Medicare Add Ons 2010

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There are several alternatives to sole Medicare Part A and Part B coverage. The simplest one is to find a plan that covers prescription drugs, part D plan. These are usually available through private insurance companies and can be found on Medicare website, which is an excellent resource. The costs depend on the area and company and are in the range of $30-$40/month in most cases for 2010. There are co pays associated with this plan. Generic (Tier 1) drugs require a co pay of about $7-$10 dollars for a 30-day supply. Tier 2 (contracted brand names) are in the order of $30-$40 for a 30-day supply. And the cost keeps going up the more expensive the drug is. There are a total of four tiers. Expensive drugs such as chemotherapy drugs may require 30-33% co pays.

What about co pays and deductibles for doctor visits and hospital bills? Here is where a real major choice comes in. First, you have to decide whether you want to go into a supplemental plan, sometimes referred to as Medigap policy or go with a Medicare Advantage type plan, which can be an HM0, PPO, or PFFS type plan. Basic differences include choice of providers and in-network and out-of-network limitations. With supplemental policies, also known as Medigap policies, the insured retains the freedom to go to any provider as long as that provider accepts Medicare. Supplemental or Medigap policies are placed into various plans (plan A, plan B, and so on) and cover none, very little or a lot of doctor visits and hospital co pays that can be incurred from Medicare Part A and Part B participation alone. If a person qualifies for one of the plans under Medigap, the supplemental plan may cost on the order of hundredth of dollars per month. But, that person retains freedom to be treated anywhere in the U.S. and some plans offer abroad emergency coverage as well. Look on medicare.gov and you will see what the differences are. Under current regulations, any particular provider may charge 15% over Medicare charges. So, there is a potential of these additional 15% co pays that may become insured person's responsibility. Also, supplemental or Medigap policies do not cover prescription drugs, so additional Part D premium for drug coverage may be required.

The other choice is to enroll into Medicare Advantage type plan, also referred to as Part C. All major insurance companies offer a variety of these plans. The insurance companies may call Medicare Advantage plans something different though, so you may need to be specific about what you are looking for. AARP has excellent customer service representatives that explain everything in detail. Medicare Advantage plan participant maybe in an HMO, PPO, or PFFS setting. All or only some of the options may be available in your area and different companies offer different choices. Most of Medicare Advantage plans include drug coverage, so the insured person only has to worry about copays. Copays are very similar to co pays that people find in employer sponsored plans. Monthly premium can be as low as $0 or can be higher. At least two drawbacks exist in Medicare advantage plans. First, your favorite doctor or hospital maybe out-of-network, so your co-pays skyrocket or you may become responsible for most of the out-of-network bills. The second drawback is that drug costs are only covered to a limit. That is however, a drawback of all plans, unless a person hits "catastrophic" drug expense. The phenomenon is usually referred to as "doughnut hole". For 2010, the coverage gap is for drug costs between $2830 and $4550 per year. Some plans also require first $310 for drugs to be paid by the insured.

In short, there are many choices when it comes to selecting a Medicare coverage option. Medicare.gov is an excellent in-depth resource that can calculate your total health care cost based on the medications that you are taking. Insurance company websites do the same, and some even let you specify your doctor to see if you will be paying in-network or out-of-network co pays. Do not expect to learn everything in couple of hours. Shop around. You will probably need to speak with a few representatives. Check in your communities, which may have scheduled informative events.

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