Watch our Medicare videos to understand how Medicare works so you can choose the right plan for your needs. Our helpful, easy-to-understand videos walk you through the basics of a wide range of Medicare topics.
Our Video Series
What is Medicare?
If you're nearing 65 or you're thinking about retiring, you're probably starting to think about Medicare. But what exactly is Medicare? Simply put, it's a federal health insurance program for people 65 or older, and certain people with disabilities or other specific medical conditions. Medicare is made up of different parts. Parts A and B, also called original Medicare are offered by the federal government. Parts C and D are offered by private insurance companies like Blue Cross Blue Shield of Massachusetts. Each part has different benefits and costs.
Some preventive Medicare benefits are available free of charge, while other benefits have deductibles and monthly costs like regular health insurance. To learn more about Medicare, be sure to watch some of the other videos in this series.
What are the four parts of Medicare?
When most people talk about Medicare, they talk about the four main parts. Part A, which covers hospital expenses. Part B, which covers doctor visits. Part C, or Medicare Advantage, which covers all the benefits of part A and B plus more. And part D, which only covers prescription drugs. There are also Medicare supplement or Medigap plans. Part A and B together are known as original Medicare. These parts are administered by the federal government. Part A helps cover inpatient care at hospitals and skilled nursing facilities plus hospice care and home healthcare. Typically, you won't have to pay a monthly premium because you or your spouse already paid for it through payroll deductions when you were working, but you may still have some costs including a deductible. Part B helps cover doctor visits and things like outpatient care and preventive services. Part B usually has a monthly premium, which is based on your income and is typically deducted directly from your Social Security check.
Generally, original Medicare covers 80% of your doctor bills after an annual deductible. To help cover the deductible and extra 20% some people enroll in a Medicare supplement plan, also called Medigap. Just like original Medicare, Medicare supplement plans offer the freedom to see any doctor or hospital that accepts Medicare. However, some healthcare expenses such as prescription drugs and dental care are not covered. Separate plans can be bought to help cover those expenses, more on that in a minute. Instead of managing lots of different plans, many people prefer the simplicity of having all coverage in one place. That's where a Medicare Advantage plan comes in. A Part C plan or Medicare Advantage plan includes all the same benefits as original Medicare plus more. They may include prescription drug coverage and some include routine dental, vision and hearing benefits. You need to be enrolled in original Medicare before you can get a Medicare Advantage plan. So you pay a monthly premium for the Medicare Advantage plan, plus you still pay your Part B premium.
Remember when we mentioned separate plans that cover prescription drugs? Those are Part D plans or prescription drug plans. These plans can be purchased by themselves typically to compliment original Medicare or a Medicare supplement plan. You pay a monthly premium for a prescription drug plan, which covers many commonly used generic and brand prescription drugs. While original Medicare is provided by the federal government. Medicare Advantage Plans, Medicare supplement plans and prescription drug plans are provided by private health insurance companies like Blue Cross. To learn more about the different types of Medicare plans, call our Medicare experts at +1-800-678-2265.
What are the different types of Medicare plans?
While original Medicare is a great start, it only covers a portion of healthcare expenses. Medicare Advantage plans and Medicare Supplement plans both offer greater coverage but are very different. Let's take a look at them both.
Medicare Advantage plans provide a wide range of coverage all in one plan. They cover everything Original Medicare does plus more. They can also cover things like hearing, vision, and dental care, and may even come with things like fitness and weight loss benefits. Plus, most Medicare Advantage plans include prescription drug coverage. Medicare Advantage plans are provided by private insurance companies and have monthly premiums, so it's important to shop around.
Here are three other things to keep in mind about Medicare Advantage plans. If it's a Medicare HMO plan, your doctor and hospital network may be limited to the plan's provider network. Secondly, out-of-pocket costs, like copays, can vary by plan, so it's important to look over all the plan benefits. And finally, you can only change your Medicare Advantage plan during specific time periods each year.
Another type of Medicare plan is the Medicare Supplement plan, also called a Medigap plan because it helps cover the gap in healthcare costs. Original Medicare covers about 80% of doctor expenses. A Medicare Supplement plan helps cover the extra 20%. A Medicare Supplement plan doesn't cover as many services as a Medicare Advantage plan, so you'd need to pay for extra coverage, like prescription drug coverage, separately. It typically has a monthly premium that's higher than a Medicare Advantage plan, but you enjoy low out-of-pocket costs. Also, if you have a Medicare Supplement plan, you can see any doctor anywhere in the US as long as they accept Medicare, which is great if you travel a lot.
However, there are a few things to keep in mind when considering a Medicare Supplement plan. As we mentioned, Medicare Supplement plans do not include prescription drug coverage, so if you need that, you'll have to purchase a separate prescription drug plan. They also don't include the extra benefits typically found in a Medicare Advantage plan, such as hearing and vision coverage.
