Supplemental Insurance: Is It Really Worth It?

Each year, thousands of Americans transition from group health, no insurance, or a personal health insurance policy to Medicare; in 2015, more than fifty-five million Americans took advantage of Medicare coverage. And that’s good.

However, many people don’t realize that Medicare only covers part of their health care costs. The individual must cover the remainder, which includes copays, deductibles, and dental, hearing, and vision care.

Generally, when US citizens turn sixty-five, Medicare enrollment is automatic. However, the significant coverage gaps above can cause financial hardships if you don’t understand the choices Medicare offers. For example, “original” Medicare provides Part A (Hospital) insurance and Part B (Medical) insurance. However, Part A and Part B have different costs: Part A is automatic for most people; Part B is $104.90 per month in 2016. Both have copays and deductibles, which can be steep.

By sixty-five, most of us take at least one prescription medication. For prescription coverage under Medicare, you must have a Medicare prescription drug plan. Therefore, you should consider Medicare’s Part D; be aware, however, that it will cost extra.

For help with copays and deductibles for lab tests, doctor visits, and hospitalizations, you’ll need to shop for supplemental coverage. Medicare pays private insurers a fixed amount each month to manage your health care. You may hear it called “Medigap,” “Part C,” or “Medicare Advantage,” and it requires an additional monthly premium payment.

Each supplemental plan covers different doctors, hospitals, and lab facilities, so it’s important to work with an experienced health insurance agent to choose a plan that will cover the medical providers you want to work with.

If this all sounds confusing, it is. While you can navigate the Medicare website, gather information about the various plans, and even choose a policy online, you run the risk of making a costly mistake. Call my office before you make that important transition to Medicare.

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