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Medicare Insurance Comparison

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Do you have to sign up for Medicare Part A?

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Just the essentials...
  • The Individual Mandate requires qualified health insurance
  • Medicare Part A satisfies the requirements of the Individual Mandate
  • Medicare Advantage meets standards of the Individual Mandate
  • Individuals must have Medicare Part A to get Original Medicare

Subscribers to Medicare must decide whether to use the government-run system called original Medicare or the private sector plans called Medicare Advantage.

To get Original Medicare, users must buy Medicare Part A. To get private insurance coverage; users must buy Medicare Advantage, not Medicare Part A.

Eligible people only need to sign up for Part A to get Original Medicare. Comparison shopping will help consumers when reviewing plans for Medicare Advantage, Medigap, and Part D Prescription Drug benefits.

Explore Medicare Advantage quotes for free by entering your zip above!

Buying During Open Enrollments

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Consumers can purchase Part A during the open enrollments. The Initial Open Enrollment period is the seven-month period around the 65th birthday. Consumers have a window around Social Security eligibility to buy Part A.

If they don’t buy during the open enrollment period, they must wait until the annual open enrollment that runs from January 1 through March 31 each calendar year.

Part A policies purchased in the open period begin coverage the following first day of July. Late enrollment creates the possibility of a late enrollment penalty that will apply to every month of coverage.

The Types of Medicare Programs

Types of Medicare chart

Medicare has public and private insurance plans. The items listed below describe the major parts of Medicare insurance.

  • Medicare A – Hospital insurance
  • Medicare B – Medical insurance
  • Medicare C – Medicare Advantage
  • Medicare Advantage – Comes with Prescription Drug benefit
  • Medicare Part D – Prescription Drug insurance
  • Medigap – the Medicare Supplement

Individual Mandate

Medicare Part A Hospital Insurance satisfies the individual mandate. Those that buy Part A will avoid the penalty tax for no insurance. Standing alone, Medicare Part B does not meet the requirements of the individual mandate.

Original Medicare improved with Obamacare. The law added many new prevention and wellness services at n charge to the consumer.

Original Medicare

Original Medicare consists of Medicare Part A – Hospital Insurance and Medicare Part B – Medical Insurance. The federal government administers these programs the Centers for Medicare and Medicaid work with other parts of the US Department of Health and Human Services to carry out the Medicare laws.

Medicare Advantage

The Congress authorized Medicare Advantage to provide more choices for consumers. They wanted to add the creativity and marketing of the private sector to increase the choices available to Medicare beneficiaries. They wanted to see lower prices and a greater variety of services.

Types of Medicare Advantage Plans

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Private insurance companies offer Medicare Advantage plans. They have various prices and combinations of services. By adding variety, Medicare Advantage plans may fit the individual better than Original Medicare.

They offer opportunities to decrease premiums, increase deductibles, and increase flexibility for outside services. Medicare Advantage gives consumers more choice and control over their medical care than does Original Medicare

  • HMO stands for “Health Management Organization” – True to its name, it pioneered the idea of health maintenance, prevention, and wellness. This type of organization uses network resources and a primary care physician to make referrals.
  • PPO is the “Preferred Provider Organization” – Next to the HMO, it is the most common form of managed care. The primary difference between HMO and PPO policies is that the preferred providers get higher insurance payment than outside resources with an HMO. The PPO does not use a primary care physician, and patients do not need referrals to use network resources.
  • The HMOPOS – This is the variation on the HMO that permits outside resources and provides insurance coverage. The system uses a primary care physician to make referrals to network resources. The PCP can also refer to outside resources and the insurer provides coverage with a higher level of consumer payment than with in-network resources.
  • EPO is the Exclusive Provider Organization – This type of organization uses in-network services and no outside resources. This model offers a simple, low-cost approach to health insurance.
  • PFFS is the Private-Fee-for-Service model – This plan uses agreements with medical services providers that establish how much they will get paid and the portion left for the consumer. These arrangements often get lower prices for services than other types of managed care.

Complete Coverage

A comprehensive combination of Medicare insurance would cover hospital care, medical services, and prescription drugs. When using Original Medicare, one can increase coverage and cut down on out-of-pocket expenses with a Medicare Supplement policy.

These supplements will pay part of the unpaid balance that Medicare leaves to consumers. The below-listed items describe complete Medicare coverage options.

  • Parts A, B, and D.
  • Parts A, B , D and Medicare Supplement.
  • Part C with PD.

Medigap fills a Space

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Original Medicare leaves as much as twenty percent of covered benefits for payment by the consumer. Over a period of time and with a heavy use of serves, these small copays can add to a large financial burden.

For many consumers, a Medicare Supplement policy makes good economic sense in combination with Medicare Part A and Part B.

Medigap supplements are guaranteed for sale only during the initial open enrollment which runs for five months after an applicant has both Medicare Part A and Medicare Part B.

Buy Part A to Get Original Medicare

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Consumers can buy Medicare Part A and comply with the individual mandate. Medicare Part A is qualified health insurance coverage; it exceeds minimum coverage and provides the essential health benefits.

For effective protection against high and unexpected medical costs, one should also purchase Medicare Part B to form the Original Medicare.

The alternative method is the buy a Medicare Advantage policy that provides the benefits of Medicare Parts A, B, and D. Comparison shopping will help find the right prescription drug benefit, Medigap Supplement, and Medicare Advantage insurance.

This selection process involves picking among private provider plans and deciding the best fit for the individual situation.

Find the best Medicare Advantage providers in your state by entering your zip below. Click here to get started!

References:

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MedicareInsurance.com is privately owned and operated. MedicareInsurance.com is a non-government asset for people on Medicare, providing resources in easy to understand format. The government Medicare site is www.medicare.gov.

This website and its contents are for informational purposes only and should not be a substitute for experienced medical advice. We recommend consulting with your medical provider regarding diagnosis or treatment, including choices about changes to medication, treatments, diets, daily routines, or exercise.

This communication’s purpose is insurance solicitation. A licensed insurance agent/producer or insurance company will contact you. Medicare Supplement insurance plans are not linked with or sanctioned by the U.S. government or the federal Medicare program.

MULTIPLAN_GHHK5LLEN_Accepted Last Updated 3/18/2018