Medicare open enrollment begins October 15. Everyone’s healthcare needs are different, especially if you have been diagnosed with cancer or another serious health condition. Make sure you know which plan is right for you and enroll before December 7 to receive the most comprehensive and appropriate coverage.
What’s Covered in Each Medicare Plan?
Medicare plans fall into four parts covering a variety of needs. Before enrolling in a Medicare plan, familiarize yourself with each part to understand what your plan will cover.
Original Medicare (Part A and Part B)
Original Medicare is managed by the federal government and has two parts: Part A (hospital insurance) and Part B (medical insurance). Original Medicare plans cover an approved amount of costs after your deductible. You can go to any doctor or hospital in the U.S. that takes Medicare.
- Medicare Part A covers most inpatient hospital care. It also covers skilled nursing facility and nursing home care, hospice care, and some home care services. Most people do not have to pay premiums for Part A coverage.
- Medicare Part B covers medically necessary services and preventative care including doctor visits, outpatient care, diagnostic imaging, chemotherapy, and other injectable drugs.
Medicare Advantage (Part C)
Medicare Advantage plans, or Medicare Part C, are offered by private insurance companies approved by Medicare. Part C plans provide all Part A and Part B coverage and may include some prescription drug coverage. They may also include vision, hearing, dental, and health and wellness program coverage. Most private plans have an out-of-pocket maximum that limit how much you pay for covered medical care in one plan year.
Prescription Drug Coverage (Part D)
Medicare Part D offers expanded prescription drug coverage for those who enroll in for Medicare Part A or Part B. If you have been diagnosed with cancer or another serious health condition, your prescription medication needs may change. While Medicare Part D is optional, if you are taking prescription medication, you may have to pay out-of-pocket without this coverage.
Approved Medicare Part D plans usually require a monthly premium. If you have prescription drug coverage through your employer, be sure to review the coverage offered to ensure it has the same level of coverage as a Part D plan. Visit www.medicare.gov and use the plan finder to compare all available prescription drug plans offered under Part D. Consider which medications are covered under each plan and learn about any costs or restrictions in coverage.
Medicare Supplement Insurance
Medicare Supplement Insurance, also known as Medigap, helps fill the “gaps” in Original Medicare and can help offset out-of-pocket costs associated with cancer treatment, such as copayments, coinsurance, and deductibles. After Medicare pays the Medicare approved amount for covered health cost, your Medigap insurance company will pay its share.
Questions to ask if you decide to shop for a Medicare Advantage or Supplement Insurance Plan:
- Can I keep my doctor? Ask your current doctor if they accept Medicare, and then check the plan’s network to see if their names are listed.
- Do I need referrals to see specialists? If you see specialists, such as a chiropractor, make sure you understand how the plan’s network covers specialists.
- Am I covered when I travel? What is the plan’s travel benefit? If you like to travel, make sure the plan’s travel benefits fits your lifestyle.
- Does it have a high Star Rating? This is a yearly quality rating from the government which can indicate how a plan is performing.
- Are my meds covered? Cross reference your medication list with the plan’s drug formulary.
- Is there a dental or fitness benefit included?
Visit Medicare.gov for more information about open enrollment options.
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