FAQs
Most frequent questions and answers
Medicare has Part A (Hospitalization) Part B (all outpatients services) and Part D (for a drug plan)
It is called Medicare Advantage Prescription Drug plans and includes Parts A, B & D, but is from private insurance companies.
It is called Medicare Advantage Prescription Yes, MAPD plans are subsidized by the federal government thus most plans have no monthly premiums and offer other products like dental, vison and gym memberships. They do have copays for services like doctor visits.
These are plans from private insurance companies and offer everything that Original Medicare offers but these plans pay the 20% that Medicare doesn’t pay and some additional services.
There are 84 different plans in Southern Nevada. That is a difficult question but to break it down as simply as possible. You or a broker needs to verify that all your doctors and all your prescription medications are covered by the plan you choose. Once you have done that, you can proceed with confidence that you have chosen the best plan for you.
It depends on which plan you choose. The Medicare Advantage plans have two times yearly that you can change your plan. October 15-December 7th known as the annual enrollment period (AEP). You can change to as many plans as you want but the last one you chose is the one that starts on January 1st. During the open enrollment period (OEP) which starts on January 1st and ends on March 31st, you can change your plan one more time and that plan will stay with you until December 31st.
The stand-alone drug plans can only be changed during the annual election period from October 15th through December 7th annually.
Depends upon your doctors and medications. Most doctors take Original Medicare (Parts A & B) so having Original Medicare only has many advantages but one very big disadvantage. The disadvantage is Original Medicare does not have a maximum out of pocket like most insurances. Meaning if you have a $300,000 hospital stay Medicare will only pay 80% and you must pay the balance. That balance could be as high as $60,000.
Medicare Supplements allows you to see any doctor, go to any hospital that takes Medicare (in the US) where you can seek medical services. These plans pay 20% that Medicare doesn’t.
Medicare Advantage plans and supplements both eliminate that concern because they do have a maximum out of pocket to protect you if you have a catastrophic illness.
There is no better, it depends upon your current medical condition and the cost of treatment. I’ll use myself as an example. I have Rheumatoid Arthritis which requires two monthly shots and the cost is very high at $4000.00. The Medicare supplement is better for me because it pays the balance that Medicare doesn’t so all I pay is my monthly premium. On an Advantage plan I’d have to pay 20% of the $4000 or $800 per month. My supplement picks up what Medicare doesn’t and the premium (based on age) is $400.00 per month.