Navigating Medicare Options
by Richard
This is a heads up warning for those of you approaching retirement.
You will be forced to become your own health care benefits analyst as you hack through the thicket of options available to you.
Fortunately, there is a wealth of information available online through CMS (the Center for Medicare Services).
I wish I could tell you that those licensed to sell the enhanced options (the supplemental policies, and Medicare Advantage Policies) were acting in your best interest…but what I’ve found is that the product that racks up the highest sales commission is the one most highly touted.
Here are your basic choices:
1. Plain, vanilla, unenhanced Medicare (including Part A for hospital expenses and part B for doctor bills)
Like any other health insurance policy, pay close attention to the co-pays and deductibles.
Also, you will need to shop for your Part D prescription drug benefit separately, from among the many private vendors who compete for this business.
My critique of the traditional product is that it is geared entirely towards reimbursement for treatment…with almost zero incentive for prevention.
The medical complex has learned how to milk this “fee for service” model, by layering in redundant services and treatments to boost their revenue. The curse of any third party reimbursement model.
2. Medicare supplemental policies
These are the “alphabet” enhancements (A-N) designed to plug the holes for deductions and co-pays built into traditional Medicare. The appeal is strong for the chronically ill who are habituated to high and persistent usage of medical services.
For the relatively healthy…the expense of these supplements exceeds their utility. In fact, these supplements more closely resemble prepaid medical care, rather than insurance.
The insurance brokers love these policies due to their high costs and high commissions.
3. Medicare advantage policies (part C)
This is the private insurance option for receiving Medicare benefits and resembles the wide open competition found in the part D drug benefit options.
Alert consumers can find plans that offer no restrictions on providers, that include the drug benefit at no cost, and that include a wide range of preventive screenings to ameliorate chronic illnesses.
As you would expect, such a sensible and affordable option is under constant assault from so-called health reformers who value uniformity and conformity far more than allowing competition to stimulate a new paradigm in health care.
My advice?
Take advantage of Medicare Advantage while you still have that freedom of choice.
