Medicare coverage

Medicare coverage choices can be confusing!

What is the best plan for you or your loved one?

Medicare Open Enrollment is October 15 – December 7, 2019.  With 10,000 boomers turning 65 years old and retiring every day, the topic of healthcare coverage through Medicare is more timely than ever. Do you know that by 2027, nearly half of U.S. health spending, will be financed by federal, state and local governments as baby boomers age into Medicare?!

Whether you are seeking guidance and information about your own Medicare needs or for an aging loved one, it is important to know where to turn for accurate and comprehensive information based on your (or your loved one’s) specific health conditions, diagnoses and current prescription medications.

One of the most reliable (and free) resources available to you is through your State’s Department of Insurance Seniors’ Health Insurance Information Program, also known as SHIIP. This program is staffed by knowledgeable, trained volunteers ready to review your specific information and, based on that data, provide you with options that best fit your individual needs. SHIIP provides objective, impartial information. SHIIP volunteers are not allowed to recommend nor endorse a specific plan and they never receive compensation from insurance brokers, companies or agencies. In North Carolina, you may call and schedule an appointment with a SHIIP volunteer in your county.

Choices in Medicare coverage sometimes can seem confusing. From the Medicare and You 2020 Handbook, here is a helpful comparison “at a glance” of Original Medicare vs Medicare Advantage.

Original Medicare: You can go to any doctor or hospital that takes Medicare, anywhere in the U.S. In most cases, you don’t need a referral to see a specialist.

Medicare Advantage: In most cases, you’ll need to use doctors who are in the plan’s network (for non-emergency or non-urgent care). Ask your doctor if they participate in any Medicare Advantage plans. You may need to get a referral to see a specialist.

COST can be very different between Original Medicare and Medicare Advantage plans.

Original Medicare: For Part B covered services, you usually pay 20% of the Medicare-approved amount after you meet your deductible.

Medicare Advantage: Out-of-pocket costs vary by plans. They may have lower out-of-pocket costs for certain services.


Original Medicare: You can join a separate Medicare Prescription Drug Plan (Part D) to get drug coverage.

Medicare Advantage: Prescription drug coverage is included in most plans.

Original Medicare: covers most medically necessary services and supplies in hospitals, doctor’s offices and other health care settings.

Medicare Advantage: Plans must cover all of the medically necessary services that Original Medicare covers. Most plans may offer extra benefits that Original Medicare does not cover — like vision, hearing, dental and more.

Read more about this important and timely topic online at following this link. Youu can order a printed copy of the Medicare & You handbook by calling: 1-800-633-4227 (1-800-MEDICARE) and speaking with a Medicare representative.

Medicare open enrollment
Selecting a Medicare plan during open enrollment