At Leon Health, we understand you have many choices — and decisions — when it comes to health care coverage within Medicare. If you are close to reaching the age of 65 or are eligible for Medicare because you have a diagnosed qualifying disability, there are several Medicare plan choices you can consider. Our team is here to help you understand your benefits, eligibility, and how the different Medicare plans can meet your needs. Our goal is to make the process easier for you.
When deciding if Medicare is right for you, it’s important to consider the following:
- Costs, including premiums, deductibles, and other costs
- How well will the plan cover the services you need
- Other health coverage you have
- Prescription drug needs
- The quality of care you currently receive with your health plan
- Travel coverage if you frequently travel outside the U.S.
- Whether your doctor and hospital choice are included in the plan
Are You Receiving Social Security Benefits?
If you’re one of the 61 million individuals receiving Social Security benefits, you will automatically be enrolled in Medicare. Those who are automatically enrolled can still opt out of Part B — medical coverage — if it’s not what you need. Keep in mind that there are financial consequences if you do opt out.
Original Medicare
If you are nearing 65 and considering Medicare, keep in mind that the Original Medicare, which the federal government administers, includes Part A and Part B. Medicare Part A is also called hospital insurance. It covers:
- Home health care
- Hospice care (under certain medical conditions)
- Hospital inpatient care
- Skilled nursing facility care
Medicare Part B is also called medical insurance. It covers:
- Ambulance services
- Clinical trials
- Durable medical equipment, including crutches, walkers, wheelchairs, blood sugar monitors, and oxygen equipment
- Limited outpatient prescription drugs
- Mental health services
- Urgent care
Medicare Advantage
Medicare Advantage Plans are a little different from the Original Medicare plan. These plans, called Part C, are an alternative to the Original Medicare plan. If you participate in or are eligible for the Original Medicare plan, you can participate in a Medicare Advantage plan. These are bundled plans that give you added coverage benefits. You get hospital and medical coverage, and you may also get additional coverage such as drug coverage (Part D), dental, hearing, or vision.
Medigap Plans
It’s important to consider whether you need Medicare Supplement Insurance to fill any gaps in coverage in the Original Medicare plan. If there are gaps in your coverage, a Medigap policy can help pay some of those costs. These may include copayments, coinsurance, and deductibles. Some Medigap plans cover you if you need care outside the U.S. while traveling. Keep in mind that it does not generally cover long-term care, vision or dental care, hearing aids, glasses, or private nursing.
Next Steps
If you’re interested in learning whether Medicare is right for you, we’re ready to help. Are you ready to talk to one of our specialists about Medicare plans? Please call us at 305.541.5366 to schedule an appointment or learn more about the Medicare plans offered through Leon Health.
