Medicare and Health Insurance Options at Age 65

There are loads of health insurance options for people over age 65. Below we’ll discuss each of them so you get a better understanding of what to look for and which type of plan might work best for you.

medicare-and-health-insurancePrivate Insurance
Some people, over 65, have company sponsored group medical health insurance that carries over into retirement. These plans must be reviewed by a Professional Medicare Insurance Advisor to determine whether or not it is in your best interest to stay on your retiree plan, or opt out of your retiree plan and go onto Medicare and a Medicare Insurance plan.  Do not try to make this decision on your own, as making a wrong decision could jeopardize your ability to get back onto your retiree plan if needed.

Original Medicare
Medicare has four parts. Medicare Part A covers Inpatient Hospital stays, Skilled Nursing stays and Institutional care. Part A normally comes to you free of charge.  Medicare Part B covers outpatient services such as doctor visits, rehab therapies, lab work, outpatient surgeries, etc. Medicare Part C is also known as the Medicare Advantage program.  There are 33 Medicare Advantage HMO plans in Orange County alone and most include prescription coverage. There is also a Medicare Advantage PPO program available that includes prescription drug coverage.  Using the expertise of a non-biased, Independent Medicare Insurance Advisor is essential here, as there are so many plan benefits to compare.  Medicare Part D is the prescription drug program.

Prescription Drug Plans
If you choose a Medicare Advantage plan that includes prescription drug coverage, you do not need to be concerned about a Prescription Drug plan as it will be included in the Medicare Advantage plan.  If you choose to take a Medicare Supplement or Medigap plan you will need to review and choose a Part D Prescription Drug plan and that is quite a task.  A Professional Medicare Insurance Advisor should be able to assist you in choosing a plan that covers you and your current medications adequately.  Don’t assume all plans are the same because they ARE NOT.  Each plan covers medications differently and those plans change a bit each year.  It’s important that you have a Medicare Insurance Advisor on your team so he/she can help you with these important decisions.

MediGap/Medicare Supplement Insurance
Medicare Supplement (sometimes called Medigap plans) are offered by private insurance companies.  The Medicare Supplement policy normally covers the balance of what Medicare does not pay.  The most popular plan available through the Medicare Supplement arena is PLAN F, as it is the most comprehensive plan available.  For a little as $160 per month (at age 65) you can have complete, comprehensive coverage with NO CO-PAYS and no out of pocket cost when you access care.  Your Professional Medicare Insurance Advisor will help you determine how these programs work.

Medicare Advantage Plans
These programs are usually HMO plans although there is one PPO program available in California. Medicare Advantage plans usually have a ZERO monthly premium and include prescription drug coverage. They require that you access all care through a primary care provider so there are limitations. You also are required to pay a CO-PAY when you access care. Each plan and cop-pay is different and using your Medicare Insurance Advisor is always recommended.

As you can see, there are many options and decisions to be made when it comes to which health insurance plan is best for you once you turn 65.  We can help you by providing free, un-biased, education regarding all of the plans and help you make the decision that works best for you.  Once you’ve made that decision, we can help you get enrolled into the plan of your choice.

Call us today to schedule a free consultation and discuss your health insurance options. 

We’re happy to help.  (714) 729-3161