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Original Medicare And Prescription Drug Plan

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With original Medicare, Parts A and B, and a Prescription Drug Plan, your are getting three things:

  1. Ensuring you won’t encounter any penalties.
  2. Moderate copays for medical services.
  3. No network restrictions.

With this setup you will have all only what original Medicare covers for your medical coverage. In short, this means you will pay 20% for most medical services like doctors, labs, equipment, ect. If you need coverage for hospitalization of any kind, then you will pay a deductible of $1340.00 that will cover you for all hospital services in a 90 day window. Remember, his only covers what original Medicare covers. Services such as dental, glasses, hearing aids, ect will need to be purchased as a separate insurance plan or paid cash. For a deeper dive into what original Medicare covers Click Here.

When it comes to prescriptions, your coverage will be determined on which Part D plan you purchase. It’s important to remember that your medications will not be covered the same on each plan, and coverage may vary based on dose and brand for even the same medication. There will be some things that are the same no matter what. The Donut Hole, also known as the “Gap Phase,” will follow you everywhere. This is when you will pay a percentage of the your medication costs instead of a flat copay once your total drug costs for the year have passed $3750.00. For more details about this Click Here.

This setup will work well for those who see doctors across multiple counties, have many doctors who take different networks, and/or can’t afford or don’t think their costs will surpass $2200 for the year. The first two reasons make getting a Medicare Advantage plan difficult, and the network restrictions would force you to stay local for your medical care. The $2200 isn’t completely arbitrary. Once your costs for the year reach this amount it makes a Medicare supplement an attractive option. At $2200 your yearly cost may be more than or equal to what you may have paid for a plan that would have covered most, if not all, of your copay/coinsurance that year. For more information on Medicare supplements Click Here.

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