Medicare Coverage in Retirement
Q: I recently turned 65 and I have enrolled in Medicare Part A, Part B and Part D. I had great insurance all of my life through my employer and I would like to have the same type of coverage again. I had to only pay $10 when I went to my doctor and it covered everything. I would like to have that same type of coverage now. Is it available?
A: It sounds like you are accustomed to HMO coverage through your group health plan. There are many insurance companies that offer Medicare coverage with similar types of benefits. These are referred to as Medicare Advantage HMO plans and are offered through private health insurance companies. If you enroll in a private Medicare Advantage HMO plan, you are no longer covered under Medicare. The private health insurance company assumes the responsibility of your health care and you pay your monthly premium directly to that insurance company. In addition to receiving your monthly premium, the insurance company is also compensated by the Federal Government for assuming the risks associated with your health care costs.
Under a Medicare HMO plan, you will need to choose a primary care physician, just like you did on your group HMO plan. If it is important for you to keep your current doctor, you might want to ask him/her if they accept any Medicare HMO plans. If they do, they can probably also advise you which of the plans they offer provide the better coverage and are the easiest to work with. If your doctor does not accept Medicare HMO plans, you may also consider a Medicare Supplemental Health Insurance Plan that will provide you with more comprehensive coverage than Medicare Part A and Part B, but will allow you to continue using your current doctor.
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