My name is Evan Breedlove and I have spent most of my career working with, developing and administering health insurance plans for employees and clients. As we get older, health care becomes more important in our lives. Do you understand your options? Do you have the best plan available at the right price, to protect your wealth and your retirement? This is what we will explore.
Medicare basics Supplemental plans If you have Medicare Coverage, Part A and B, as we have discussed in the past, you need to have additional health insurance coverage. Medicare is basically a 80% – 20% plan. It covers basically 80% of most medical costs, but you are responsible for the other 20%. The 20% that you would owe is unlimited. Your exposure could be a great deal of money. The good news is that there are several very good plans available to you to help you pay for that 20% at very little cost to you. These plans can help you protect your wealth and retirement.
When you look out at the market, there are many companies offering many variations of plans. The trick, is to find the best plan to meet your individual needs at the right price. Ou will find that these plans all have pros and cons. There is probably no perfect plan available. There are a lot of variations, however, there are basically three types of plans available. These plans are often referred to as Part C plans.
No. 1, Supplemental Plan-This is what I can the Cadillac of plans. After you pay a deductible, if you have any hospital costs, almost all of those costs are paid. If you have any doctor bills, almost all of those costs are paid. So, if you want to go to the hospital or your doctor and not incur any costs, this is the plan for you.
The negative part, of these plans is that you have to pay an additional premium for these plans. A monthly premium, in addition to your monthly Medicare premium of $174.70. These plans also do not include a drug plan which you will need to purchase. The additional premium that you have to pay will vary depending on the time of your, your age, and your health. In some cases, you may need to answer some health questions and you may not be accepted. These premiums will also probably increase every year.
I will advise clients, that if you have a lot of health issues, this may be the plan for you. These plans will usually only cover hospital and doctor costs. They do not offer any additional coverage such as dental, vision, or hearing benefits.
No. 2, PPO Advantage Plans-Advantage plans will also help you to pay that 20% of medical costs that Medicare does not cover. Most of these plans do not have a premium in addition to the $174.70 Medicare premium. These plans do not have a deductible. They offer a maximum out of pocket cost in any given year that you have to pay. They pay for most hospital and doctor costs, out-patient costs, and most of these plans include drug plans that pay for all or most of your drug costs. They also offer many perks, such as dental, vision, and hearing, etc.
The negatives of these plans are that they do have co-pays, but they are very inexpensive. They are also regional, limited to the area where you live. However, the PPO Plans allow you to go to doctors out of network and the region but at an additional cost.
No. 3, HMO Advantage Plans-These plans will also help you to pay that 20% of medical costs that Medicare does not cover. The HMO Plans are very similar to the PPO Plans we just discussed. The main difference is that HMO plan benefits are some better that what the PPO Plan offers. Most of these plans do not have a premium in addition to the $174.70 Medicare premium. These plans do not have a deductible. They offer a maximum out of pocket cost in any given year that you have to pay. They pay for most hospital and doctor costs, out-patient costs, and most of these plans include drug plans that pay for all or most of your drug costs. They also offer many perks, such as dental, vision, and hearing, etc.
The negatives of these plans are that they do have some co-pays, but they are very inexpensive. They are regional, limited to the area where you live. HMO Plans will not allow you to go to doctors or hospitals that are not in network or out of the region.
Next month we will discuss in detail the specifics of Advantage Plans and the benefits they provide. If you have questions, I can be reached at 479-6292476. Stay well!
