Once you reach the age of 65, you become a senior citizen, whereby you have more options than just company plans. Or Health Care Insurance Marketplace (HCIM) plans such as Medicaid or Medicare. In this article, you’ll learn the different types of MA plans for those over 65 in search of health insurance coverage.
The Advantage Plans
These are private Medicare Advantage (MA) plans and provide an alternative to the Original Medicare plan.
You may be eligible for a medicare advantage in Nebraska if you are enrolled in Original Medicare, have reached age 65, and live in the same service area as the plan.
Medicare Advantage plans can provide more benefits beyond Original Medicare, such as prescription drug coverage. These plans also offer an extensive network of doctors, hospitals, and other health care providers. Also, preventive services are available at no additional cost to you.
Prescription Drug Plans
These allow those on Original Medicare to enroll in a plan with prescription drug services.
- A Prescription Drug Plan (PDP) is an insurance plan that provides coverage for prescription drugs and other healthcare services.
- The benefits and costs of a Prescription Drug Plan vary depending on the specific plan and individual circumstances. However, they generally have lower monthly premiums than traditional Medicare Part D plans but higher annual deductibles. Additionally, most PDPs require you to pay out-of-pocket for certain prescriptions until you meet your deductible amount before your monthly premium kicks in to cover those expenses.
- To enroll in a PDP, you must be eligible for Original Medicare Parts A & B and be willing to pay the monthly premiums associated with this plan. You may also need additional prescription drug coverage from another source if your current policy does not include enough benefits for medications covered by Original Medicare Parts A & B (especially since there are no co-pays associated with those plans). Finally, some people who qualify for Medicaid may be able to enroll in their state’s Medicaid program instead, which could offer even more comprehensive benefits than traditional Part D plans.
Supplemental Plans
This is called Medigap, which fills in the gaps of Original Medicare.
Supplemental plans are also called Medigap (Medicare Advantage Plans). This covers things like co-payments and deductibles. You can buy this as a stand-alone supplement to your basic Medicare. Supplemental plans come in several flavors, just like the original plan.
The most common ones are Plan A, which pays for the coinsurance amount and all non-formulary drugs; Plan B, which pays for 50% of the out-of-pocket expenses after you reach $333 per year deductible; and Plan C, which pays up to 80% of out-of-pockets when incurred by enrollees but requires an annual deductible that varies based on age—$185 for people over 65 in 2016.
Part D plans (prescription drug coverage) offer prescription drug coverage through private insurance companies or through Medicare itself according to their specific needs.
The Cost and Coverage
The cost of a medical insurance plan is a major consideration. You’ll want to find out if the monthly premium is affordable and the out-of-pocket maximum. An affordable health plan will typically include coverage for prescription drugs, hospital stays, emergency room visits, and other common types of treatment.
Your health insurance policy’s coverage should also be considered when shopping for a new plan. For instance, does it cover preventive care? What about maternity services? Does it cover mental health issues or substance abuse treatment? Do they offer dental insurance as well? These are important things to consider before signing up for any particular health plan.
The Doctors/Hospitals you can see.
You can see any doctor or hospital that accepts Medicare. If you’re on a Medicare Advantage plan, your provider network will be limited to doctors and hospitals in the plan’s network.
Contact your insurance company if you have questions about what doctors or hospitals are in your network.
Conclusion
There are many different options for Medicare. Knowing the MA Plan benefits and identifying your needs is vital to choose what plan is right for you. It is important to choose the right plan because you want to ensure that you get the coverage and benefits that will best meet your needs. There are many different options for Medicare, and knowing the MA Plan benefits and identifying your needs are vital to choose what plan is right for you.
