Typically, Medicare beneficiaries over the age of 65 have three ways to access their Medicare: First is staying on Original Medicare (Parts A & B) and enrolling in a Part D Prescription Drug Plan (PDP). Second, you can remain on Original Medicare (Parts A & B) and cover the gaps in Original Medicare by purchasing a Medicare Supplement plan along with a Prescription Drug Plan (PDP). Third is enrolling in a Part C Medicare Advantage Plan that includes prescription drug coverage. The second and third options provide the same essential services but differ in structure.

Original Medicare consists of Part A (Hospital and Skilled Nursing Insurance) and Part B (Medical Insurance). It is widely accepted and allows visits to any Medicare-participating provider or hospital across the country. There are fixed deductibles, copayments, and coinsurance for each service, but no annual out-of-pocket maximum. To help manage out-of-pocket expenses, you have the option to purchase a Medicare Supplement Plan, which helps cover costs such as the Part A deductible and the 20% Part B coinsurance once the deductible is met. Additionally, you can acquire a Part D Medicare drug plan for prescription drug coverage.

Another way to manage out-of-pocket expenses is by enrolling in a Part C Medicare Advantage plan, offered by private health insurance companies. These plans may require an additional premium on top of the standard Part B premium and typically include coverage for Parts A, B, and often Part D. They usually feature set copays and coinsurance for services until you reach the plan’s annual out-of-pocket maximum. Generally, you'll need to use providers within the plan’s network, and the plan may require prior authorization for certain services or prescriptions.

When considering how to choose your Medicare, think about the following:

• Do you have chronic health conditions that necessitate frequent doctor visits?

• Which doctors, hospitals, and providers are essential to you?

• Do you take regular prescription medications?

• Is it important for you to access routine medical care while traveling, or will you only seek emergency care when away from home?

• Are you comfortable with paying deductibles, copays, and coinsurance for services as they arise?

• What monthly premium can you manage and are willing to pay?

If you are already enrolled in Original Medicare, you can purchase a Medicare Supplement at any time, but there are specific periods when you can enroll in, drop, or change your Part C Medicare Advantage or Part D Medicare Drug Plan.

As a Licensed Independent Insurance Agent at Bolte Insurance, I represent major health insurance companies in our region and am well-versed in the diverse plan options available. My colleagues and I guide you through the enrollment process, helping to narrow down plan options and present the Medicare solutions that may best meet your needs. To schedule an appointment to explore your options or initiate your Medicare journey, please contact our office today at 419-732-3111.

Disclaimer: Not connected with or endorsed by any government or Federal Medicare Program.