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Medical insurance can be expensive, which means buying it is not always fun. But think about what you get when you buy medical insurance. You don't just get more affordable access to your doctor. You're also more likely to remain in good health as you age. You're far less likely to have to empty your wallet for a medical emergency, too. What it all comes down to it is this: medical insurance is a good idea, even if it costs a bit more than you'd like. Read more about medical insurance here on this blog. We have all sorts of insights to share.

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Insure Your Health, Insure Your Future

What You Need To Know About Choosing And Using Private And Medicare Insurance

by Vincent Evans

Are private and medicare insurance the same? If you're almost ready to turn 65, take a look at what you need to know about your current coverage, the health insurance marketplace, federally-sponsored programs, and your options.

Which Type of Insurance Do Adults 65 and Over Have To Choose? 

Your age doesn't dictate the type of policy you have to select. But it does allow you to choose from additional options. Medicare is a federal health insurance program for people ages 65 and older, people with end-stage renal disease (ESRD), and some younger adults with specific types of disabilities. 

In 2021 there were more than 63 million Americans enrolled in Medicare plans, according to the U.S. Centers for Medicare and Medicaid Services (CMS). Even though tens of millions of older adults use this type of health insurance, you don't have to select a policy. If you have private insurance through your employer or via a self-pay plan (from the health insurance marketplace) and are over 65, you can continue to use your non-Medicare policy. There is no requirement or mandate for seniors to select a federally-funded insurance policy.

Which Type of Insurance Is A Better Choice For Adults 65 and Over?

There's no one-size-fits-all answer to this question. Some seniors who have private insurance will want to, and should, keep their employer-sponsored or private pay policies. Compare your options and each program's benefits before you leave one policy for another. Consider how much you currently pay for your non-Medicare plan. Medicare is a federally-funded plan. But it doesn't mean every part is free. While most people don't need to pay for Part A (hospital insurance), Part B (doctor's office or medical insurance) is not free. Likewise, Part D (prescription drug coverage) or an Advantage Plan may have premiums or monthly costs. 

Along with premiums, you will also need to compare the coverage amounts, limits, and prices. Look at the deductibles for each plan, copays, and co-insurance out-of-pocket costs. These costs will increase if you use an out-of-network provider (these include doctors, nurse practitioners, hospitals, medical facilities, labs, and other healthcare settings). If you're not sure whether to keep your private plan or move to a federally-funded policy, make sure that you can continue to see your current healthcare providers without additional expenses.

Can Adults 65 and Over Use Both Types of Insurance?

You already have a policy. But aren't ready to let it go. Can you also choose and use Medicare? The answer to this question is yes. Each insurance plan is considered a payer. The coordination of benefits rules will determine which insurance plan (or payer) will pay for the primary costs of medical services. This may leave deductibles, copays, or other costs for you to pay. If you have a private plan and Medicare, the secondary payer (the other insurance coverage) will pay for all or some of the remaining unpaid costs.

Contact an insurance agent to learn more about Medicare insurance.

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