How To Spends Less On CoPays — Prescription Drug Coverage

medicare prescription drug plans

There are a number of strategies that can help you pay less for your insurance costs and Medicare prescription drug plans. Medicare Supplement or Medigap insurance can help cover the out of pocket costs you would be responsible for under Original Medicare alone. The different Medicare supplement rates will vary with the plan and company that you choose. You should always do the math to determine which plan is going to best suit your potential medical needs.  Medicare supplement or Medigap plans fill in the gaps of Original Medicare by reducing or even eliminating your out of pocket costs.

You need to know what you will be charged for an office visit. Medicare reimburses 80% of the Medicare-approved part of your visit. Medicare has set $65 as the appropriate amount for an office visit. Medicare will pay 80% of that $65 and you pay the rest. Medigap policies can help pay the rest. Whether it is worth it to you to have a policy, in this example, depends on how often you go to the doctor in a given month. Will the amount the Medigap policy pays be more than the premium you pay for the Medigap policy?

And what if your doctor or specialist charges more than $65 for a visit? What about medical procedures or other things Medicare does not cover? A Medigap plan can help lower the costs of copayments in these cases too. Different Medigap plans have different coverage. Usually, more expensive plans offer more coverage. Again, before signing up for any plan, try to assess how much you will save with the plan versus the cost of the premium.

Another way to save on your copayments is to carefully choose your Medigap plan. While the plans are all identical as to coverage they can vary as to cost. Plans may differ in cost from company to company or from state to state. Be sure to look at your plans and their copayments carefully. In many cases two Medigap plans that can save you money are plans G and F. These plans cover services that can be expensive and are often cheaper than other Medigap plans. Plans often differ in subtle but significant ways. Below are three of the 10 plans by way of example.

Plan F for instance, pays the Medicare Part A deductible and coinsurance, the Part B Deductible and excess charges, the skilled nursing facility coinsurance, as well as the foreign travel emergency care. The plan F is the most expensive plan because it is the most comprehensive plan in terms of coverage.  As, always do the math to determine if the Plan F fits your specific medical needs.  The Plan F is the only plan with the ability to eliminate all out of pocket costs not covered by Original Medicare.

Plan G, as another example, covers 100% of Part B Excess claims on plans purchased after June 1, 2010. This plan also covers the Part A deductible, copayments, and coinsurance. It covers coinsurance and copayments for Part B as well. It provides for 365 extra days of hospitalization over what Medicare covers, allows for three pints of blood annually, care in a skilled nursing facility, coinsurance/copayments for hospice care, foreign travel medical emergencies, and home care when Medicare approves.

Plan C is a popular Medigap policy. It covers Medicare Part A Coinsurance, all costs after hospital benefits are used up, Medicare Part B copayments/coinsurance (excluding preventative services), your first three pints of blood (Medicare usually covers blood after the first three pints), and Medicare Preventative Part B Coinsurance. Medigap Plan C is also notable for covering Skilled Nursing Facility Care Coinsurance. This can be expensive after the first twenty days. Between 20 and 100 days is covered under this plan. The plan also covers some parts of Foreign Travel Emergencies within the limits of the plan.

These are just a sampling of the Medigap plans available and how they can save you on copayments and coinsurance. Whether a particular plan works for you depends on your medical needs and expenses. The cost of a plan depends on the kind of plan you choose, your age, where you live, and the insurance company offering the coverage. Remember that while the Medigap plans have to be identical, the insurance companies can charge different rates.

If you have used an insurance company before you should also consider something else; were you satisfied with the services provided by that company? They may save you some money on copayments but if you were dissatisfied with the company, that is a small comfort. Always compare the plan prices and the plan rules between different insurance companies. While saving on copays and coinsurance is a good thing, you need to understand the plan in its entirety. Research can help you get the best deal.

Another thing to consider when choosing a Medigap plan is what plans are offered by a given company. While there are 12 plans, insurers are only required to offer Plan A. Beyond that, they can choose whether or not to offer a plan. Plan availability may also differ by state. You should also be sure to note specifically what Medigap plans do not cover: vision care (including glasses), dental, hearing aids, long-term nursing home care, and other services.

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