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Home › MedicareWire Blog › Does your Medicare healthcare strategy need a makeover?

Does your Medicare healthcare strategy need a makeover?

August 25, 2012

Are you paying more than you should for your Medicare healthcare coverage?  According to Ellen E. Schultz at the Wall Street Journal, many seniors are over paying, not getting all of the coverage they need, or are simply confused by the variety of choices:

In many cases, the problems stem from hasty decisions during their initial enrollment, as well as misguided reliance on incomplete information provided by sales people touting Medigap, prescription-drug or Advantage plans.

Even if you are happy with your coverage, you might want to re-evaluate your choices in light of the Affordable Care Act, which has added some benefits. Preventive screenings, such as mammograms and colonoscopies, are now covered, and the “doughnut hole,” which causes many seniors to pay thousands of dollars for prescription drugs out of pocket, is being phased out.

To help pay for the improved coverage, the overhaul rescinds subsidies that private insurers receive for Advantage plans, which are private programs that are intended to provide coverage similar to Medicare. It isn’t clear whether providers will drop plans, increase premiums or make other changes.

I agree with Ms. Schultz on one point, it is a good idea to review all Medicare benefit and plan changes annually so that you can make wise choices during open enrollment.  However, Ms. Schultz is completely misinformed or misguided on two critical points:

  1. The Affordable Care Act of 2010 (Obamacare) had nothing to do with the recent additions to your Medicare benefits.  The Medicare program continually adds new services and benefits that help keep the cost of Medicare down.  Preventative medicine (e.g.,  mammograms and colonoscopies) are a cost savings measure for the government.
  2. The Part D Prescription Drug Plan “donut hole” is scheduled to be phased out under the current Administration, but that does not mean it is necessarily a good thing.  Part D plans are private insurance and insurance companies are not in business to loose money.  As the donut hole closes, Part D premiums will rise, making them less affordable to more people.

Don’t get sucked into believing the rhetoric and half-truths being tossed around by the media during this election year.  Anything can be and will be twisted into a reason to vote one way or another.

Just remember this, your Original Medicare (Parts A and B) only cover about 80% of your healthcare needs.  For the other 20% you will be required to pay out of pocket or purchase additional insurance to reduce your risk.  There are three types of plans you need to evaluate every year:

  1. Part D prescription drug plans;
  2. Part C Medicare Advantage plans (HMO/PPO type coverage that may include a Part D plan); and
  3. Medicare Supplement plans (aka, Medigap)

The more you read about each type of plan the more informed you will be so you can make the best decisions for your health care needs.

 

Article by David Bynon / MedicareWire Blog / medicare, medicare advantage, medigap, part d plans

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