Fact & Fiction in Medicare: Here’s What You Need to Know to Find the Best Coverage

Turning 65 this year? Don’t wait for your birthday to start researching your Medicare options. With all the plans and parts, it can seem like swimming through an alphabet soup (plan A, B, C and on and on). You can more successfully navigate the world of Medicare by starting your research in advance. To help you along the way, the team at Long & Foster Insurance is dispelling and confirming a few myths and truths about Medicare.

A Medicare Advantage Plan (Part C) is bet­ter than Medicare Supplement Insurance.

FALSE. Neither program is better than the other is. Rather, the plan that’s best for you will depend on your personal health and financial situation. Here are two questions to consider when evaluating whether Medicare Supple­ment Insurance (or MedSup as it’s also called) or the Medicare Advantage plan is best for you.

  • Would you rather pay a higher monthly pre­mium but less when you visit the doctor, or a lower monthly premium and higher co-in­surance or deductibles? MedSup programs often have higher monthly premiums than Medicare Advantage, but the co-insurance and deductibles can be more expensive with a Medicare Advantage plan.
  • Do you have preferred doctors or are you open to see any practitioners? With Medi­care Advantage, you’ll see a specific group of providers, but you can choose your doc­tors with a MedSup plan.

You can switch from a Medicare Advantage Plan to a MedSup program.

TRUE. If you sign up for a Medicare Advantage Plan first but decide to switch to a MedSup, you can do so during Medicare open enroll­ment, but you’ll have to go through medical underwriting. That means the insurance pro­vider who oversees the MedSup program will evaluate your overall health and medical con­dition. After a successful medical underwriting, you’ll be able to sign up for the MedSup plan.

I’ll never be dropped from my Medicare Advantage Plan.

FALSE. Your Medicare Advantage Plan can be cancelled at the end of the year. If that occurs, you’ll be offered an option to sign up for a MedSup program. Your annual premiums for a MedSup program may increase from year to year, but you cannot be dropped from the plan as long as you pay your premiums. It’s import­ant to note, though, that if you have to sign up for MedSup because you were cancelled from a Medicare Advantage Plan, you may only be offered certain plans. Your options will vary by state and by insurance provider.

MedSup plans are the same across companies.

TRUE. These plans are standardized by the government, so a MedSup plan G from one provider will offer the same coverage as the same plan from another provider. That makes it easier for you and your insurance agent to compare plans and determine what’s most affordable for you.

All Medicare prescription drug plans are the same.

FALSE. While the government regulates Med­Sup plans, prescription drug plans are not con­trolled in the same manner. Private insurance companies oversee these programs, and their rates change often in how they’ve set up price tiers for prescription drugs. Depending on the plan in which you’re enrolled, you could save hundreds, or even thousands, of dollars each year by switching to a new drug plan.

As you can see there are many variables with Medicare and an experienced health insurance broker, like those at Long & Foster Insurance, can help you navigate through the process and get the best coverage for your needs.