What are the Medicare Alternatives? – Overview
If you are eligible for Medicare it does not mean that you should rush to enroll in it. There are plenty of Medicare alternatives.
These include employer-sponsored group health insurance coverage plans, Veteran benefits, TRICARE, and even the Indian Health Services.
Experts also name Medicare Advantage as one of the best Medicare alternatives.
Let’s check out some possibilities and choices regarding Medicare alternatives.
1. Employer-Sponsored Insurance Coverage
If you are eligible for the premium-free Medicare Part A then it makes complete sense to enroll in it.
However, if we talk about Medicare Part B, then you can choose to delay enrollment in case your employer provides health insurance through creditable coverage plans.
You can choose to keep your employer-sponsored group health insurance plans till you are employed. Medicare offers excellent group insurance plans, depending on the employer company’s size.
In case your company has 20+ employees then the employees qualify for primary group coverage. The coordination of benefits is the main determining factor for which plan will reimburse first.
Companies with less than 20 employees can seek small business group insurance.
In case you work for such a company, then this coverage is not considered creditable under Medicare Part B. Additionally, you could also face a Medical Part B penalty if you fail to enroll in time.
It is crucial to compare Medigap and Medicare Part B premiums with your employer’s deductions from your paycheck.
You should count the cost of medications, co-payments, and deductibles in this. If Medicare Plus offers a lower price, then it makes sense to drop your employer-sponsored Medicare insurance plan.
2. Medicare Retiree Insurance
At times, you may get to enjoy the benefits of employer-sponsored health insurance even after retirement, through Retiree Insurance.
This works excellently as a Supplemental insurance policy to support your Medicare plans.
Apart from this, you can also enroll in retiree insurance separately however this will not provide insurance cover to your spouse.
Remember that retiree insurance does not come under creditable coverage, hence you may face penalties in the future.
3. Marketplace Insurance
It is possible to purchase insurance through the ACA Marketplace even before you are eligible for Medicare plans.
However, this will also result in you losing your premium subsidy when you are eligible for Medicare Part A, the premium-free insurance plan.
In short, you will need to pay the full cost of health insurance which makes Medicare more affordable.
Experts advise buying marketplace insurance even if they are not as well as Medicare. You should remember that such coverage is not creditable so you may incur penalties if you delay getting enrolled.
4. Medicare Advantage
Medicare Part C is also known as the Medical Advantage plan. However, experts don’t consider Medicare Advantage to be a Medicare alternative health insurance despite it being called a “replacement plan”.
You will need to enroll in Medicare Part B to get on the Medicare Advantage plan. In addition, Medicare Part C should cover the services which are included in Medicare Part A and Part B.
Medicare Advantage does come useful in certain situations. For instance, this is excellent for those eligible due to disability.
Almost all states offer supplemental options for those below 65 years. Additionally, Medicare advantage premiums for those under 65 can be as much four-fold as compared to those over 65.
Medicare Advantage can also be beneficial when you cannot afford Medigap monthly premiums. This is especially true if you are dependent on Social Security income after retirement.
You need to remember that Medicare Advantage has several out-of-pocket costs related to it.
Hence, even if you choose a zero-dollar or low premium plan, you will still need to pay considerable out-of-pocket costs.
Thus, it is highly advised to consider the pros and cons depending on your particular situation before enrolling in the Medicare Advantage plan.
Medicare is not compulsory and the best Medicare alternative depends on your specific situation.
You can get the best health insurance if you combine Medicare Part A or Part B with a Medigap plan.
It might also be possible that your employer-sponsored Medicare group insurance could be better, especially if Supplemental options are not affordable.
Always remember, some insurance cover is always better than no insurance cover.
I am a dedicated healthcare researcher and an enthusiast specializing in medical grants, medical education and research. Through my articles, I aim to empower healthcare professionals and researchers with valuable insights and resources to navigate these critical aspects effectively.