Original Medicare consists of two parts, Hospital and Medical insurance benefits, but what most people don’t know is that Medicare was never intended to cover all hospital and medical costs. In some instances, Original Medicare may have a premium to pay along with deductibles and co-insurance costs with no limit on out-of-pocket expenses. It also does not cover routine vision, hearing, dental, or prescription drugs.
Private insurance companies will sell a supplemental prescription drug benefit under what is known as Part D. There are many different Part D prescription drug plans available for purchase. Because Part D prescription drug plans differ in their costs, the drugs they cover, and the pharmacies they work with, it is important to fully understand your choices.
For people that want more health care coverage than Original Medical offers, they can purchase a Part C Medicare Advantage plan. They may still have a premium to pay as well as co-payments, co-insurance, and deductibles but Part C plans also have a set maximum amount for yearly out-of-pocket expenses. Some Part C plans may also cover prescription drugs, routine vision, hearing, and dental that are not covered under Original Medicare.
Medigap is another name for Medicare Supplement Insurance. With Original Medicare, beneficiaries must pay some of the cost such as deductibles and co-insurance. Because of these gaps in Medicare Parts A and B coverage, private insurance companies sell Medicare Supplement Insurance plans to fill in those gaps. If you are in the Original Medicare plan and have a Medigap policy, Medicare will pay its portion of your covered medical costs then Medigap will pay its portion. When considering a Medigap policy, it’s important to understand that although the plan benefits are all standardized, cost can vary. You can compare the different Medigap plans side-by-side on at medicare.gov
You may only apply for an Oregon Medigap plan if you reside within the State of Oregon and are enrolled in Medicare Parts A and B. Some people get Part A and Part B automatically, others have to sign up for Part A and/or Part B. You can check online to see if you’ve signed up for Part B at medicare.gov or call the Social Security office at (800) 772-1213.
While many people prefer the options offered by Medicare Advantage or Medigap Plans; others may prefer just having Original Medicare coverage and purchase a supplemental prescription drug plan. When considering all of your options, it’s important to work with a licensed insurance agent that understands Medicare and the available plans. Rhodes-Warden Insurance can help you navigate the maze that insurance can be and simplify the challenge of understanding your choices for Medicare supplemental coverages.
To get help with deciding which options may be best suited for your needs, call us at (541) 258-2131 during our business hours of Monday through Friday, 8:30 a.m. to 5:00 p.m. or simply complete our Contact Request form below and we will call you to schedule an appointment at one of our offices in Lebanon, Albany or Stayton, Oregon.
Initial Enrollment Period - Essentially you have a seven month window to sign up for a Medicare Plan. This is the three months before your birthday months, the month of your birthday and the three months after your birthday months. So contacting our office to schedule a time to meet with us to discuss your options and get answers becomes very important.
Annual Open Enrollment Period - If you are already enrolled in Medicare, October 15th through December 7th is an important time of year. Anyone with Medicare can join, change, or drop a Medicare Advantage or Prescription Drug plan. Our knowledgeable Medicare specialist at Rhodes-Warden Insurance can provide the information to help you understand the changes to your existing plan and your options for the upcoming year. Since available appointment times fill quickly, be sure to mark your calendar and contact our office well in advance of the open-enrollment period to schedule a time with us to review your choices.