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By   /   November 19, 2011  /   Comments


Most seniors are baffled by the medical insurance that is available to them once they reach the age of 65. In fact, most people don’t understand insurance, in general and run away from it every chance they have. I, did too, until I got into the business. It was to me like a different language. Now, after attending insurance school and having the experience I have had over the years, plus getting older and becoming a senior, I can understand how it works. But the average person doesn’t have that background and insurance scares the heck out of them. One of the main reasons that I write for the Albany Journal is so that I feel that I can help seniors, as the saying goes because “I are one” and I feel that I can explain it in terms other seniors can understand.

Let’s take a look at Medicare, Medicare Supplement, and Medicare Advantage in their simplest terms. I will try to eliminate the fear that may exist and cause a person to slip into a coma when someone brings up the topic.

Medicare health insurance is made up of four parts: First, there’s Part A, which helps cover the patient care in hospitals, skilled nursing facilities, and in hospices plus certain home health care. You pay no premiums for this because you paid medical taxes while working.  Next is Part B, which helps cover the cost of doctor’s services, outpatient care, and certain other medical services. You pay a premium monthly for this care which is deducted from your Social Security Check. (Parts A and B are often referred to as Original Medicare or Traditional Medicare)

Then there’s Part D: This is a separate plan that covers prescriptions. Prescriptions used to be covered by Traditional Medicare but not anymore. Now you must go online and look at the various plans that are approved in your state and pick the one that best fits your needs. The plans vary by the medicines they offer, by different premiums, deductibles, etc. It is a little complicated for the general public so have your insurance agent help you with choosing the plan you should be on.

Finally, there’s Medi-gap or Medicare Supplement Insurance: Since Traditional  Medicare Ins. Doesn’t pay for everything, you need to have this insurance  to take care of the medical insurance that fall in this gap that aren’t covered.  It is standardized insurance since about 1992 and the only differences are what you would pay in premiums and who you buy it from. For example, a plan F, which most people get, is the same regardless of who you buy it from. Private insurance companies sell this insurance so go see your favorite trusted agent, like me to get it.  Shop around for the least expensive plan F you can find.

Your other option is not take any of the above and instead get what is called a MEDICARE ADVANTAGE Plan that is offered by private insurance companies. All the elements we talked about above are in one of these types of plans. To get on one of these plans, you must drop your Medicare Plans that you have paid into all of your life. They operate like a PPO plan and have deductibles, and co-pays, etc. If you are never ill, they could end up saving you a lot of money but as we get older that usually is not what happens to us. We usually start having health problems and then these plans could end up costing you a lot of money.  I have a lot of health problems and since I have been on Traditional Medicare, it hasn’t cost me a penny except for private hospital rooms that I have chosen. There are lots of things you need to watch out for if you decide to go this route so you definitely need to see a trusted insurance agent to help your decide if this is the route you should be traveling.

The best advice that I can give anyone is not let the government get involved in any of our insurance plans. Anything the government gets involved in, they seem to mess it up. As long as things are the way they currently are, your best friend should definitely be your insurance agent and I am not saying that because I am one. When you figure out how much of your total budget is involved in insurance, you need an expert in the business to help you make the best decisions that you can in these matters.

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