization up to 365 days, and if you sign up Plan F once you pay your premium you should not have any out of pocket expenses for any service that Medicare covers.

With Original Medicare you’ll pay the following in 2014.

  • 60 days: deductible of $1,216
  • 61-90 days: $304 a day
  • 91-150 days you will pay $608 a day***

***Only if you have not hit your lifetime reserve of an extra 60 days. If you have hit our lifetime reserve you will have to pay the entire per day fee to the hospital.

What would this cost you with the most Basic Medigap Plan?
$1,216, because all coinsurance is covered for hospitalization up to 365 days. If you were to get more comprehensive coverage you would also have a plan that covers deductibles, Part B excess charges, and foreign travel exchange.

Which Medicare Health Insurance Should I get?

Depends. If you are on a budget, a very tight budget and don’t travel much get Medicare Advantage. If you have a little extra money lying around put it toward a Medigap plan. Note that you should get a separate Rx plan with Medigap since it is not sold with any of the plans.

Next Steps
For further questions about Medicare Advantage or Medigap please call 800-930-7956 or Contact Senior65.com.