Medicare beneficiaries have options to help them avoid the out-of-pocket expenses inherent in Medicare. Two choices work with Medicare and a third option, Medicare Advantage plans, is an alternative to original Medicare.
Beneficiaries with Medicare Part A and Part B may enroll in a Medicare Advantage plan from a private insurance company. That will provide all original Medicare benefits and may add extra coverage like dental care, eyeglasses and hearing aids. Like Medicare, Advantage plans cover preventive healthcare with no out-of-pocket costs. Many Advantage plans also cover common prescription drugs.
Medicare Supplement insurance, or Medigap, may be added to original Medicare to fill gaps in benefits, with the exception of prescription drug coverage. That was previously available through Medigap Plans H, I and J. Beneficiaries who have those plans retain that coverage, but no currently available Medigap plans cover drugs. Prescriptions are only covered by Part D plans now. Like Medigap plans, Part D plans work with original Medicare.
Healthcare Reform and Medicare
Medigap Advisors president Wiley Long has reservations about healthcare reform and says, “Unfortunately, more than half the costs of reform are scheduled to be paid for by reducing spending on the elderly and disabled who receive Medicare. Medicare’
Long notes that Medicare Advantage plans restrict beneficiaries to using a network of doctors in non-emergency situations, but he advises beneficiaries to consider Advantage plans if their Medigap insurance is too expensive. He expects Medigap plans to also restrict which doctors beneficiaries can see as a way to hold down costs.
Long says, “Millions of newly insured people will be wanting to take advantage of their low-cost benefits, so Medicare actuaries are predicting doctor shortages.” He is concerned that healthcare reform encourages doctors to form Accountable Care Organizations or ACOs. Long warns beneficiaries:
He is also apprehensive that fee cuts will lead to “more and more waiting lists and doctor shortages.” Long encourages beneficiaries who have found a doctor to develop a relationship with that doctor.
He also recommends, “Definitely get a Medigap and Part D plan or, alternatively, a Medicare Advantage plan. If you already have an Advantage plan, reshop during the annual enrollment period from October 15 through December 7. You'll probably be able to save a lot of money.”
Medigap Advisors will continue to analyze healthcare reform issues that affect beneficiaries. Information explaining the Medigap alternative is available at www.MedigapAdvisors.com/