Most people have a general sense of what Medicare is.
Medicare is the government-run health insurance program for those age 65 and older or those under 65 with certain disabilities.
But unless you’ve explored the specifics, you may not realize you have a lot of decisions to make regarding Medicare.
Medicare covers many medical expenses. However, large gaps in coverage could saddle you with unexpected medical bills. And this could lead to potential financial disaster.
For example, did you know that the inpatient (Part A) deductible is not an annual deductible? You could incur this more than once a year!
The 2024 Part A deductible is $1632.
Multiply that a couple times and you’re talking about a lot of money!
We recommend you purchase a Medicare Supplement policy. Also known as Medigap, this type of plan provides coverage for the extra costs that Medicare does not pay.
Understanding the Terms
— Medicare, Medigap, Medicare Advantage
Here is a breakdown of some key terms:
Medicare (aka “Original Medicare”). This is administered directly by the government. Medicare includes three parts:
- Part A (hospital coverage)
- Part B ( medical coverage)
- Part D (prescription coverage – available if you have Part A and/or Part B coverage)
There is no limit or cap on your annual out-of-pocket costs with Original Medicare. Click here for more info.
Medigap (or Medicare Supplement). Private insurance that you purchase in addition to Medicare, to supplement coverage. You must have Medicare parts A and B in order to buy Medigap coverage. As the name Medigap suggests, these plans cover gaps between what Medicare will pay and your out-of-pocket expenses. Examples include deductibles, coinsurance, copayments. Medigap does not cover gaps in prescription coverage. Click here to learn more.
Medicare Advantage (Part C): An alternative to Original Medicare, this is Medicare-approved coverage administered by a private insurance company. It includes the coverage under Original Medicare Parts A and B (and usually Part D), and, unlike Original Medicare, offers a list of doctors to choose from similar to an HMO. It usually covers more things than Original Medicare (for example, dental, hearing, vision). However, your choice of providers is fairly limited. You cannot purchase Medigap coverage if you have Medicare Advantage.
Medicare Part D: Prescription drug coverage. You can purchase Part D plans from a private insurer if you don’t have prescription coverage in a Medicare Advantage plan.
When to Enroll in Medicare
If you miss a deadline or cutoff date for Medicare enrollment, your coverage could cost you more money in the long run. Click here to learn more.
Help with Medicare
Virginia Medical Plans can help you understand Medicare and your options!
Please call our office at 703-707-8270.
