Medicare Options in Montana
When people work hard their entire lives and scrimp a little bit to save cash for a comfortable retirement, they deserve to live a life that is free from any financial strains. But even after careful financial planning and being diligent about saving, a single excessive medical bill can become an inevitable setback that can quickly lead to bankruptcy.
Several research reports reveal that numerous people in the US aged 65 and above have to face medical debt and bankruptcy after going through a single health issue situation in their homes. Apart from that, many people with disabilities and chronic conditions who have several medical needs are more likely to have a higher level of debt than other individuals. Approximately 16 million adults in the US owe $1,000 in medical debt, while 3 million people owe more than $10,000.
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Medical debt isn’t limited to any demographic group but happens more commonly to people who have disabilities or do not have sufficient funds to pay for their medical treatments. This is why the Medicare health insurance program was initiated to give people a chance to have a comfortable retirement without the perils of going through financial trouble because of a medical health emergency.
You become automatically enrolled in the Medicare coverage program once you reach the age of 65. People also qualify for Medicare if they have received 24 disability benefit payments, had renal failure, or had ALS. With a proper health coverage plan, you never have to worry about spending your savings or facing bankruptcy at the time of a health emergency again.
Since there are so many healthcare programs to choose from, it’s essential to opt for a coverage plan that meets all of your special requirements and financial situation. But searching for the right healthcare program can be challenging and requires a lot of extensive research.
This is where our certified Medicare insurance agents come in. Our highly-qualified insurance agents at Integrity Now Insurance Brokers are annually accredited by America’s Health Insurance Plan (AHIP). With our in-depth knowledge of the dynamics and the complexities of the industry, we will help you streamline a robust healthcare plan that will help you stay debt-free. Our insurance agents will go with you line-by-line through every insurance policy to ensure that you’re getting maximized protection at the most competitive rates.
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Original Medicare
The Original Medicare, also known as the traditional Medicare, is by far the most popular healthcare plan in Montana. This program consists of Part A and Part B.
Part A provides coverage for hospital services like in-patient treatments, lab tests, skilled nursing facilities, and hospice care.
Part B covers outpatient care, doctor appointments, mental health, in-home care, partial hospitalization, and certain medical equipment.
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The Original Medicare Part A and Part B only cover 80% of the total medical expenses. For the leftover 20% coinsurance, you have the option to purchase a secondary healthcare policy like Medigap that is funded by private insurance companies. Medicare Part B also includes a monthly deductible that you’re expected to pay if your financial situation allows it.
Medicare Part C (Medicare Advantage)
Many senior citizens in Montana prefer the Medicare Part C option because it is an all-in-one solution for all of their medical requirements. Medicare Advantage is a complete package consisting of all the benefits of Part A, Part B, and Part D (prescription drug coverage). This insurance plan is provided by private insurers who work under contract with Medicare.
Other additional benefits offered in Medicare Part C are dental, vision, hearing, transportation to doctor appointments, over-the-counter drugs, gym membership, and other health and wellness support programs.
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There are four types of Medicare Advantage Plans available in Montana:
Health Maintenance Organization (HMO)
HMOs mandate their subscribers to only opt for in-network providers for receiving healthcare services.
This collective of medical insurance providers covers medical treatments by physicians and hospitals that work on their terms and conditions. To be eligible for the HMO, you must have a primary care provider (PCP), a specialty referral, and get approval for certain treatments and medications.
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Preferred Provider Organization (PPO)
Medicare PPO plans have a recommended network of providers that you can choose from. You can also opt for an out-of-network healthcare provider for a higher price.
To qualify, you do not require any specialty referrals or a primary care provider. The PPO provides coverage for prescription drugs, but you can also purchase drug coverage separately.
Private Fee-For-Service (PFFS)
Offered by State-licensed organizations that work under contract with the Center for Medicare & Medicaid Services, the PFFS healthcare plan also includes a recommended network of providers their users can choose from. To become eligible, you do not require a specialty referral or a primary care provider, drug coverage is included, and there are higher premiums for people who choose an out-of-network provider.
Special Needs Plan (SNP)
This plan is only available for people who are diagnosed with certain medical conditions. This healthcare plan offers special treatments and medical services that are designed to meet the specific needs of people with chronic conditions.
For this program, you require a PCP and a specialty referral. Prescription drug coverage is included, and you can join this plan at any time if you meet the eligibility criteria.
Montana Medicare Part D
Since Medicare Part A and Part B do not provide coverage for outpatient prescription medications, Medicare Part D is a coverage plan that specifically pays for prescription drugs.
This creditable Medicare coverage policy prevents its users from any out-of-pocket expenses that could be spent on medications. This plan includes chemotherapy drugs, intravenous medications, and other over-the-counter drugs as well.
Supplemental Health Insurance – Medigap Options in Montana
Since the Original Medicare Part A and Part B only cover 80% of the total medical expenses, many people in Montana like to purchase the supplemental Medigap policy, which pays for the rest of the 20% coinsurance.
Medigap, also called Medicare Supplement, is a comprehensive healthcare plan that Medicare beneficiaries invest in to get coverage for whatever isn’t covered in the Original Medicare. This set of health insurance policies is labeled from A through N.
