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October Newsletter 2009
Popularity Contest: The Benefits of Medicare Advantage, Medigap, & PDPs
by Jenny RoseWhen it comes to all-inclusive health insurance at an affordable price, seniors are finding a real deal with private insurance plans. The soaring rates of enrollment over the years in Medicare Advantage, Prescription Drug Plans and Medicare Supplement Plans (also known as Medigap) demonstrate the continued popularity of these plans among seniors.
In 2009, 10.2 million seniors enjoyed the benefits of a Medicare Advantage plan up from 7.6 million in 2006, while similar increases are seen in private Prescription Drug Plans and Medigap. In 2009, 26 million seniors enrolled in a stand alone or Medicare Advantage prescription drug plan, a jump from 22.3 million in 2007, and Medigap attracted nearly 10 million enrollees in 2009.
So why are these plans so popular? For starters, traditional Medicare only provides basic health insurance with high deductibles and co-pays, while Medicare Advantage plans provide everything offered under traditional Medicare plus additional benefits. Here is a brief overview of what different categories of plans may offer.
Medicare Part A (Hospital Insurance):- Benefits: Pays for inpatient hospital, skilled nursing facility, & some home healthcare
- Premium: No premium after 40 quarters, $244/month for people with 30-39 quarters of Medicare-covered employment, $433/month for those who have less than 30 quarters of Medicare-covered employment
- Deductible: $1,068 during the first 60 days of each benefit period
- Coinsurance: $267/day for days 61-90 for hospital stays & $534/day from 91-150 days, $133.50/day per benefit period for days 21-100 for Skilled Nursing Facility coinsurance
- Benefits: Medicare-eligible physician services, outpatient hospital services, some home health services, & durable medical equipment
- Premium: $96.40/month, unless your income is above $85,000 (single) or $170,000 (married) in which case it may be higher
- Deductible: $135/year
- Coinsurance: Once you meet the $135 deductible, you pay 20% of the Medicare-approved amount
- Benefits:
o Lower premiums than Medigap plans
o Prescription drug benefits are available
o Provides all of Part A & B coverage, & must cover medically-necessary services
o Some plans may also include vision, dental, and hearing coverage
o Some of the plans coordinate your care, using networks and referrals (HMOs & PPOs), while others do not use networks (Private Fee for Service). - Premium: $39/month on average for 2010 (premiums will vary by plan)
- Deductible: Varies by plan
- Coinsurance: Varies by plan
- Benefits: Comprehensive prescription drug coverage, Coverage for brand name and generic prescription drugs
- Premium: $30/month on average for 2010 (premiums will vary by plan)
- Deductible: May not be higher than $310
- Coinsurance: The gap begins at $2,830 and lasts until $4,550
- Benefits:
o May pay Medicare Part A & B deductibles
o Could pay part or all of Medicare Part B coinsurance amounts
o May have preventative care coverage
o Covers copayment or coinsurance for certain services
o May include coverage for emergency care outside the U.S.
o Optional coverage for additional benefits, like hearing and vision - Premium: Premiums will vary according to plan and carrier. You just pay the part B premium of $96.40/month, unless your income is above $85,000 (single) or $170,000 (married) in which case it may be higher
- Deductible: Plans are available that will pay Part A deductible or Part B deductible
- Coinsurance: Once you meet the $135 deductible
Depending on where you live, the prescriptions you take, and your personal priorities, a Medicare Advantage or Medigap plan combined with Prescription Drug coverage can provide you with the best insurance available. To speak with our team of experts and find your optimal Medicare plan, call us at 1-800-819-6906 or go to PlanPrescriber.com.
Read the other October 2009 articles:
