If you’re one of the millions of Americans caring for an aging parent or spouse, you may be feeling overwhelmed. And, if you’re making their health care decisions, navigating Medicare can seem like yet another chore. This Medicare overview can help make it easier. Read on to learn about the basics of Medicare and how to help your parent or loved one get the coverage that best fits their needs.
Medicare Parts A and B
When Medicare was signed into law in 1965, it included two “parts” or kinds of coverage. Part A is hospital insurance and Part B is medical insurance. Together, Parts A and B are referred to as “Original Medicare.”
With Original Medicare, there are deductibles and coinsurance to pay. And it does not include important benefits like Part D prescription drug coverage and routine care, like vision and dental. That’s why many people choose to enhance their coverage.
Adding to Original Medicare coverage
If your parent or loved one needs more benefits than Original Medicare provides, they have options, including:
Medicare Advantage plans, also called Medicare Part C, are run by private insurance companies, like ConnectiCare. They include Part A and Part B benefits, plus most include additional benefits like routine care and wellness programs. Another “advantage” of these plans is the limit on how much a Medicare beneficiary will have to spend each year for covered medical expenses. This is called the annual out-of-pocket maximum and every Medicare Advantage plan has one.
Medicare Part D prescription drug coverage
Medicare Part D is not offered by Medicare itself. You can get Medicare Part D from a
Medicare Advantage plan. This is called a Medicare Advantage Prescription Drug plan, or MAPD.
You can also choose to purchase a separate Part D plan run by a Medicare-approved, private insurance company. These usually come with a separate premium.
Medicare Supplement plans
Medicare Supplement plans, also known as “Medigap,” help cover some of the costs that Original Medicare does not, such as deductibles, coinsurance, and copayments. Medicare Supplement plans do not include prescription drug coverage. A separate Part D plan would need to be purchased.
Things to consider when choosing a Medicare plan
As you explore plan options, you’ll want to take into account your loved one’s medical and prescription drug needs, financial resources, and the level of flexibility they prefer. Check with doctors and health care providers to see if they accept different types of Medicare coverage.
If they need more coverage than Original Medicare, here are two options to consider:
- A Medicare Advantage Prescription Drug plan can help simplify things and ease the financial burden with $0 premium plans, combined medical and prescription coverage, and extra health and wellness benefits. Some even include dental, too.
- A Medicare Supplement plan may be a good option if your parent or loved one doesn’t mind paying a higher monthly premium in exchange for fewer out-of-pocket costs for medical services. Remember, to get coverage for prescriptions, a separate Part D plan must be purchased.
We can help
Choosing a Medicare plan for your parent or loved one is a big decision. You don’t have to figure it out on your own. ConnectiCare has provided health plans to Connecticut residents since 1981. And, we’re the health plan of choice for nearly 50,000 Medicare Advantage members.1
Call us for more information or to set up a personal consultation. We can meet with you at a time and place that’s most convenient. You can also schedule an appointment at one of our ConnectiCare centers across Connecticut. Call 1-855-432-3393 (TTY: 711) today.
1 ConnectiCare Medicare Advantage membership as of July 2019