Best Medicare Plans of September 2021

Alice Townsend

Medicare is a major part of your healthcare if you are 65 or older. Choosing the right Medicare plan for you is crucial to your long-term health. We’ve reviewed Medicare plans based on treatment, customer satisfaction, and overall quality.

Is Medicare worth it?

Medicare is the federal health insurance plan that covers treatments and procedures for older individuals. Once you turn 65 years old, you are eligible to begin coverage under Medicare. Additionally, some younger people with certain disabilities, or people with End-Stage Renal Disease, are eligible for Medicare coverage.

Regardless of which group you’re in, chances are, Medicare coverage is worthwhile. It helps you afford most medical treatments and procedures you may need throughout the rest of your life. Without it, you could be paying tons of money out of pocket. Medicare ensures you do not need to worry as much about the cost of medical treatments as you get older.

How does Medicare work?

Every person who qualifies for Medicare insurance coverage has two main options they can choose from: Original Medicare, or Medicare Advantage. Original Medicare is the federal health insurance plan offered by the government, while Medicare Advantage is an alternative offered by private insurance.

Original Medicare has a list of specific services available you can choose to include in your Medicare coverage:

  • Medicare Part A: Part A consists of hospital insurance, which includes coverage for stays in the hospital, hospice care, or nursing home care. This also covers select home healthcare options.
  • Medicare Part B: Part B makes up medical insurance, including doctor treatments and procedures, outpatient care, and some preventive care.
  • Medicare Part D: Part D includes coverage for prescription drugs, as well as some shots and vaccinations.

With Original Medicare, you pay a monthly premium for your overall coverage. You are typically required to pay a monthly premium for Part B (and sometimes Part A) and can add on Part D as a separate plan. Original Medicare includes a yearly deductible and requires you to generally pay about 20% of the medical services you receive throughout the year.

Medicare Advantage, alternatively, bundles Parts A, B, and usually D. Medicare Advantage is usually considered Part C, and also often includes additional coverage Original Medicare does not, like vision and dental coverage. You pay for the services you receive with Medicare Advantage.

Those who choose Medicare Advantage will have to go through a private insurance company, while generally offering health maintenance organizations (HMOs) or preferred provider organizations (PPOs) types of plans. Both require you to receive care in the network affiliated with your insurance provider.

What does Medicare cover?

Regardless of whether you go with Original Medicare or Medicare Advantage, you are covered for a range of medical treatments and procedures. Generally, these coverage options include:

  • In-patient hospital care: If you are admitted to hospital, you will be covered for your stay, as well as any treatments or surgeries you receive while at the hospital.
  • Cancer treatments: If you are diagnosed with cancer, and need conventional treatments like chemotherapy, your Medicare plan will cover the costs associated.
  • Medical equipment: Walkers, wheelchairs, and other medical equipment that has been deemed medically necessary by your doctor is covered by Medicare.

Medicare covers many treatments and procedures that you may need throughout your life. However, it does not cover everything. Medicare does not usually cover ambulatory services, as well as therapies like speech therapy, occupational therapy, podiatry, or psychological services. Additionally, Original Medicare does not cover dental or vision services.

How are Medicare insurance costs determined?

Medicare insurance costs vary depending on whether you go with Original Medicare or Medicare Advantage. For Original Medicare, your premiums are determined by:

  • Income level: Premiums for Part B of your Medicare plan is determined by your income level. Your adjusted gross income will factor into whether you are required to pay more on average if you exceed a certain income level.
  • Social Security benefits: Social Security checks are determined based on the cost of living, and Medicare premiums are deducted from Social Security. If the Social Security benefits are unable to cover a change in Medicare premiums while still providing you with your regular amount of Social Security, the premium will not raise. This only applies to individuals that receive Social Security.
  • Part D addition: Part D is an additional piece individuals can add to their Medicare coverage. This will lead to a higher overall monthly premium.

Additionally, some Medicare Advantage plans do not come with a monthly premium. Your costs will be determined by which services you receive under your Medicare Advantage plan, the yearly deductible you are responsible for, whether you visit in-network providers, and more.

When to get Medicare insurance coverage?

Medicare insurance is automatically given to some individuals, however, there are instances where you need to apply for coverage. Those 65 years and older are eligible, as well as some younger people who have kidney failure or certain disabilities.

If you fall into any of these categories, it is best to get Medicare insurance coverage as soon as possible. This is so that you can ensure you get coverage for the medical attention you may need, and know you are covered when unexpected things occur.

How to choose the best Medicare insurance?

When deciding on the right Medicare coverage for you, you need to decide between Original Medicare or Medicare Advantage. To help you pick what’s best for you, consider the following:

  • Consider your medical needs: If you have specific medical needs that need certain types of treatments, you will want to ensure your Medicare will cover you for these procedures. Medicare Advantage typically covers a wider range of benefits, but requires you to receive care through your private network.
  • Location: Certain areas may not have certain Medicare Advantage plans available. If there is a Medicare Advantage plan you were interested in, be sure to confirm it’s offered in your area ahead of enrollment.
  • Review potential costs: If you are more likely to need medical treatment throughout the year, you may want to look into Original Medicare. The monthly premium you pay for Original Medicare will cover many of your routine procedures and doctors visits, where Medicare Advantage will require you to pay a copay and other costs associated.

Regardless of which plan you choose, remember that you can only enroll for either Original Medicare or Medicare Advantage during specific enrollment periods. If you are unhappy with your plan, you are eligible during these times to try another plan and see if it works better for you.