Original Medicare consists of Medicare Part A and Part B. Original Medicare is run by the government and covers certain inpatient and outpatient services. You can enroll in Original Medicare if you meet any of the eligibility requirements, such as qualifying by age (65 or older).
After you enroll, you will be required to pay premiums, deductibles, copayments/coinsurance costs to stay enrolled. Medicare Part A is premium-free for many enrollees who have met the requirements. However, Part B premiums must be paid each month. As a Medicare beneficiary, you can choose to stick with your Original Medicare coverage or enroll in Medicare Advantage. However, you must be enrolled in Original Medicare first before you can make that switch.
Medicare Advantage plans are sold by private insurers that have been approved by Medicare.
Medicare Advantage Explained
Unlike Original Medicare, there are different types of Medicare Advantage plans, with different costs and coverage features. A key feature of Medicare Advantage plans is that they combine the coverage from Medicare Part A and Medicare Part B. Many will also cover additional services not available under Original Medicare, such as prescription drug coverage, routine dental, vision, and hearing coverage.
If you are eligible, you can enroll in Medicare Advantage during your Initial Enrollment Period (starts three months before your 65th birthday) or during the Annual Enrollment Period (October 15 – December 7). There are Medicare Advantage plans with $0 premiums, while some may have higher premiums depending on the type of plan.
Medicare Advantage and Original Medicare Costs
Usually, if you are enrolled in Medicare Advantage, you will need to keep paying your Medicare Part B premium to stay enrolled. Though there is a standard premium for Part enrollees, the premium may vary based on your income. There is an Income Related Monthly Adjustment Amount (IRMAA) for Part B enrollees, but some Medicare Advantage plans may help cover part or all of your Part B premium.
Unlike Original Medicare, Medicare Advantage plans have a yearly limit on out-of-pocket expenses. If you reach this limit, you’ll pay nothing for approved services for the rest of the year. While Original Medicare enrollees typically cover 20% of approved costs, Medicare Advantage plans have varying costs. In certain cases, you may pay more if you visit providers out of your plan’s network.
Want to Learn More? Give Us a Call!
For more information about Medicare Advantage plans and the costs you can expect, contact Jersey Medicare Solutions today! Also, if you want to know more about Original Medicare and Medicare Advantage in Dover, please check out our blog here.
Thomas M. Brzezinski is one of the founding partners of WMAG William & Michael Advisor Group LLC and Jersey Insurance Solutions. He has been involved in the insurance industry for over ten years and specializes in developing client relationships that last a lifetime.
