Nearly 4.8 million Floridians are enrolled in Medicare, the U.S. health care program for people over 65. If you’re one of them, you probably know that during the Annual Enrollment Period, from now until December 7, you have the opportunity to change how you receive your Medicare benefits. Changes you make now will take effect beginning Jan. 1, 2023.
Original Medicare or Medicare Advantage
You can receive Medicare benefits in one of two main ways: Original Medicare, which is a fee-for-service health plan with two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Once you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share. If you need drug coverage, you can add a separate Medicare drug plan (Part D).
The second option for receiving Medicare benefits is Medicare Advantage, also known as Medicare Part C. Medicare Advantage is provided by private insurance companies that contract with Medicare. Plans include part A, Part B and usually Part D. They may also offer extra benefits that Original Medicare doesn’t offer, such as vision or dental. The number of Medicare Advantage plan choices continues to increase—according to the Tampa Bay Times, “Floridians enrolled in Medicare will be able to choose from 627 Medicare Advantage plans compared to 583 plans in 2022.”
Considering your options
So how do you choose?
Coverage is very similar. Both options cover most medically necessary services and supplies related to care in the hospital, your doctor’s office, and other healthcare facilities. Main differences include things like doctor and hospital choice (with Medicare Advantage, you need to stay in the plan’s network for non-emergency care), whether or not you need a referral to see a specialist, and as mentioned above, whether or not some routine exams—vision, dental, hearing—are covered. Medicare Advantage plans are increasing in popularity among Medicare-eligible seniors, largely because of the added benefits available as well as the cap on out-of-pocket costs, something Original Medicare doesn’t have.
As you consider your options, think about what type of healthcare needs you’ll have over the coming year. Of course, unexpected things happen, but you may already know you’ll need to see a specific doctor, or you’ll need certain prescription drugs over the course of the year. Once you have this figured out, you can compare plans to see which one is right for you. It pays to spend some time comparing the total you’ll pay for medical care, including premiums, co-pays, and deductibles for each option.
For more in-depth information on how Medicare Advantage and Original Medicare plans compare with each other, click here.
How L & M Insurance Group can help
Sound confusing? If you’re interested in finding out more about Medicare Advantage plans, L & M Insurance Group can help. In addition, we can also help if you want to stay with Original Medicare, but you want a supplemental policy (“Medigap”) to help cover your deductibles and coinsurance costs. A supplemental policy may be cheaper for you than covering all the out-of-pocket costs on your own, especially in the event of a catastrophic illness. We represent companies that offer Medicare Advantage, Medigap, and Medicare Prescription Drug plans, including UnitedHealthcare and Aetna. We’ll be happy to help you decide if one of these plans makes sense for you. Please call us at 813-672-4100, or click here to contact us online.
For additional information on Medicare benefits and plans, please see https://www.medicare.gov/.
