If you're 65 or older, it’s time to choose a Medicare plan. At Frio Regional Hospital, we'd like to help make that choice a little easier by offering some plain and simple facts.
Think of Original Medicare as a buffet. Choose Part A for inpatient hospital expenses, hospice, and home health care. Part B for outpatient medical care, such as doctor visits, x-rays, blood work, and preventative care. And Part D for prescription drugs.
Now, think of Medicare Advantage as a sit-down meal that bundles everything into one comprehensive plate called Part C, purchased through a private insurer. With this plan, you should know that your regular doctor, specialty physician, or hospital may not be in the insurer's network. If so, you will need to find new doctors and a new hospital that accepts Medicare Advantage.
Original Medicare:
- Typically covers 80%
- Supplemental insurance (Medigap plan) is recommended to help cover out-of-pocket costs
- Accepted nationwide
- Visit any doctor/provider who accepts Medicare and is taking new patients
- You don't need a referral to see a specialist
- Buy separate Part D for prescription coverage
- Provides the widest range of coverage
- Covers services anywhere in the U.S.
- Enroll/change plan coverage any time
Medicare Advantage:
- Purchase from a private insurer such as Aetna, Humana, United Healthcare, or another
- Premiums may be lower, but out-of-pocket costs with co-pays may be much higher
- Many services must be pre-approved, which can take up to three days
- You must select a doctor, hospital, or other service provider from the insurer’s network
- Your doctor/hospital may not be in the network
- Some plans cover extras, such as wheelchair ramps and shower grips for your home, meal delivery and transportation to/from doctors’ offices
- You may have limited services, or you may be denied service, depending on the Insurance
Company, not your doctor - Coverage is only for location of primary residence
- Once enrolled, you’re locked in for the year
If you have questions regarding which Medicare Plan is right for you, please contact your Medicare representative, or private insurance carrier.
For more information, call 830.334.3617.