If you are approaching Medicare eligibility you may be wondering, “Is Medicare good insurance?” (spoiler alert, it’s great!)
Sometimes Medicare gets a bad rap. People complain about prescription drug prices and the dreaded “donut hole,” or fuss about the lack of coverage for long-term care. But here’s the thing: Americans are overwhelmingly satisfied with Medicare—a recent survey showed nearly 90% of enrollees are happy with their care and satisfied with their coverage choices.
If you’re approaching Medicare eligibility, it’s important to approach Medicare with the right frame of mind. Yes, depending on the plan and coverage you choose, it might be very different from your employer or union health care plan. But there’s a lot of good things in Medicare that you might not have had with your previous coverage. Take a look at these 5 reasons why Medicare is good insurance that you will end up loving.
1. Medicare premiums are lower than private health plans
Nearly everyone qualifies for premium-free Part A, so you only pay your Part B premium for Original Medicare coverage. In 2019, the Part B premium is just $135.50. The average monthly private health insurance premium for a healthy 25-year-old is $403 [2], over $250 a month more.
Not only that, Medicare premiums tend to rise more slowly than private health plans because they’re pegged to inflation. Private insurance companies have to factor in claims, the economy, state and federal regulations, and even lawsuits when they calculate premiums. Since 2013, private insurance premiums increased 123%, while Part B premiums only increased by about 25%, or $30 a month.
And there’s even more good news for Medicare enrollees on the premium front: Premiums for Medicare Advantage and Medicare Part D Prescription Drug Plans are actually trending down. Most people will pay lower Medicare premiums in 2020 than they did in 2019. How often does that happen in the private sector?
2. There’s even “Extra Help” for people who need it
The government recognizes that Medicare is the only game in town for most seniors, so they created programs to make it affordable for those with limited income. There are state and federal programs to help pay Part B premiums, plus deductibles, copayments, and coinsurance amounts. Even the Part D prescription drug program has an income-based assistance program to lower the cost of medications.
If you qualify for both Medicare and Medicaid, you may be able to enroll in a special Medicare Advantage plan that covers all your health care needs—including prescription drugs—and pay nothing in monthly premiums.
3. Choices, choices, choices
When you have employer coverage, you have to go with whatever the company offers in terms of health insurance. It doesn’t matter if the coverage is less than ideal, your options are limited by your employer.
That’s definitely not the case with Medicare. Although most people stick with Original Medicare, the 35% who choose Medicare Advantage have an average of 21 different plans to choose from [3] . In other words, you’re not stuck with someone else’s idea of what’s best for you—you can choose your coverage based on what’s best for your own situation.
Even better, you’re never stuck with your choice for years on end if you’re unhappy with it. You have the option every year during the fall Annual Election Period to switch up your coverage, and if you’re enrolled in Medicare Advantage, you have a second period at the beginning of the year to make changes to your plan.
4. Totally predictable health care costs—if you want it
Medigap
There’s a lot of uncertainty if you choose Original Medicare; there’s no limit to what you can pay out-of-pocket in deductibles, copayments, and coinsurance amounts. But if you buy a Medigap plan, you can get first-dollar coverage on all your health care costs, so you pay almost nothing when you need medical care.
In 2020, a slight change to Medigap rules will eliminate two plans, Plan C and Plan F, that pay your Part B deductible, but if you buy a plan before January 1, 2020, you can keep it. After that date, you can still get comprehensive coverage with Plan G, except you’ll have to pay your Part B deductible, which will be $197 in 2020.
Medicare Advantage
You can also control your health care costs with a Medicare Advantage plan. Most plans have just one deductible—if they have one at all—instead of one for Part A and one for Part B with Original Medicare. In addition, instead of paying a percentage of fees like you do with Part B, most Medicare Advantage plans use a set copayment.
And all Medicare Advantage plans have a mandatory out-of-pocket maximum set by the federal government each year, although most plans set their limits below the government amount. What that means for you is that you’ll never pay more than your plan maximum each year, no matter how much health care you need.
5. New benefits to keep you healthy and safe at home
Medicare has a lot of benefits for preventive care, whether you choose Original Medicare or Medicare Advantage. The program frequently reviews recommendations for wellness and preventive care and adjusts coverage accordingly, so you’ll always have access to the screenings, tests, and immunizations you need to stay healthy.
But the Centers for Medicare and Medicaid Services has gone a few steps further with Medicare Advantage plans and authorized a whole slate of new benefits aimed to keep seniors safe, healthy, and independent at home. The new benefits include expanded coverage for telehealth services, non-medical transportation, in-home meal delivery, home health care including custodial care and home-making services, and even allowances for home safety equipment and devices. There are even new caregiver benefits, including respite care.
Get help with Medicare
So, don’t believe the naysayers who complain about Medicare. It might be a little different than your employer coverage, but it will probably be a lot better in many ways.
If you’re not sure which path to take with your Medicare coverage, or how to choose the right plan for your needs, the team of Medicare experts here at Dickneite Senior Benefits are committed to providing you unbiased information on the best plans and unmatched legendary service for the life of your policy.
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