If you’re over the age of 65 and ready to enroll in Medicare, you might be surprised by how little original Medicare really covers. While hospital care and doctors visits are covered under Medicare parts A and B, prescription drug coverage tends to be sparse for those who don’t have Medicare insurance. Here, we’ll look at the options seniors have for Medicare prescription drug coverage and talk about the best way to choose a plan.
Getting Medicare Prescription Drug Coverage
There are two ways to get drug coverage under medicare. The first option, Medigap, keeps medical coverage under original Medicare and only supplements prescription drug coverage. The second, Medicare Advantage programs, provides a number of additional benefits through a private insurance company, much like those provided through an HMO or PPO. Either way, coverage can vary by cost, coverage, convenience, and quality. It’s no secret that those factors are important. While the typical senior household has $66,900 is savings, studies suggest that the average man needs $124,000 to cover health care in retirement and that the average woman needs $152,000. The costs might even rise, as the retirement of the Baby Boom generation takes a toll on Medicare offerings. Here’s what to look for when you’re trying to choose the best prescription drug coverage in these trying times.
What to Look For
Take note of the monthly premiums, yearly deductibles, copayments, and coverage gaps of both options. Medicare insurance and Medigap are both likely to have monthly fees varying by plan, deductibles, copays, and some limitations on coverage that you should be aware of before making a decision.
Know what you need, and look for a plan that will meet those needs. Look at the formularies, lists of drugs covered under the plans and their prices as well as coverage rules about prior authorization from a doctor.
Look at each Medicare insurance option to ensure that your current pharmacy or another one convenient to you is included in the plan’s network. You may be subject to higher copayments or coinsurance amounts if you work with a out-of-network pharmacy.
All Medicare insurance plans are assigned quality ratings based on member satisfaction surveys, plans, and health care providers. You can find information about the ratings of various plans on the Medicare website.
Before You Decide…
Medicare Open Enrollment lasts from mid-October to early December. Before switching plans, review your current health and prescription drug plans and look around for one that might better suit your needs. Help is available on the Medicare website to those who can provide their Medicare numbers and effective dates, dates of birth, last names, and zip codes.
Make sure you do your research and make an informed decision. Getting the coverage you need doesn’t have to be difficult. Read more blogs like this.
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