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Long Beach California

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What are the Best Medicare insurance Plan for 2021

If you are like me you want to know what is the best Medicare insurance plan for 2021 that will meet all of my Medicare needs.  According to CMS which is in charge of Medcare, they state there is no “best plan” as each person’s individual health needs are all different.  What may be best for you may not be what is best for your spouse, friends, or extended family members.  

With Medicare you have 3 different paths you could go.  You can either choose:

  1. Original Medicare with no Medigap plan
  2. Original Medicare with a Medigap policy
  3. Medicare Advantage plan

 

While very few people intentionally pick option 1, it is still an option that people do go with.  Let’s explore all of your Medicare options for 2021 plan year.

Best Medicare Plan 2021

Original Medicare - No Medigap Plan

When you first sign up for Medicare Part A and Medicare Part B, this is typically done at your local Social Security office, over the phone, or via their online enrollment portal.  For those individuals who decided to not use a Medicare Insurance Agent, they might not have realized that they should also consider a Medigap plan and thought they were fully covered and finished everything.  

While yes, you have officially signed up and are now covered by Original Medicare there are some things you need to know that the Social Security office does not inform you of.  This is of course that Original Medicare does not cover 100% of your total cost which will leave you with some pretty large gaps in coverage.

While we love Original Medicare, obtaining this coverage without a Medigap plan in place is not advisable.  This is due to the cost you will face once you use your Medicare benefits.

For instance, Medicare Part A is most commonly known as your hospital coverage.   If you ended up in the hospital there are some deductibles and copays that you will be faced with.  

Part A Deductible & Co-insurance Consideration for 2021 plan year:

  • $1,484 Deductible for each benefit (Jan 1 – Dec 31)
  •  $0.00 Co-Insurance per Day – 1-60 Hospitalization
  • $371 Co-Insurance per day – 61-90 Hospitalization
  • $742 Co-Insurance per day – Day 90+ **Lifetime Reserve Days
  • You are responsible for ALL COST – 90+ **No Life Time Reserve Days remaining

 

Medicare Part B which is more commonly referred to as your Doctors and Outpatient services coverage.  

Part B Deductible & Co-insurance for 2021 plan year:

  • $203 deductible per plan year
  • 20% co-insurance of the Medicare Approved Amount
  • Additional 15% charge for Doctors who don’t accept Medicare Assignment

While the monthly premium for just having Original Medicare is very reasonable, when you look at your overall cost of Original Medicare it can get real expenses.  This is mainly due to the fact that your Part B coverage has a 20% co-insurance.  Depending on the bill amount this can equal tens of thousand of dollars.  This does not count the cost of staying in a hospital for an extended period of time.  

Original Medicare with a Medigap policy

When you are considering Medicare, most Americans have historically picked option 2 which is obtaining Original Medicare with a Medigap plan.  Depending what which Medigap plan /Medicare Supplement plan you pick, virtually all of the cost listed above disappear.  For instance if you pick Plan G from your Medigap plan options, the only cost you will incur outside of your monthly premium will be your Part B annual deductible of $203. 

Plan G will cover all of your Part A deductibles and copays.  They may also include coverage for up to an additional 365 days in the hospital at no cost to you.

Plan G will also cover 100% of the cost related to any copays and coinsurance.  This means the 20% coinsurance goes down to zero.  In addition Plan G of your Medigap plan will also cover 100% of the 15% charge for Doctors who do not accept Medicare Assignment.  

Going with Original Medicare with a Medigap policy gives you the freedom of going to any Doctor or Hospital throughout the USA who accepts Medicare.  You can do this without a referral or the need of obtain pre-authorization to have a medically necessary surgery.

Integrity Now Insurance Brokers are big fans of staying on Original Medicare and obtaining a Medicare Supplement plan.   This path provides very broad coverage options with no handcuffs related to being tied to a network of Doctors and Hospitals.  If you want to go to a specific cancer facility 9 states over, this plan gives you that freedom.

Best Medicare Advantage Plans for 2021

Medicare Advantage plans are a great option for a lot of Medicare beneficiaries.  If you live in a large city like Long Beach, CA, you can find some great Medicare Advantage plans that include a ton of benefits.  In addition, there is so much competition in Los Angeles and Orange County that insurance carriers are almost giving away these plans.  

For 2021 the max out of pocket limits will be $7,550 per year.  While this is very high, if you live in Los Angeles or Orange County California, there are Medicare Advantage plans available were the max out of pocket cost is only $799 per year.  In addition many of your Doctors office visits and Hospital stays come with a zero dollar copay.  Many of these plans do not even charge a separate monthly plan premium.  

If you are someone who has heart disease or you have been diagnosed with type 2 diabetes, some Medicare Advantage plans have special programs that are specifically designed with you in mind.  They will custom fit your Advantage plan to include specific prescription medications for your Part D coverage and include a specific network of Doctors to help take care of you.

If you are super healthy, there are Medicare Advantage plans that will pay some of your Part B insurance premium.  One Advantage plan covers up to $109 per month of your Part B premium and provides you with a $40 per month towards over-the-counter products at your local CVS or Walgreens.  Like I said they are basically paying you to join their plan. 

With Medicare Advantage plans they are primarily HMO style plans.  This means you can only go to a specific network of Doctors and medical facilities that are covered by the plan you selected.  These plans do not allow you to jump on a airplane and obtain Medicare coverage 5 states away, so you can go to the top cancer facility of your choice.  You may not even be able to go to a local cancer facility in your own State if your Medicare Advantage plan does not include them under your specific plan.  

When considering a Medicare Advantage plan you will want to make sure all of your must have Doctors, Medical Facilities and Part D prescription drugs are covered.  

We are here to help you figure out which plan is best for you.  We look forward to hearing from you and remember our services are 100% free to you.

Integrity Now Insurance Brokers, Inc.

562-735-3553

4 Parts of Medicare