October 15th is the beginning of the Annual Election Period (AEP) when seniors can switch from one Medicare provider to another. That window lasts until December 7th. Here is how the various Medicare programs are put together:
The Original Medicare Program is a program for everyone 65 and older from the Federal Government. It’s made up of 4 Parts:
Parts A and B
Part A is for Hospitalization and usually is free if you’ve paid at least 10 years of Medicare taxes. If you do end up needing to use your benefits, there is a large deductible that needs to be met before Part A starts paying benefits, and then you will be covered for the first 60 days before you start to pay copays and coinsurance.
Part B is outpatient medical coverage. The monthly premium is set by the government and automatically deducted from your Social Security benefit each month. There is a deductible you pay before Part B pays anything, then it is a 80/20 split and you are responsible for 20% (unlimited) of the bill.
Because of the deductibles, copays and co-insurance in Original Medicare, seniors are guaranteed coverage from multiple insurance companies to cover those “gaps”. Rates are very affordable and benefits are standardized across companies to make it easy for seniors to choose the best fit for them.
Part C is also called Medicare Advantage (MA). It’s an alternative to Original Medicare. Medicare Advantage may include prescription drug coverage, along with other extra benefits. It is offered through private insurance companies, so you don’t enroll in it at the Social Security office or website. These are usually network plans such as HMO’s and PPO’s with copayments and coinsurance based on services you use. If you have an MA plan, this becomes your primary insurance and Original Medicare gets set aside.
Part D is your prescription drug coverage. Part D coverage is available as a Stand Alone Option (PDP) or as part of a Medicare Advantage plan (MAPD). Part D plans are offered by private insurance companies contracted and approved by Medicare. It is mandatory that you have credible drug coverage when you join Original Medicare or if you choose a Medicare Advantage plan.
To learn more about the options of having Original Medicare with a Supplement and Drug Plan OR choosing a Medicare Advantage plan, please complete the form on this page.