One of the most critical first steps to take when starting your Medicare decision is understanding that there are two main Medicare programs: Original Medicare and Medicare Advantage. The number one reason people regret their Medicare decision is that they didn’t fully understand the differences between the two programs.
Original Medicare includes two main parts:
Medicare Part A – Hospital Coverage
It covers your inpatient hospital stays, your skilled nursing hospice, and things like that.
Medicare Part B – Medical coverage
This covers your doctor’s visits, your durable medical equipment, your lab tests, and things like that.
With Original Medicare, Medicare only covers 80 percent of your approved costs. This means either you or a Medigap (supplement) plan will pay the remaining 20 percent.
Since the Federal Government administers original Medicare, it means that they are the ones negotiating the prices with your doctors and hospitals. They determine what they will get paid for the approved services they provide you.
That means, when you join Original Medicare, you can get care from any doctor or hospital across the entire country that accepts Original Medicare.
Studies show that about 95% of U.S. doctors accept Original Medicare.
With that said, Original Medicare generally does not provide coverage for prescription drugs. There is an exception, though; it will cover medications that must be administered by a medical professional such as chemo.
For all other medications, you will need to get a separate, stand-alone, Medicare Part D drug plan.
Key Takeaways:
- There are two Medicare paths: Original Medicare. & Medicare Advantage
- With Original Medicare: you get all of the benefits with Medicare Part A & Part B
- You need a Medigap plan to cover the 20% of costs Original Medicare does not.
- You also need to Medicare Part D plan for your prescription drug coverage.
Medicare is complicated and too many people make the wrong Medicare decision, which is jeopardizing their healthcare and their savings.
This is why people turn to The Medicare Coach for help. We are an independent experts not associated with any insurance companies, agents, or brokers making our advice completely unbiased.
To get help with your Medicare decision, you can register for our next free online Medicare workshop by going here: https://join.themedicarecoach.com/free-workshop