Private insurance companies that provide Medigap coverage must adhere to federal regulations since Medigap plans are governed by every state’s insurance commissioners. To qualify for Medigap, you must be enrolled in the Original Medicare Part A and Part B, and you must be 65 years old or older. Other people who qualify for Medigap are people who have been diagnosed with amyotrophic lateral sclerosis or end-stage renal disease.
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Medigap insurers in Montana set their premiums in three ways.
Issue Age Rating
This premium depends on the enrollee’s age at the time they apply. Enrollment premiums cost less for people who are under 65 than for people over 80. The overall rates may be affected due to inflation and other reasons, but never because of the enrollee’s age.
Attained-age Rating
Most insurance companies prefer to use this approach to calculating premiums. The person’s premiums become higher as they get older. These premiums are also less expensive for younger buyers.
Community Rating
Unless mandated by the state, this method of calculating premiums is typically avoided by insurers. The premiums are not affected by the enrollee’s age.
Although there are ten basic Medigap plans to choose from, Plans N, F, and G are very popular among the people of Montana.
Medigap Plan F
Medigap Plan F is a popular coverage plan that covers all the gaps found in the traditional Medicare Part A and B. Plan F covers the Part B annual deductible ($233 in 2022), Part A coinsurance, and other hospital expenses for up to a year after using Medicare benefits.
Plan F also eliminates the financial burden of international trips, skilled nursing facilities, and hospice care as well.
Medigap Plan N
Plan N is a reliable alternative to Plan F and is less costly in comparison. If you’re enrolled in Plan N, you will be expected to pay the copayments for doctor appointments and hospital stays. Your Part B premiums will not be covered, and you will be responsible for paying $20 for in-office visits and $50 for emergency room visits.
Medigap Plan G
The Medigap Plan G offers the same benefits as Plan F but also covers the Part B premiums. With Plan G, you will have coverage for Part A premiums, hospital costs, coinsurance, hospice copay, and skilled nursing facilities. This healthcare plan also includes 80% coverage for international travel emergencies.
When applying for a health insurance plan, you have to make sure you’re getting comprehensive coverage with additional benefits at competitive rates. This is why many first-time Medicare enrollees find the process of enrolment a daunting experience. But at Medicare Hope, you can rely on us to provide you with sturdy health insurance policies that meet all of your requirements and are within your budget.
To learn more about the different Medicare options available in Montana, make sure to go through our blog and learn the step-by-step process of applying to Medicare.
Comparing Medicare Advantage Plans in Montana
Here are some factors you should consider when purchasing a Medicare health insurance plan.
Provider Network
Many Medicare programs require enrollees to choose a healthcare provider that works on their terms and conditions. This is why they charge higher premiums when users opt for an out-of-network provider.
Do your research and find physicians and hospitals that are a part of their network, so you don’t have to spend an excessive amount on medical bills.
Amount of Coverage Required
When investing in a healthcare plan, make a note of all of your primary needs and requirement and choose a plan that fulfills all of them.
Medigap and Medicare Advantage plans provide additional benefits like coverage for dental, vision, hearing, and other healthcare programs that aren’t a part of Original Medicare. This is why make sure to talk to your insurance agent to find a plan that is best suited to your needs.
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Check Plan Ratings
To compare plan ratings in your area, make sure to check out the performance data that is annually released by the Center for Medicare & Medicaid Services (CMS).
Out-of-Pocket Expenses
Out-of-pocket expenses include copayments, deductibles, and coinsurance that you’ll be expected to pay. In the Original Medicare plan, there is no limit on the out-of-pocket expenses, but other healthcare plans like Medigap can help lower these expenses.
To compare the pricing on different plans in Montana, you can use our plan finder tool by clicking here.
Monthly Premiums
A monthly premium can have a significant impact on your budget in addition to the Part B deductible. Make sure you sign up for at least one plan that does not charge you a monthly premium.
Drug Coverage
Find out if your prescription medication is enlisted in your plan’s formulary. If not, you can ask your doctors to recommend a generic or alternate version of that drug that is mentioned in the formulary.
Freedom to Travel
Medicare insurance plans also enable beneficiaries to travel internationally or domestically and use their Medicare benefits.
Any health emergencies, check-ups, treatments, and medical bills will be covered whenever you travel.
Extra Benefits
Always check if your healthcare plan offers benefits like vision, dental, and other targeted medical treatments which are a part of your primary needs.
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Why Choose Medicare Hope Insurance Agents?
Our certified team of Medicare insurance agents at Integrity Now Insurance Brokers is highly experienced in the insurance industry and is well-versed with the industry’s complexities and jargon. With our extensive experience and knowledge, you are in safe hands.
At Medicare Hope, we prioritize your health and safety and are committed to going above and beyond to make sure you have the protection you deserve. Our experts will properly guide you and help you make an informed decision when choosing a healthcare plan.
With our access to the nation’s A-rated health insurance companies, we have helped countless people land comprehensive health coverage plans that meet all of their needs and financial situation.
Get in touch with our AHIP-certified team of Medicare insurance agents today, who will help you compare quotes and fill you in with all the details that you require. Call us now to book a free consultation.
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