Many people in the United States have to offer aging parents some kind of assistance. Whether you provide financial or emotional support, it’s always a good idea to stay informed about issues pertinent to the care of aging parents.  An important topic is your loved one’s health insurance plan. Atop the list should be understanding the Medicare process.

What Is Medicare?

Medicare, also known as Original Medicare, is a federal program available to seniors aged 65 and older, some younger people who have disabilities, and people with ESRD (End-Stage Renal Disease.) Medicare is divided into four parts:

  • Medicare Part A (Hospital Insurance)
    • Covers hospitalization, nursing home care, some home health care, skilled nursing facility care and hospice care.
  • Medicare Part B (Medical Insurance)
    • Covers some doctor visits, outpatient services, medical supplies, and preventive services.
  • Medicare Part C (Medicare Advantage Plans)
    • This is a coverage available through private health insurance companies. These private health insurance plans may offer additional benefits in addition to the Part A and Part B benefits. Some Medicare Part C health insurance plans may have zero premiums and some may charge. Additionally, most of these Part C private plans include prescription drug coverage
  • Medicare Part D (Prescription Drug Coverage)
    • Covers drug prescriptions and is offered through private insurance companies. Depending on income and need, some Medicare recipients may qualify for subsidies which will reduce costs when purchasing drug prescriptions.

Medicare Advantage Plans

If your parent already has Medicare, a Medicare Advantage Plan may be a good option. These Plans are also known as Part C of Medicare (see above) and are offered through private health insurance companies approved by Medicare. Once a person joins a Medicare Advantage Plan their Medicare coverage does not go away. Instead it becomes managed by the Medicare Advantage Plan.

All Medicare Advantage Plans cover basic medical needs but they do vary in costs and how medical services are obtained.  Here’s a list of things you should consider when choosing a Medicare Advantage Plan:

  • Is there a monthly premium?
  • Are there any deductibles?
  • How much is a doctor’s visit or medical service (copayment or coinsurance)?
  • What services do you get?
  • What doctors accept the plan you are choosing?
  • Do you get extra benefits? If so, do they cost you anything?
  • What are the yearly out-of-pocket cost limits?
  • If you have Medicaid, can the plan still cover you?

Supplemental Insurance (Medigap)

Supplemental insurance plans are sold through private health insurance companies. These plans can help lower your health care costs (copayments, coinsurance, and deductibles). If your parent purchases a supplemental insurance plan (Medigap) and uses it along with Medicare, the supplemental insurance covers its portions of the costs after Medicare covers its portion of the costs. However, a supplemental insurance policy (Medigap) cannot be used in conjunction with a Medicare Advantage Plan.

Many readers find the 1800health Medicare Basics Guide useful to consolidate their parents’ information so they can help them make better Medicare choices.

Sources

Medicare.gov

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