So which ones should you choose? It depends on what matters most to you. If you'd rather have lower monthly premiums and don't mind different costs for different services, are flexible about choosing doctors and specific provider networks, and want routine services like hearing, vision, and dental covered under one plan, a Medicare Advantage plan could be best for you. Or if you don't mind paying higher monthly premiums in exchange for low out-of-pocket expenses, want flexibility to see any doctor, and are okay with paying for additional plans that cover things like prescription drugs, hearing, and vision, a Medicare Supplement plan may be right for you. Either way, Blue Cross Blue Shield of Massachusetts offers both Medicare Advantage and Medicare Supplement plans. Want to learn more? Give our Medicare experts a call at 1-800-678-2265.
How do Prescription Drug Plans work?
Many people are surprised that prescription drugs aren't usually covered under original Medicare parts A and B. To get prescription drug coverage, you can do one of two things. Enroll in a Medicare Advantage plan that includes prescription drug coverage or buy a standalone Medicare Part D prescription drug plan.
Coverage can vary by company and by individual plan, so it's important to shop around and find out if your particular prescriptions are covered. You should also compare copays, or the amount you would be expected to pay, as well as the deductible and monthly premium. Another thing to keep in mind is the coverage gap or donut hole. With most part D plans, if you spend a certain amount on your covered prescription drugs, you hit a coverage gap, or donut hole, where your coverage will be limited and you'll have to pay more for your prescriptions. This coverage gap lasts until you reach your plans out of pocket limit. Many people never reach the coverage gap, but it's still important to keep it in mind. As you look at plans that may offer some enhanced benefits in the coverage gap.
Blue Cross offers standalone prescription drug plans. These plans can help you save money with special savings through preferred cost sharing at participating network retail pharmacies. Depending on your financial situation, you may also qualify for financial assistance to help pay for your Medicare prescription drugs. To learn more about this, contact the Social Security Administration. You can sign up for a Part D plan as soon as you become eligible for Medicare. For most people, that's when they turn 65. Even if you don't currently take any prescription drugs, it's still a good idea to enroll in a Part D plan. If you wait to sign up later, you may have to pay a higher premium one. To know more about Part D prescription drug plans, call our Medicare experts at 1-800-678-2265.
What type of Medicare plan is right for me?
With so many different types of Medicare plans and different providers, choosing the right plan can seem complicated. But before you start looking, you need to ask yourself these questions.
One, how often do you see a doctor or specialist. Two, if you take prescription medicine, what kind do you take and how much. Three, would you be willing to switch doctors if it meant lower costs for you. And four, will you be traveling regularly. Keep your answers to these questions in mind as you begin to look at different Medicare plans.
Here are some other factors you should keep in mind as you compare plans. The first is cost, but don't just look at the monthly premium. Be sure to factor in other out-of-pocket expenses you'll pay throughout the year, like deductibles and copays. Next, look at plan benefits. Does the plan come with routine eye exams? What about dental benefits? If it's important for you to be able to keep your current doctors, check the plans network to make sure they are part of it. How much flexibility do you need with healthcare choices? If you travel a lot, you'll need a plan that covers you in areas other than right where you live. If you take prescription drugs, you'll want to see if your particular drugs are covered, and find out what the copay would be for them. Can you use any pharmacy you want? If not, does the plan's network include pharmacies near you? Finally, consider the reputation of the provider. How much experience do they have providing Medicare coverage? If you speak to a sales rep, do they seem well-informed and helpful?
These seven factors can help guide you as you navigate through your Medicare choices. But remember, even if you wind up not being happy with your choice, you will have opportunities to change your plan every year.
Still have questions about which plan is right for you? Our Medicare experts can help guide you in the right direction. Give us a call at 1-800-678-2265.
When can I enroll in Medicare?
When can you enroll in Medicare? You can sign up for Original Medicare or Parts A and B during the initial enrollment period. Which starts three months before your 65th birthday, and ends three months after your 65th birthday. If you're still working past 65 and you have insurance coverage through your employer, or your spouse's employer, that is as good as original Medicare, you may be able to delay enrolling. However, most people still enroll in Part A, since there is typically no monthly premium. When you finally do retire, you qualify for what is called a special enrollment period when you can enroll in Medicare.
Your first step, if you haven't already done so, is to enroll in Original Medicare. Once you've enrolled in Original Medicare, you can sign up for a Medicare Advantage Plan or a Part D prescription drug plan. If you want to enroll in a Medicare Supplement plan, you can do so at any time. If you're ever unhappy with your plan coverage, don't worry. There are opportunities to change plans every year. The annual enrollment period runs from October 15th to December 7th every year. During this time, you can change types of coverage, or switch plans, and even switch providers. And if you have a Medicare Advantage Plan, there is also a three-month window from January 1st through March 31st when you can change plans. For more details on when you can enroll in Medicare, give us a call at 1-800-678-2265.
