Navigating the ABCDs of Medicare Coverage
For older Americans, it’s open enrollment season for Medicare. That means from October 15-December 7, you have decisions to make when it comes to your 2023 medical coverage.
From Medicare A (also known as original Medicare) to Medicare B, C and even D, it’s easy to quickly become overwhelmed by choices. We asked Ari Parker, J.D., a senior Medicare advisor, for guidance on what can seem like a confusing alphabet soup.
Parker is part of the team at Chapter, an advisory firm that helps older Americans maximize their Medicare benefits. “There are over 24,000 Medicare coverage plans nationwide,” he explains, “and it’s important to shop all the plans available to you each year so you don’t miss out on important benefits.”
Know what you’re shopping for
As you may know, Medicare Part A covers 80% of any in-hospital costs you incur over the course of the year.
So what happens to the remaining 20%? That’s an important question, says Parker, “because there’s no ceiling to the expenses you might incur, which can add up quickly if you have a serious accident or illness.”
Here’s where Medicare Part B comes in. This coverage pays the 20% of in-hospital costs not covered by Medicare A, as well as outpatient expenses such as doctor visits, diagnostic tests, durable medical equipment and even ambulance transport if you need it.
For both Medicare A and B, you’re free to see any healthcare provider that accepts Medicare patients. So what other letters of the Medicare alphabet do you need to know about?
Medicare Part C (also known as Medicare Advantage) coverage is provided by private companies approved by Medicare. These plans follow the managed care model, which means you’re restricted to healthcare providers who are in-network with your specific plan.
Why would someone choose Medicare Advantage over the original Medicare A and B? According to Parker, “It provides additional benefits such as prescription, dental and vision coverage, but you do have to stay in-network, which limits your choice of providers.”
Medicare Part D provides outpatient prescription drug coverage. Also offered by private companies, Part D can be a stand-alone plan paired with your Part A coverage or part of your Medicare Advantage plan if you choose that route.
Take the time to understand your Medicare options
As a Medicare advisor, Parker counsels hundreds of older Americans every year.
When asked how retirees could make the most of their Medicare healthcare benefits, he offers the following three tips:
- Shop all the available options every year. Plans change all the time, Parker says, and staying with the same default plan year after year could mean you're missing out on better coverage and/or significant money-saving options.
- Consider the pros and cons of managed care. Are you OK with having to change providers if your current doctors aren't in network? If you plan to travel or split your time between homes or family members, does each location have the in-network providers you may need?
- Don’t discount smaller carrier options. As Parker noted above, there are 24,000+ Medicare plans across the country. Bigger carriers with larger marketing budgets may be top of mind, but that doesn’t necessarily mean they have the best plan options for your unique needs.
Financial decisions in retirement
For Americans on fixed incomes, it’s important to make informed decisions when it comes to spending. For example, do you want to age in place or downsize to a smaller home? Will you need funds to make renovations or cover the cost of in-home healthcare?
Instead of relying solely on savings to cover expenses, many homeowners 55+ in select states are researching the benefits of a reverse mortgage loan. Simply stated, this type of loan allows you to access the equity you’ve built up in your home, and use it for daily expenses so your invested assets can continue to grow. As with any mortgage, you must meet your loan obligations, keep current with property taxes, insurance, and maintenance.
As one of the nation's top reverse mortgage lenders, Reverse Mortgage Funding (RMF) educates homeowners on the pros and cons of reverse mortgages so you can decide if one is right for you. To learn more, give RMF a call at (888) 277-1567.
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