Should I Switch My Medicare Plan?

Changing your Medicare insurance plan is a deeply personal choice that requires balancing budget-related concerns with your healthcare goals and needs. Once you are enrolled in Medicare, you may find that your current coverage simply no longer meets your needs. Understanding how to navigate your options may be the key to securing the Medicare coverage that is right for you.

Medicare Benefits Solutions

Sep 3, 2020

 3 minutes read

How Original Medicare works

Medicare began as a two-part healthcare program that separate hospital insurance from medical insurance. This two-part system helps control costs for the program, providers and beneficiaries, and consists of Part A and Part B.

Generally speaking, any treatment you receive as an inpatient at a hospital or skilled nursing facility falls under hospital insurance, or Part A. Outpatient and diagnostic services, as well as specialist and routine exams, generally fall under Part B medical insurance. 

For most people, Part A is a premium-free benefit, which means they pay nothing for it each month. Part B does require a monthly premium, but this premium can be reduced if the recipient qualifies for dual-eligibility with their state’s Medicaid program.

Many recipients choose to keep their Original Medicare benefits. Others switch to a Part C plan that combines Part A and Part B with additional benefits.  Recipients who have healthcare coverage through a third-party carrier, such as a plan through an employer or a spouse’s employer, may delay enrollment in Part B. Delaying Medicare enrollment without maintaining creditable coverage can result in late enrollment fees.

Medigap vs. Medicare Advantage plans.

A Medigap plan supplements Original Medicare. Medigap, also known as Medicare Supplement, plans may cover the cost of some premiums, deductibles, copays and coinsurance. Some Medigap plans offer overseas coverage for certain medical necessities. 

By contrast, a Medicare Advantage (MA) plan is an alternative to Original Medicare. MA plans are required to include the same Part A and Part B benefits as Original Medicare, but include additional coverage. These extra benefits can include routine dental and vision care, hearing exams, fitness benefits, and prescription drug coverage.

Medicare does not allow beneficiaries to enroll in a Medigap and Medicare Advantage plan at the same time.

Stand-alone Prescription Drug Plans or Medicare Advantage?

Part D prescription drug plans are offered by private insurers. Many of the insurers offer stand-alone plans and Medicare Advantage plans with prescription drug coverage. 

Some recipients choose to receive prescription drug benefits through a Part C plan because these packages offer comprehensive coverage in one package.

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