@richdees23 - You can go to
Medicare.gov: the official U.S. government site for Medicare | Medicare and sign up (if you have not already done so). Once signed up and able to sign in, it will have some of the information you will need to look at plans... and what it doesn't have (and needs) it will ask you.
Because you have reached an age (or situation) that allows you Medicare, you halfway there. Typically, this is how it works...
- Medicare (Part A, Hospital & Part B, Medical), a public health service, and pays for the majority of your medical bills... including a power wheel chair (every 5 years), a BiPAP machine, CoughAssist, and most other items that you will need. Typically, Medicare pays for 80% and you will pay the remaining 20%. I pay $148.50/Month for Medicare (it is automatically deducted from my monthly Social Security payment). So, you can pay that 20% (and more for specialists), OR
- You can add a Medicare Supplemental Plan. This plan, which also has its own monthly fee (mine in 2021, for my age and location, is $183.25 through Anthem Blue Cross/Blue Shield). There are different plans that may or may not be available for your age/location. Mine, which I believe may no longer be offered to new enrollees is a "Type F". This Supplemental's main purpose is to pay for the 20% that is your responsibility and which is not paid my Medicare. These plans will have different deductibles and maximum out of pocket limits... so pay attention to those. These plans, their cost (for you) and their coverages can be found at the Medicare website I pointed you to at the beginning of this post. One thing that Medicare and Supplemental Plans don't have is your "Part D" Drug coverage. So...
- Medicare Part D is typically provided as its own Plan by private insurance companies. Again, based upon your age, location and that insurance companies experience, you'll get a monthly price quote (mine, through Humana, is $63.20/Month). On the website, you'll be able to enter any prescription drugs that you are taking and your preferred pharmacy(s). Each plan you look at will have different premiums, different deductibles (what you pay fully out of pocket before they begin to pay their portion) and different max out of pocket amounts. The illustration presented will also show not just annual costs, but also monthly. Monthly amounts can be important to be aware of with these plans... and especially if on a fixed budget. Part D drug plans have something called the "Donut Hole". It is a period of time (which typically ends once a certain personal out -of-pocket amount has been reached) wherein your monthly costs can be considerably higher before returning to a more desirable amount. I'llustrations will provide an estimate of monthly costs, will show how long it will take to meet deductibles and when you will enter and when you leave the Donut Hole period.
So... the describes the normal components of insurance that are available to you though your participation in Medicare. But we now have another option to the above - The Medicare Advantage Plan.
Medicare Advantage Plans - These plans may or may not be available in your particular area. If available, Medicare's site will show them as an option. These plans include Medicare Part A and Part B, Medicare Supplemental and Medicare Part D drug plans. They also will list additional coverage items not included in many of the Supplement only plans that I talked about in 2., above. Examples would be coverage for Prescription Glasses and Exams, some dental work, memberships to certain fitness clubs, transportation get to medical appointments (i.e. taxi, Uber, bus, etc.) and for ambulance transport. It will also include much the same drug coverage as your Part D.
Many Advantage Plans have a "ZERO DOLLAR PREMIUM". Yep... you read that right... $0.00 Monthly Premium. Basically, as I understand it, Medicare passes oversight of your Medicare benefits off to the private insurance company. They additionally pass on the $148.50/Month Medicare premium to them. So that was the easy part to explain. The rest becomes a bit more challenging as you evaluate plans and try to apply what you might anticipate for medical needs and possible hospital differences. Along with no monthly premium comes an agreement to pay different costs, deductibles and max out-of-pocket costs. Basically, you'll pay certain amounts for services that you actually use... versus the other plans that provide a specific set of coverages for an age/location related set premium. It can get tricky... but for some, there are definite potential cost advantages. I have a personal insurance agent that helps guide me through all of the intricacies of health insurance. I'll meet with him by phone on Monday and anticipate that for 2022, I'll move to an Advantage Plan.
I hope at least some of this has been a help to you... or to others. I've tried to keep it simple and as accurate as I could. But know that I am not an insurance agent... and there exists the possibility that my understandings might be in error. It is always a good idea to let a licensed insurance specialist help guide you. Whether you do it all yourself through the Medicare site and then enroll online or via phone with the individual companies... or use an agent/specialist... the premium is going to be the same. Good luck in finding that which works best for you!
My best...
Jim
