Now
here is what you need to know: If you decide to enroll in a Medicare Advantage
Plan (MAP) you will have to pay a monthly premium under this plan in
addition to having a Medicare Plan B premium deducted from your Social
Security (p. 17). Now here is the real
eye-opener: A Medicare Advantage Plan (HMO, PPO, etc.) is offered by “private
companies” that are Medicare-approved by the U.S. Department of HHS and the administration
of these services are set by government rules. If you elect a Medicare
Advantage Plan (MAP) you get Medicare Part A (Hospital) and Part B (Doctor’s)
coverage but it is “NOT ORIGINAL MEDICARE” as administered by the federal
government. Additionally, it is not a supplemental plan because when you enroll
in a MAP you are essentially dis-enrolled or “NOT” covered under ‘Original
Medicare” and as such, you have to meet different deductibles, co-insurance/co-payment
limits, and whatever else.
Perhaps
the only real ‘Advantage’ in a MAP is that you have a yearly out-of-pocket
maximum limit (p. 69), whereas under ‘Original Medicare’ there is no upper
limit for annual out-of-pocket costs (p. 64). As with anything of value it is
good to get as much information as possible before you choose the best plan for
your needs. Contact MEDICARE and ask the representative to give you the cost of
your annual deductible for Original Medicare part A (Hospital) and also for
part B (Doctor) charges. The one thing that I found puzzling is that if I
enroll in a MAP and pay premiums then why part B payments still are being
deducted when I am no longer covered under Original Medicare, but when I asked
this question all the person on the line did was continue to repeat that I have
to have parts A and B to enroll in a MAP; which to me was not a real answer but
rather the usual- you know what I mean.
Interestingly,
there are no “Medigap” plans listed in the book (at least, for WA State) but
quite a few Medicare Advantage plans, and Medigap is actually a supplemental
plan because when you enroll in one you are still covered under Original
Medicare, too. The thing is though; the premiums are usually quite a bit higher
in some cases than either a MAP or Original Medicare but the annual deductibles
are a lot lower in most (??) cases. When considering either plan outside
Original Medicare try to find out if the annual out-of-pocket costs include
deductibles, co-payments, co-insurance and/or other fees to determine if you
are getting the most bang for your buck. This is your body and health needs and
it doesn’t take a Rocket Scientist, having a representative or independent
agent from one of these agencies contacting you, or attending a workshop to
choose a plan; the good thing about all of this is you can always change your
mind if you learn something else is better, and opt-out within the enrollment
period. At the very worst, you can just wait another year and try another plan
or remain in Original Medicare.
Robert
Randle
776
Commerce St Apt 701
Tacoma,
WA 98402
March
1, 2017
