There’s a lot to learn about Medicare. Identifying your health needs, knowing your budget, and understanding your Medicare plan options can all help you find the Medicare plan that’s right for you.
What is Medicare?
Medicare is health insurance for U.S. citizens and qualified legal residents who are 65 and older. You can first enroll in Medicare three months prior to turning 65. You may also be eligible for Medicare at an earlier age if you have certain health conditions or disabilities, like end-stage renal disease or amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s Disease).
There are different Medicare plan options available to help you get the coverage you need. As you explore the plans, it’s important to first understand the parts of Medicare:
- Medicare Part A (Hospital Insurance). This helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care. Part A helps to make up Original Medicare.
- Medicare Part B (Medical Insurance). Part B is also part of Original Medicare and helps cover services from doctors and other health care providers; outpatient care; home health care; durable medical equipment including wheelchairs, walkers, and other equipment; and many preventive services like screenings, vaccines, and annual wellness visits.
- Medicare Part C, or Medicare Advantage. These plans are offered by private health insurance companies, like Rocky Mountain Health Plans (RMHP). Medicare Advantage plans provide additional benefits that go beyond Original Medicare and combine Medicare Parts A, B, and often D.
- Medicare Part D. This is prescription drug coverage that helps pay for the costs of prescribed medications, including many recommended vaccines.
- Medicare Supplement Insurance. This is also called Medigap. These plans are available from private health insurance companies that help pay your share of costs in Original Medicare. Medicare supplement plan options are standardized, meaning they all include the same benefits regardless of the company selling them.
Explore the Benefits of a Medicare Advantage Plan
Medicare Advantage plans must follow rules set by Medicare, and they combine coverages provided by Original Medicare. When you join a Medicare Advantage plan, you’ll have access to Medicare Parts A, B, and often D all in one plan – and you’ll still have access to Original Medicare. Many Medicare Advantage plans also offer extra benefits and features like routine vision, hearing, dental, and fitness coverage not provided by Original Medicare.
There are different types of Medicare Advantage plans. Some require care from providers only in that plan’s network, while others may help cover out-of-network care. Certain Medicare Advantage plans are designed specifically for individuals with special needs or those who qualify for both Medicare and Medicaid.
Consider These Factors When Comparing Medicare Plan Options
It’s important to find a Medicare plan that meets your individual health needs and budget. When choosing a plan, you may want to consider:
- Your health care needs. Do you have any health conditions or illnesses that require specialized medical services?
- Costs. Some Medicare Advantage plans have a monthly premium but also offer the protection of an out-of-pocket maximum, which limits the amount you pay each year. Out-of-pocket costs to consider include deductibles, copays, and coinsurance.
- Providers and doctors you see. Some Medicare Advantage plans may require you to see a provider within the plan’s network. Make sure any of your preferred providers are in network prior to enrolling.
- Prescription medications you take. Each drug plan will have a formulary, or list of covered drugs. It’s important to check to see if the prescriptions you take are covered.
- Other insurance coverage you have. Medicare works with other types of insurance plans and coverage, like if you’re still working and have coverage from your employer or if you receive veteran benefits.
- Travel. Original Medicare generally doesn’t cover any care outside of the United States. Coverage by Medicare Advantage plans varies by the plan. Some Medicare Advantage plans from RMHP offer worldwide coverage for emergency care and ambulance services for a $0 copay.
Enroll with RMHP Today
Many insurance companies provide Medicare plan comparison charts to help you evaluate your options. Review the benefits and costs of RMHP’s CareAdvantage Medicare Advantage plans to learn more. Are you eligible and ready to enroll? RMHP makes it easy to apply today.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare.