Did you know that Medicare covers almost 3 million Pennsylvania residents? In addition to Traditional Medicare, seniors have at least 50 Medicare Advantage plans available to them, which can seem overwhelming. At AmeriBest Home Care, we strive to help seniors make the best choices for their home and health care. Here is our comprehensive guide to your options available through Medicare in Philadelphia PA.
Medicare Philadelphia PA: Original Medicare and Medicare Advantage
Original Medicare, or Traditional Medicare, includes hospitalization insurance (Part A) and medical insurance (Part B). The government pays for healthcare costs and a beneficiary can obtain care anywhere in the country so long as they accept Medicare. With Medicare Part A, if you or your spouse paid into Medicare through your wages, coverage is typically free. Medicare Part B typically has a monthly premium.
Original Medicare Part A and B cover hospitalization and most outpatient services. However, it doesn’t cover prescription drugs. Likewise, it doesn’t cover dental care or routine vision care.
Medicare Advantage is a private coverage alternative to Original Medicare. Where Original Medicare only includes hospitalization and medical coverage, Medicare Advantage often includes prescription coverage (Part D), as well as other supplemental benefits such as vision and dental.
Because Medicare Advantage is managed through private insurers, consumers have multiple options for coverage, based on their needs and services available in their area including HMOs (health maintenance organizations) and PPOs (preferred provider organizations).
Advantage plans cover the essential services of Medicare Part A and Part B. However, Advantage plans don’t cover hospice care. Fortunately, Original Medicare covers hospice, even if you’re enrolled in Medicare Advantage.
The costs for Medicare Advantage vary based on the insurance provider. Some plans offer integrated Part D, meaning that beneficiaries only pay premiums for Part B, just as they would with Original Medicare. While premiums are widely variable, they’re often less expensive for consumers than Original Medicare with the addition of Medigap coverage. When considering cost, it’s important to look at the out-of-pocket costs on Medicare Advantage plans, as these establish how much a patient must pay for care before Medicare picks up the costs.
Medigap is supplemental coverage that helps to pick up the gaps left behind by Medicare Part A and Part B. This includes covering co-pays and deductibles as well as plans that cover emergency expenses when traveling outside of the country. If you’re enrolled in Medicare Part A and Part B, you can purchase Medigap coverage.
Medicaid is a government-funded program that provides low-income and disabled Americans with health insurance coverage. Seniors who qualify for both Medicare and Medicaid, may receive full benefits under both programs (known as full-benefit dual-eligibles) or have Medicare but receive Medicaid to help pay expenses like Medicare premiums (called partial duals).
Are You Considering Options for Medicare in Philadelphia, PA?
At AmeriBest Home Care, we want to empower you to choose the right plan and care for you or your loved one. Whether you’re caring for elderly parents or someone with a disability, it’s important to consider your options carefully. Contact us today to discuss your options with one of our program coordinators.