Medicare is a vital service for seniors in this country, but one of the most common complaints is
how hard it can be to understand. There are various parts and types of plans, many with similar-
sounding names and unclear distinctions. In order to help you make the best decision for your
healthcare, we have summarized the answers to some of the most common questions about
What Is The Difference Between Original Medicare And Medicare Advantage?
Original Medicare is made up of what is known as Part A (Hospital Coverage) and Part B
(Medical Coverage). Most people are automatically enrolled in Part A and Part B when they turn 65. This is the most basic level of Medicare and, though potentially very useful, there is a lot it
doesn’t cover. One of the biggest gaps is prescription drug coverage, which is what Part D is. You can either add Part D to your Original Medicare Coverage or have it as part of a Medicare Advantage plan.
A Medicare Advantage plan is purchased from a private insurer, such as Aetna. The service is
approved by Medicare, and you still pay your Part B premium, but it is much closer to private
health insurance. Medicare Advantage tends to offer more complete coverage, including things
like dental and vision as well as more prescription coverage.
What Is Medigap?
Medigap, also known as Medicare supplemental insurance, is a type of policy you can take out
to supplement your Original Medicare. Simply put, it insures you against large deductibles,
potentially saving you hundreds of thousands of dollars if you have any sort of medical
emergency or long-term illness.
To make things more needlessly confusing, Medicare Supplement plans are also denoted by
the letters A through N (except for E, H, I, and J, which no longer exist).
How Much Do I Have To Pay For Medicare?
The Medicare pricing structure is a bit complicated and confusing, but the basics of it are:
● Part A (Hospital Coverage) is free for anyone who has paid 10 years into the system
throughout their careers (or whose spouse has done so)
● Part B (Medical Coverage) costs $135.50 a month, more for high earners
● Part D (Drug Coverage) costs depend on the insurer, but the 2018 average was $34 a
month, with a maximum deductible (the money you pay out of pocket) of $405. If you get
Part D as part of a Medicare Advantage plan, it’s included in the overall cost of your
● Part C (Medicare Advantage) costs vary widely, and are paid in addition to the Part B
premium. Think Advisor has a handy list of average plan costs by state.
● The average cost for Part F, the most popular Medigap policy, is $1,813 a year.
Can I Change My Mind?
Yes, you can! There is an annual Open Enrollment period for Medicare Advantage in which you
can make any changes you want to your coverage. This includes going back to Original
Medicare and switching to a new Medicare Advantage plan.
You should be careful if your plan is to switch to Original Medicare plus Medigap, as you may
not be accepted for the Medigap plan. Joining a Medigap policy after the initial one-time
enrollment window requires underwriting, so you will have to pass a series of health questions.
Check that you can pass these before leaving a Medicare Advantage plan.
Since 2018, you also get a three-month trial period after open enrollment in which you can make
changes to your chosen coverage. This gives you a lot more freedom and flexibility, and means
you can test out the service before sticking with it for good.
This is not a comprehensive guide, but it does provide a good overview of the basics. If you
need more guidance, there are actually plenty of websites and online resources dedicated
entirely to helping people navigate Medicare. Just make sure to do your research thoroughly
and not let yourself be discouraged by complicated-sounding insurance jargon: the internet is
there to help you figure it out, and doing this will help you make sure you are getting exactly the
coverage you need.
Also, Medicare is not what covers Senior Living Costs. In Utah, there is a program called New Choices Waiver that is through Medicare.
Call us to schedule a tour and/or ask about financing at 801.763.0622