You can also make this change during the Medicare Advantage Open Enrollment period, which runs from January 1 to March 31. If you make this change and want prescription drug coverage, be sure to sign up for this. If you don’t and decide to get Part D coverage later on, you could face a penalty for late enrollment.
Traditional Medicare and Medicare Advantage are two different plans. With Original Medicare, you can go to any doctor or hospital that accepts this insurance, which most do. You also shouldn’t need a referral to see the doctors you want. Original Medicare also covers most medically necessary services and supplies.
However, Original Medicare generally does not cover medical care outside of the U.S. It also doesn’t cover some benefits like eye exams and most dental care. And, if you need prescription drug coverage, you’ll need to join a separate Medicare Part D drug plan.
Medicare Advantage, on the other hand, acts more like an HMO insurance plan. In most cases, you can only use doctors and other providers who are in the plan’s network and service area. You may also need referrals to see specialists.
Advantage plans cover what Original Medicare does, and even offers coverage for vision, hearing and dental, as well as prescription drugs. It’s also cheaper than Original Medicare. These plans are certainly attractive, which is why you probably went with one in the first place!
However, Advantage plans have their drawbacks. You’re often limited on the doctors you can see, the out-of-pocket caps can be as high as $7,550 in 2022 ($8,300 in 2023) and networks and coverage change year to year. The insurance companies get to decide what is medically necessary.
If you do plan to switch over to Original Medicare, you may also want to consider adding supplemental insurance. Also known as Medigap, these plans help pay for out-of-pocket costs, such as your 20 percent coinsurance. You cannot get supplemental coverage with Advantage plans.
There are many different Medigap plans available, so it’s easy to find one that fits your budget. Due to the rising costs of health care and declining health care benefits, supplemental insurance is becoming even more important. These plans have a monthly premium, but they will pay for themselves if you have a serious illness or condition.
Since it’s Open Enrollment for Medicare, now is the time to make the switch. If you miss out, you will have another opportunity at the start of next year. The benefit in switching over now is that your new benefits will go into effect on January 1. To discuss your Medicare needs, schedule an appointment with Leonard Financial Solutions.