What if I'm working past 65?
Like many people, you may choose to work past 65. If so, you may not need a Medicare plan right away, but there are still some things you need to do.
First, check to see if your employer offers coverage for those 65 and older. If you are on your spouse's plan, you should have them ask their employer. Even if your employer does offer a plan, you may still want to check it against a comparable Medicare plan to see which offers better benefits and savings.
But let's say you're going to stay on your employer's plan. You may still want to sign up for certain parts of Medicare to avoid penalties or gaps in coverage. Since Medicare Part A is free for most people who have worked at least 10 years, you should go on and enroll in it. Whether or not you need to enroll in Medicare Part B, when you turn 65, depends on the size of your company. If your employer has 20 or more employees, you can probably delay enrolling in Part B until you retire, but it's still a good idea to check with your employer and Social Security to find out what you need to do. You should also ask your employer about their plan's prescription drug coverage. If prescription drugs aren't covered, or if the coverage doesn't meet the Medicare standard, you'll need to enroll in a Part D Prescription Drug Plan, when you turn 65, to avoid paying penalties later.
When you are finally ready to retire, Medicare will be waiting for you, and you can choose the option that best fits your needs. Whatever you choose, be sure to enroll at least two months before you retire, as it takes a while to process your enrollment and you don't want to be left without coverage.
To learn more about your Medicare options, if you plan on working past 65, call our Medicare experts, at 1-800-678-2265.
Medicare Advantage or Medicare Supplement?
Medicare plans come in all shapes and sizes, and Blue Cross Blue Shield of Massachusetts has a wide range of plans to choose from. But with so many choices, how do you know which one is right for you? Let's take a look at your options. Medicare Advantage plans are a popular Medicare plan because of all the benefits they include. Our Medicare Advantage plans include everything original Medicare offers, plus prescription drug coverage and other additional services like wellness programs, allowances towards hearing aids, vision and dental services and more. Blue Cross offers two types of Medicare Advantage plans, HMOs and PPOs. Our standard HMO plans offer affordable fixed copays. You select a primary care doctor from our extensive network. The doctor will manage your care and give you referrals for specialists and services. Doctors and services outside of the plan network are not covered except in emergencies.
However, we also offer a Medicare HMO Blue FlexRX plan that lets you choose a doctor outside of the network, but at a higher out-of-pocket cost. Our PPO plans give you even more freedom and flexibility. You can choose any doctor you want as long as they accept Medicare and you won't need a referral to see a specialist. Out-of-network services are covered, but sometimes at a higher cost. In addition to Medicare Advantage plans, we offer Medicare Supplement or Medigap plans. These plans help cover some of the costs original Medicare does not, such as co-payments, co-insurance and deductibles. Since these plans are meant to supplement original Medicare, they only cover the services that original Medicare covers. You won't need to stay within a specific provider network, but these plans typically don't include extra benefits such as vision and hearing coverage. However, we do offer additional benefit options that cover those expenses.
Medicare Supplement plans also do not include prescription drug coverage, so you'll need to enroll in a separate Prescription Drug Plan. Fortunately, Blue Cross offers these too. Our Prescription Drug plans or PDPs cover thousands of brand name and generic prescription drugs. You can also compliment any Blue Cross Medicare plan with comprehensive dental coverage or GeoBlue International Health Insurance. Plus, all Blue Cross members have access to a 24/7 Nurse Care Line. With over 50 years of Medicare experience in Massachusetts, Blue Cross knows what our members want, and we've created a wide range of plan options to meet these different needs. Want to know more about any of these plans? Call our Medicare experts at 1-800-678-2265.
Why should I choose a Blue Cross Medicare plan?
When it comes to picking a Medicare plan, you have many options, so why should you choose a Medicare plan from Blue Cross Blue Shield of Massachusetts? One reason is because we know Medicare. More specifically, we know Medicare in Massachusetts. In fact, we've been providing Medicare plans to people in Massachusetts for over 50 years, which brings us to another reason. More people in Massachusetts choose a Medicare plan from Blue Cross over any other health plan in the state, and more than seven million people nationwide choose Blue Cross Medicare plans.
Why did they choose us? It could be because of our broad network, which includes a large selection of doctors and hospitals, or because we offer a wide range of plans from Medicare Advantage plans to supplemental plans, to standalone prescription drug plans, comprehensive dental plans, GeoBlue International Health Insurance, and more.
No matter what you need, we've got you covered, and our Medicare plans are packed with the benefits you want, including dental, hearing and vision coverage with our Medicare Advantage plans. We also support our members with top-rated customer service ready to help you with everything from choosing a plan to checking in on a claim.
There are so many reasons to choose Blue Cross, but everyone has different needs. To find out if Blue Cross is right for you, give our Medicare experts a call at 1-800-678-2265.
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