Medicare Planning

Find a 2020 Medicare plan

You can shop here for drug plans (Part D) and Medicare Advantage Plans.

 

See your 2020 plan options now by logging in or creating an account.

 

 

Your Medicare Costs

The standard Part B premium amount in 2020 is $144.60. Most people will pay the standard Part B premium amount.

 

If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

There are 2 main ways to get your Medicare coverage

 

Original Medicare and Medicare Advantage.

 

Original Medicare includes Hospital (Part A) and Medical (Part B) insurance. If you want drug coverage, you can add a separate drug plan (Part D).

 

You can also add a Medicare Supplement Insurance (Medigap) policy to help pay your out-of-pocket costs.

 

A Medicare Advantage Plan is an all-in-one alternative to Original Medicare. These "bundled" plans include Part A, Part B, and usually Part D.

 

Most plans offer extra benefits— like vision, hearing, dental, and more.

 

Choose the Medicare coverage option you want to explore first. Don't worry, you can review both. Just start with either one.

Medicare Part A

Medicare Coverage is based on 3 main factors.

 

  1. Federal and state laws.

  2. National coverage decisions made by Medicare about whether something is covered.

  3. Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.

What' not coverage by either Medicare Part A or Part B

Medicare doesn't cover everything. If you need certain services Medicare doesn't cover, you'll have to pay for them yourself unless:

 

  • You have other insurance that covers them

  • You have a Medicare health plan that covers them

 

Even if Medicare covers a service or item, you generally have to pay your  Deductible, Coinsurance, and Copayment. 

Some of the items and services that Medicare doesn't cover include:

 

  • Long-term care (also called Custodial care)

  • Most dental care

  • Eye exams related to prescribing glasses

  • Dentures

  • Cosmetic surgery  

  • Acupuncture  

  • Hearing aids and exams for fitting them

  • Routine foot care

Medicare Part B

Part B deductible & coinsurance
In 2020, you pay $198 for your Part B deductible. After you meet your deductible for the year, you typically pay 20% of the Medicare-approved amount for these:

 

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.

  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

Part B covers things like:

 

  •  Clinical research 

  • Ambulance services

  • Durable medical equipment (DME)

  • Mental health

    • Inpatient

    • Outpatient

    • Partial hospitalization

  • Getting a second opinion before surgery

  • Limited outpatient prescription drugs

Medicare Advantage

Part C

Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. 

Description - Medicare Advantage

A Medicare Advantage Plan (like an HMO or PPO) is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. 

 

If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. In most cases, you’ll need to use health care providers who participate in the plan’s network. 

 

Some plans offer out-of network coverage. Remember, in most cases, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.  

Medicare Part D  Prescriptions Drugs

Medicare prescription drug coverage is an optional benefit.  Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to get Medicare drug coverage when you're first eligible, you'll likely pay a late enrollment penalty if you join later, unless one of these applies:

 

  • You have other Creditable prescription drug coverage

  • You get Extra Help

 

Generally, you'll pay this penalty for as long as you have Medicare prescription drug coverage.

To get Medicare drug coverage, you must join a plan approved by Medicare that offers Medicare drug coverage. Each plan can vary in cost and drugs covered.

Medicare Advantage

Part C

Description - Medicare Advantage (continued)

What are the different types of Medicare Advantage Plans?

 

  • Health Maintenance Organization (HMO) plans 

  • Preferred Provider Organization (PPO) plans

  • Private Fee-for-Service (PFFS) plans 

  • Special Needs Plans (SNPs) plans

  • HMO Point-of-Service (HMOPOS) plans- These are HMO plans that may allow you to get some services out-of-network for a higher co-payment or coinsurance.

 

Prescription drug coverage is included in most plans. 

You can’t buy or use separate supplemental coverage—but some plans have lower out-of-pocket costs than Original Medicare.   Prescription drug coverage is included in most plans. 

 

Plans usually don’t cover care outside the U.S. Also, plans usually don’t cover non-emergency care you get outside of your plan’s network. 

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