Medicare Advantage Growing
Medicare Advantage or Medicare Part C is an alternative to traditional or original Medicare. While the majority of Medicare beneficiaries are still on original Medicare, Medicare Advantage has grown to 31% of all Medicare beneficiaries, which is triple the number from only twelve years ago. In Nebraska the number of Medicare beneficiaries in a Medicare Advantage plan is 12% and growing each year. The percentage would be much higher if Nebraska had a higher population density. The success of the Medicare Advantage plans depends upon concentrated pools of beneficiaries which is a challenge because the majority of Nebraska is rural. Though Medicare Advantage is growing, consistent concerns continue to arise. People may wish to consider something to backup Medicare Advantage.
Backup Medicare Advantage
Medicare Advantage is “a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.” The co-pays, deductibles, co-insurance is set up differently from original Medicare. Like original Medicare, there are co-pays, deductibles, and co-insurance. While many Medicare beneficiaries chose to backup their Medicare Part A and Part B with a supplement, most people on Medicare Advantage plans chose not to purchase any additional insurance. They don’t backup Medicare Advantage. The reasons may be because co-pays are minimal. Medicare Advantage also has a maximum out-of-pocket where original Medicare does not. Still, people on Medicare Advantage do have concerns about serious illness and possible large co-pays, such as from a hospital stay. They may wish to backup Medicare Advantage, but they don’t know how.
Cover Co-Pays and Deductible
A possible solution to backup Medicare Advantage would be to add an indemnity plan. Indemnity plans are not health insurance. They are insurance plans that reimburse clients for certain specified events. For example, insurance company ABC will pay $500 each day you are in the hospital for a total of ten days. The money paid is to the policy holder to use as he or she wishes, not to the hospital or another insurance company. Indemnity plans may pay for skilled nursing stays past the 21st day when the co-pay is added. A stroke could require prolonged stays in a nursing home. A skilled nursing facility co-pay from day 21-57 could be as high as $160 per day. Most indemnity plans have options for cancer treatment too. The indemnity plan could reimburse several hundred dollars per treatment to compensate for high co-pays or just present a one-time lump sum, such as $5,000 or $10,000 for an occurrence of cancer.
Indemnity plans could be a nice way to fill in the gaps to a Medicare Advantage plan, and they could be a great addition to Medicare supplements or health plans in general. Medicare and health insurance only pays for medical cost that are incurred from approved medically necessary treatments. Heart attacks, strokes, and cancer come with many other non-medical expenses. You may need assistance at home after a stroke that neither Medicare or your health plan cover. Transportation to doctors’ offices are an expense because you cannot safely drive. Wages are lost when your illness prevents you from going to work. Health care costs go beyond the doctor and hospital bills. Indemnity plans may help off set the losses due to illness.
Health insurance is like a puzzle. There are many pieces and different sizes. They can be put together in a multiplicity of ways. They best way to put the puzzle together is to get all the pieces out on the table and see what fits together the best. If you have gone the way of Medicare Advantage, it may be beneficial to backup your Medicare Advantage plan. We can help you see how the puzzle works at Omaha Insurance Solutions 402-614-3389.
One of the most common questions we receive is: “Am I eligible for Medicare?” Well, there’s no black and white answer to Medicare eligibility. Your Medicare eligibility may depend on several different situations. Luckily, we make Medicare easy—this post will show you how and when to apply for Medicare based on your unique situation.
You become eligible for Medicare when you turn 65 (or younger if you have certain disabilities or diseases). If you or your spouse ha worked in the U.S for more than 10 years, you qualify for Medicare benefits.
Make Comparing Medicare Plans a Breeze
Medicare has four parts: Medicare Part A , Part B, Part C and Part D. Parts A and B include doctor and hospital insurance. Together, Parts A and B are referred to as Original Medicare.
You can apply for Original Medicare the year you turn 65, but only if you meet one of the below requirements:
- You’re eligible to receive Social Security benefits or Railroad Retirement benefits.
- You’re already receiving your retirement benefits from Social Security or Railroad Retirement.
- You or your spouse are covered for Medicare through government employment.
Medicare eligibility doesn’t mean you have to start using it. People are different—some may be ready and waiting to get their Medicare benefits and some may not need coverage yet. If you’re getting ready to turn 65, read on to see your Medicare options.
I’m Turning 65 This Year…
If you’re turning 65 soon, you may want to do one of many things depending on your situation:
- You’re retired
- You want to retire
- You have other health coverage
- You are still working and don’t want to retire yet
See the options for your situation below.
…and Want to Apply for Medicare
If you’re planning to receive retirement benefits before or at the age of 65, apply for Medicare at the same time or at least 3 months before your birthday. That way you’ll become automatically enrolled in Medicare when you turn 65.
…and Am Still Working
If you’re still working when you turn 65, you might want to keep your current health coverage provided by your employer. You can keep your current coverage and still apply for Medicare Part A (most people don’t have to pay a premium for Medicare Part A, so you won’t have to incur a cost).
However, you may consider deferring Medicare Part B to avoid the monthly premiums. We recommend checking with your employer to see how your current coverage may work with Medicare Part B before you make any decisions.
…and Am Covered by My Spouse
If you’re still getting health coverage from your spouse that’s working, refer to the paragraph above.
…and Did Not Pay Medicare Taxes While Working
There are some cases where individuals are 65 and older and a permanent resident of the United States, but they (or their spouse) did not pay Medicare taxes while working. If this is your situation, you still have options.
- Medicare Part A with premiums
- You can purchase Medicare Part A.
- Medicare Part A without premiums
- You’re receiving Railroad Retirement
- Kidney transplant patients/dialysis patients may still be able to receive benefits per special circumstance.
I’m Over 65 and Haven’t Enrolled in Medicare
If your 65th birthday has come and gone, you still have several options and opportunities to receive your healthcare.
- If you’re within 3 months of your 65th birthday, you still qualify for enrollment under your initial enrollment period.
- Otherwise, you can wait until general enrollment (January 1 – March 3).