During a recent meeting with one of our carriers, it was suggested that more than 300,000 Arizonans are protected only with Original Medicare. What that means is that 300,000 people have some coverage, but if they found themselves in a serious medical situation, they could end up being charged, annually, tens of thousands of dollars, without a cap.
A typical Medicare card will show effective dates for Parts A and B. For most working Americans, Part A will not have a cost associated with it, and generally will cover 80% of hospital costs. In 2017, the cost for those starting their Part B is $134.00/month, and it will cover 80% of the doctor and outpatient costs. The remaining 20% is the responsibility of the cardholder. In order to protect your wallet, Medicare Advantage and Supplement Plans are available to offset some or all of these costs. In either case Parts A and B must remain in effect.
What has surprised many of my clients is that there are insurance carriers offering Advantage plans with little or no monthly premium. Copays, instead, are collected for providers and services each time you use them. The primary thing to keep in mind when looking at Medicare Advantage Plans, is that they require the user to select a Primary Care Physician (PCP) from a network of providers, and obtain referrals, to specialists, from that PCP. Most Advantage Plans come with a Prescription Drug Plan built in, so a separate drug plan is not necessary.
The other way of protecting yourself from charges that are not covered by Original Medicare is with a Medicare Supplement Plan combined with a Prescription Drug Plan. Supplement Plans allow the user to see any doctor who accepts Medicare. There are no copays and no referrals are necessary, however, there is a monthly charge associated with these plans, depending on age, in addition to the payment for Part B. Supplement Plans offer multiple coverage options, so based on need, there is most likely a plan that will be right for you.
Signing up for a Medicare Supplement and Prescription Drug Plan, from the time one signs up for Medicare, with both Parts A and B, insures that they will automatically be accepted into a plan. There is 6 month window from the start of your Part B, which carriers refer to as the “Guaranteed Issue” period, meaning they cannot ask any questions about your health history. Once that period has passed, medical underwriting becomes involved, and acceptance could be based on their findings.
If you live in Arizona and would like more information about options and costs, please contact me. There is no charge for this service.