Ed Savitsky, a Sanatoga Ridge resident and a specially trained volunteer counselor for APPRISE, Pennsylvania’s free health insurance counseling program, recently provided updated Medicare information for Sanatoga Ridge residents and the surrounding community.
Ed answered questions about Medicare and provided objective information about Medigap (Medicare Supplemental Insurance), Medicare Advantage, and the differences between the two.
According to Ed:
When you get down to the bottom line as to which one will be the best and/or most affordable one for you, the answer is “it depends.” There are so many plans, your best option is to find a knowledgeable, honest insurance broker to help you, especially for Medigap plans. There are good plans that fit different people differently, in fact, spouses can be on two completely different plans depending on their health, how many times they visit their doctors (men tend to go less often than women) and how much they travel.
So, what’s the difference? Medigap plans are extremely flexible, you can visit any doctor, any hospital, anywhere in the country. You will also know what your monthly cost will be because the Supplement for Medicare A and B plus the cost of Part D (drug coverage) are charged as flat fees – they are the same every month and there are no additional fees, except for prescription co-pays.
Then you have Medicare Advantage, of which the most popular plans have $0 premiums per month and $0 for drugs (depending on what state you live in). BUT you never know how much you will have to pay in any particular month. Medicare Advantage is a pay-as-you-go plan. So, if you don’t use it, it’s $0 a month. But you pay a fee every time you go to your primary care doctor, a specialist, the emergency room, or for a hospital stay or have a prescription copay. With Medicare Advantage, depending on how often you use it, can be as much as, but not more than $6,700 out-of-pocket a year. If you’re healthy and only see a doctor twice a year, this might be the better option for you. Unlike Medigap, however, you can only see the doctors that are in your plan’s network – this could be problematic if you spend part of your year in Pennsylvania and part of your year in Florida.
There are many good plans to choose from in both Medigap and Advantage plans, but the best plan for you may be entirely different than your best friend’s. Costs vary by state, age, whether you are a smoker, and how much risk you are willing to bear.
If you have questions before contacting your broker, Ed is ready and willing to assist you. He can be reached at the TriCountry Active Adult Center in Pottstown. Contact Paula at 610-323-5009 ext.105 to set up your appointment.
