Basic Medicare (Part A and Part B) doesn’t cover everything
There are extra coverage costs that must be considered when signing up for Medicare.
You can elect to stay with Original Medicare and sign up for Medicare Part D (Drug coverage) and Medicare Supplement (Medigap) OR elect to sign up with a Medicare Advantage (Part C) plan.
Original Medicare
You can sign up for Original Medicare (Part A and Part B). You will then need to sign up for Part D (Drug coverage) and a Medicare Supplement (Medigap).
Original Medicare and Medigap plans generally do not cover vision, hearing and dental coverage.
Original Medicare Estimated Total premiums per person:
- Medicare Part A Premium- $0 (1)
- Medicare Part B Premium – $135.50 (2)
- Medicare Part D (Prescriptions) Premium Range – $15.50 – $59.10 – $119.90 (in the TN 37701 zip code)
- Medicare Supplement (Medigap) Premium Range – $44.00 – $119.96 – $263.00 (Plan D (more coverage/more expensive) or K (less coverage/cheaper) type policies in the TN 37701 zip code)
Estimated Range for Total of Premiums only = $195.00 – $314.56 – $518.40
The Centers for Medicare & Medicaid Services provides a helpful document to assist with choosing a Medigap policy.
2019 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.
The Medigap Plan F is currently the most popular. However, after January 1, 2020, Medicare Supplement (Medigap) Plans C and F are being discontinued and you will not be able to enroll in Medicare Supplement (Medigap) Plan F or C. That means that people whose birthday is December 31, 1954 (turning 65 on December 31, 2019) may be the last group able to enroll in Medicare Supplement Plan F or C.
Think twice before signing up for Plan C or F, since they will be discontinued in 2020. If you sign up for Plan C or F and choose to keep the plan, there is no way to know at this time if the premiums will rise too much. Plan G is a good alternative. Plan D might work as well.
Advantages of Medicare Supplement (Medigap) Coverage:
- You will likely be able to use your current health care providers (doctors, hospitals, etc.) and will not have to be concerned with a network of providers.
- You will likely NOT have a limited coverage area. Nor will you have to pay more out-of-pocket if you go to a provider out of the coverage area.
- The rules for certain services, health products, or referrals will likely be less strict than Medicare Advantage.
- May be a better fit if you have ongoing health issues.
- May be more flexible for your treatment options than Medicare Advantage..
- You Medigap plan will follow you if you move to a different location (e.g. State, city, county, part of a state, etc.).
If you start out with Medicare Part C (Medicare Advantage) and you don’t like it, you can generally switch back to Original Medicare during certain enrollment periods. However, Medicare Part D (prescription drug coverage) may cost more. In addition, you may not even be able to get a Medicare Supplement (Medigap) policy, and if you do it may cost more and have limitations.
In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized differently than in other states.
Medicare Advantage
As an alternative to Original Medicare, you can sign up for Medicare Part C (Medicare Advantage), which is a type of Medicare health plan offered by a private company that contracts with Medicare. It is an alternative to Original Medicare. Medicare Advantage Plans provide almost all of your Part A and Part B benefits and more than likely Part D benefits.
You will still need to sign up for Medicare Parts A & B before signing up for Medicare Advantage (Part C).
Many Medicare Advantage Plans also offer extra coverage, like vision, hearing and dental coverage.
Medicare Advantage (Part C) Estimated Total premiums per person:
- Medicare Part A – $0 (1)
- Medicare Part B – $135.50 (2)(3)
- Medicare Part D (Prescriptions) – $0 (in this estimate, Part D is included in Medicare Advantage plan)
- Medicare Advantage Premium Range- $0.00 – $85.00 – $217.00 (in the TN 37701 zip code)
Estimated Range for Total of Premiums only = $135.50 – $220.50 – $352.50
The Centers for Medicare & Medicaid Services provides a helpful document to assist with Understanding Medicare Advantage Plans.
Medicare Advantage (Part C) may be less expensive than separately obtaining benefits from Medicare Plan A, Plan B, Plan D, and Medigap. However, there may be limitations on coverage areas and provider (doctors, hospitals, etc.) selection.
Limitations of Medicare Advantage (Medicare Part C)/Questions:
- You may need to use health care providers (doctors, hospitals, etc.) who participate in the plan’s network, i.e. you may not be able to use your current providers (doctors, hospitals, etc.) without paying more.
- You may have a limited coverage area.
- You may have a limited coverage area and have to pay more out-of-pocket if you go to a provider out of the coverage area.
- There may be stricter rules for certain services, health products, or referrals.
- May not be a good fit if you have ongoing health issues.
- May not be as flexible for your treatment options as Original Medicare.
- Medicare Advantage plans have annual contracts with Medicare and can choose not to renew their contract for the following year.
- What if you move to a different location (e.g. State, city, county, part of a state, etc.)?
- Can you disenroll and return to Original Medicare? Yes, but.
- If you start out with Medicare Part C (Medicare Advantage) and you don’t like it, you can generally switch back to Original Medicare during certain enrollment periods. However, Medicare Part D (prescription drug coverage) may cost more. In addition, you may not even be able to get a Medicare Supplement (Medigap) policy, and if you do it may cost more and have limitations.
(1) You could pay a standard Medicare Part A premium of $437.00 if you paid Medicare taxes for less than 30 quarters. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $240. Otherwise, there is no premium for Medicare Part A.
(2) “In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B.” In addition, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA), which is an extra charge added to your premium.
Medicare Premiums: Rules for Higher-Income Beneficiaries
(3) In some cases some of the Medicare Part B premium may be covered by the Medicare Advantage (Medicare Part C) insurance provider, if you elect to sign up for Medicare Advantage not Original Medicare.