Medicare is complex and can be confusing. Increasing competition among insurance companies and healthcare providers adds to the complexity of selecting the best option for your individual needs and available budget.
Original Medicare is offered by the federal government and includes both hospitalization and medical coverage. That’s usually where the simplicity ends and the complexity begins. Increasingly people are selecting other options to help cover prescription drugs and other medical and health services.
Navigating through the various options can be complex. There are some 3,500 Medicare Advantage (MA) plan offerings nationally. Plans fall under five categories from Health Maintenance Organization (HMO) to Private fee-for service (PFFS) providers. Available choices vary by county and literally can be different based on your Zip Code.
Medicare Supplement insurance (Medigap) covers gaps in original Medicare. These plans offered by some 50 different private insurance companies help pay Medicare deductibles, copays, coinsurance and other out-of-pocket costs. They are often a preferred choice by those who want the ability to utilize any medical provider that accepts Medicare.
Competition is increasingly intense for your Medicare business especially by Medicare Advantage plans. Insurance companies and marketers spend hundreds of millions of dollars each year on television ads enticing consumers to call for information. Individuals turning 65 report mailboxes filled with dozens of solicitations.
According to the American Association for Medicare Supplement Insurance, some 26.5 million individuals are currently enrolled in MA plans. Around 14 million have Medigap plan coverage.
Several resources can help individuals navigate their Medicare choices. The Federal government’s website medicare.gov is an excellent resource to learn more about the various options. The website does enable you to create an account for more specific information. Or, you can access and read without sharing any personal information.
The website is generally better for finding information on MA plans. That may or may not be your best option. Information on the site can be partial or difficult to understand according to some industry professionals. For example, available ancillary benefits such as dental or vision coverage may be listed. However, there is little detail regarding what specifically is provided by the plan.
Find Local Counselors and Medicare Insurance Agents
Every state operates a State Health Insurance Assistance Program also known as SHIP. The federally funded program has been providing free, one-on-one health insurance counseling since 1990. Staffed by trained volunteers, counselors can help you compare and enroll in plans.
To find the closest office, simply do an online search for a SHIP office near me. Some programs may have a different name, such as I-CARE for South Carolina or HICAP for Texas.
One of the best ways to get information regarding options available specifically in your area is to connect with a local Medicare insurance advisor. The American Association for Medicare Supplement Insurance offers no-cost access to an online directory. Use it to find Medicare agents listed by Zip Code. Unlike other online resources that seek to gain your personal information, the organization’s directory requires no personal information.
A reason to consider connecting with a Medicare insurance agent is their experience working with other seniors in your community. Agents may know whether local medical providers are satisfied or dissatisfied with various insurance companies. Just as individuals have the ability to change their Medicare plan selections, so do medical providers.
Tapping into resources can help you better understand the myriad Medicare options. Considering the importance of picking the right coverage, accessing their information can be well worth your time.
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