What Are My Choices

On Medicare, you basically have two options:

Option One – Medicare Supplement Plan

  • Stay on Original Medicare and purchase a Medicare Supplement Plan as well as a stand alone Prescription Drug Plan (Part D). The most comprehensive Medicare supplemental coverage this year is the “Plan F”.

  • Medicare Supplement Plans usually run approximately $165 and Part D usually runs $30-$45 a month.  These are amounts in addition to your monthly Part B premium which is $104.90 (2014).  Once you pay the afore-mentioned monthly supplement premium, you don’t pay anymore out of pocket for medical services.

  • This option allows you to go to any Medicare doctor.

  • You would, however, continue to pay the co-payment for the medications you take; the amount depends on whether they are generic, brand, non-preferred brand, etc. If you reach the Medicare doughnut hole, your out of pocket expenses will increase. Either way, the generic drugs are always the most cost effective way to go.

Option Two – Medicare Advantage Plan

  • Enroll in a Medicare Advantage Plan, which is usually a $0 monthly premium in addition to your Part B premium depending on the county/state you reside in. You must have both Parts A and B to qualify to enroll in one of these plans.

  • Medicare Advantage plans are all-in-one plans that include prescription drug coverage and other non-Medicare covered benefits such as vision, preventative dental, fitness club membership, etc. 

  • This option usually works within a network of doctors.

  • Medicare Advantage Plans are run by private insurance companies and are governed by Medicare.  The government pays them a set amount of money every month to cover your entire healthcare costs whether you use the plan or not.  Getting this money from the government, they are able to offer coverage to you at a $0 monthly premium. 

  • In turn, you pay co-payments and/or co-insurance similar to your group/employer insurance, i.e., $15 at a primary care doctor, etc. 

  • Additionally, there is a limit on the amount out of pocket expense you would pay in a worse case scenario, i.e., if you run medical bills up to $100,000 or more, the maximum out of pocket you could pay may be between $3400- $6700, depending on the insurance company and plan you select.

Let us customize a plan for you. Call us today (770-514-0589) for a ONE-ON-ONE consultation.