One of the trickier parts to Medicare is understanding what parts can be combined to create your ideal coverage. Generally, there are two main paths you can choose. From there, you can fine-tune your choices to fit your budget and lifestyle.
Path 1: Original Medicare (Parts A & B) + Supplemental Coverage
Part A: This coverage is provided by the federal government and includes several important benefits:
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
Part B: This part is provided by the federal government with a premium based on monthly income. It includes other benefits that expand your coverage:
- Physician services
- Ambulance services
- Mental health care
- Durable medical equipment
- Some preventive service
Supplemental coverage: This coverage is provided by private insurance companies, like Blue Cross and Blue Shield of North Carolina (Blue Cross NC). There are two plans that are considered supplemental:
- Medicare Supplement Plan: Helps cover the costs not fully covered by Medicare Parts A and B.
- Part D (Medicare PDP): Helps cover your prescription drug costs.
Path 1 perks
- Nationwide coverage: Your coverage is good coast-to-coast at any Medicare-accepting provider.
- Flexibility: You have the freedom to travel and see any doctor or hospital that accepts Medicare.
- International travel benefits: Some plans offer coverage for emergency care while traveling outside the country.
Path 2: Medicare Advantage (Part C)
Medicare Advantage plans are PPO or HMO plans offered by private insurance companies, including Blue Cross NC. This path includes the following benefits:
- Medicare Parts A and B: Coverage for all the same services as Medicare Parts A and B, but with lower out-of-pocket costs when you use doctors and hospitals in the plan’s network. (Your Part B premium is still required.)
- Part D (Medicare Rx): Most Medicare Advantage plans include Part D prescription drug coverage.
Some Medicare Advantage plans also include other valuable benefits to support your overall wellness:
- Vision benefits
- Hearing benefits
- Dental benefits
- Wellness benefits and discounts such as no-cost fitness memberships
Path 2 perks
- All-in-one coverage: You can choose a plan that includes prescription drug coverage, as well as other benefits such as dental and hearing.
- Limits on out-of-pocket costs: Unlike Original Medicare, Medicare Advantage plans put a cap on your out-of-pocket costs. Once you hit the cap, the plan pays 100% of your covered costs.
- Affordability: Many plans offer more comprehensive coverage for a lower cost than path 1 listed above.
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