Is Original Medicare (Part A & B) Enough?

With Medicare’s Annual Enrollment Period coming up, chances are you’re hearing lots of buzz about private coverage options that replace or supplement Original Medicare. While you’re being inundated with information, you may be wondering if these private plans are really necessary.

Here, we’ll explore if Original Medicare Parts A and B provide enough coverage for your health care needs. Then we’ll cover the private coverage options available. Armed with this information, you’ll be better equipped to make a confident decision that supports your health and budgetary needs!

What do Original Medicare Parts A & B cover?

Original Medicare Parts A and B are funded by the federal government and are available to qualifying people when they turn 65 years old and people under 65 with certain disabilities.

  • Medicare Part A is known as hospital insurance because it helps cover inpatient hospital care, skilled nursing facility care, some nursing home care, hospice care and home health care.

  • Medicare Part B is known as medical insurance because it covers services like doctor visits, outpatient care, medical supplies and preventive services.

What are the Original Medicare coverage gaps?

Original Medicare Parts A and B provide good coverage, but beneficiaries (those who are entitled to Medicare benefits) still have to pay for many costs related to their health care including: services or supplies not approved by Medicare, monthly premiums, annual deductibles, coinsurance, copayments, dental care, hearing health care, vision care, prescription drugs, long-term care, ongoing home health care, health care outside of the U.S. and more.

There is no limit on out-of-pocket costs in Original Medicare, which could really add up.

 

How can private coverage help?

There are private coverage solutions to help Medicare beneficiaries save money including:

  • Medicare Part C plans (also known as Medicare Advantage) are offered by private insurance companies as an alternative to Original Medicare. Often described as “bundled” plans, they include all of your Part A and Part B coverage. Also, depending on the insurance company and plan, many Medicare Advantage plans may include additional coverage for prescription drugs, vision, hearing, dental or more. 

  • Medicare Part D is prescription drug coverage offered by private insurance companies to people on Medicare. Prescription drugs aren’t covered by Original Medicare, so many beneficiaries purchase a Medicare Part D prescription drug plan to accompany their coverage.

  • Medicare Supplement insurance plans (aka Medigap) are available to beneficiaries of Original Medicare Parts A and B. These plans are designed to help you pay for the out-of-pocket expenses that Original Medicare doesn’t cover through standardized benefits. There are many Medicare Supplement insurance plans that may be available to suit a range of medical needs and budgets.

 

The Annual Enrollment Period (AEP) is your chance to sign up for a plan with additional coverage!

Medicare’s Annual Enrollment Period, which runs from October 15 until December 7, is a great opportunity to sign up for a plan with additional coverage that can help protect you from the unlimited out-of-pocket costs of Original Medicare. During this time, you can:

  • Sign up for Original Medicare if you missed your initial enrollment period
  • Switch from Original Medicare to Medicare Advantage (or vice versa)
  • Change or enroll in a Medicare Advantage plans
  • Change Part D prescription drug plans

1Kaiser Family Foundation, A Snapshot of Sources of Coverage Among Medicare Beneficiaries in 2018, https://www.kff.org/medicare/issue-brief/a-snapshot-of-sources-of-coverage-among-medicare-beneficiaries-in-2018/, March 2021.

myHealthPolicy is here for you!
Please visit our website or call us at 888-928-1456 TTY:711 to explore Medicare coverage options that may fit your needs and budget.

To speak with a licensed agent:
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PLEASE NOTE: Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease.

The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.

myHealthPolicy.com and K.F. Agency, Inc. are not connected with or endorsed by the United States government or the federal Medicare program.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Not all plans offer all of these benefits. Availability of benefits and plans varies by carrier and location. Deductibles, copays, coinsurance, limitations, and exclusions may apply. Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

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This material provides general information about the described insurance product(s) for educational purposes only. This is not intended as investment advice or to recommend the insurance product(s).

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