Are you looking to expand your medical and prescription coverage?

Is Medicare okay, but not enough for your healthcare needs?

Have you been contemplating the health insurance market place vs Medicare?

This blog has you covered – you’ll learn about the benefits of the health insurance market place vs Medicare and how you can benefit from having both.

Don’t let health insurance overwhelm you – continue reading for what you need to know about the health insurance market place vs Medicare.

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Health Insurance Market Place vs. Medicare: A Quick Overview

The first thing you need to know is that the health insurance market place coverage does not impact your Medicare coverage. That means that having health insurance through the market place won’t disqualify you from Medicare plans.

Medicare open enrollment is different from the health insurance market place, so make sure you get your dates right:

  • Medicare Open Enrollment: October 15, 2020, to December 7, 2020
  • Health Insurance Market Place Open Enrollment: November 1, 2020, to December 15, 2020

If you already have Medicare or health insurance coverage, you can use that time to review your plan to see if it still fits your needs. If you already have a health insurance market place plan when you become eligible for Medicare, you can choose to keep that plan, as well.

The only thing you need to consider is that you’ll lose any premium tax credits you receive if you sign up for both a market place insurance plan and a Medicare plan. But having both isn’t a bad thing if you have high medical expenses – there are limitations to Medicare.

Health Insurance Market Place vs. Medicare: What You Need to Know

When deciding between the health insurance market place vs Medicare, there are a few things you need to know about how the market place and Medicare work.

1. Health Insurance Plans May Cover Some of Your Medical Expenses

Even if you have Medicare, health insurance market place plans will function the same way – you’ll have a deductible, copayments or coinsurance, and an out-of-pocket maximum. Your health coverage begins after you meet your deductible.

Having a health insurance market place plan while using Medicare is a great way to save money for people who have higher medical costs or a lot of prescriptions each month.

2. Health Insurance Plans Do Not Disqualify You from Having Medicare

Because you can have both a health insurance market place plan and Medicare, there is no disqualification from Medicare for having a plan through the market place. You’ll still qualify for the same premiums regardless of having both plans.

The one caveat here is losing the premium tax credit – don’t forget that you lose that if you sign up for a health insurance market place plan while you have Medicare coverage.

3. Medicare Plans May Cover Your Medical Expenses

Depending on the type of Medicare plan you choose, you may be fully covered or not. Medicare Part A covers hospital stays and means you’re considered “fully covered” by government regulations. Medicare Part B, which is for medical coverage, does not mean you are fully covered.

These plans will pay for certain things, but you’ll be paying for both the plans and any limitations they have with no guarantee of an out-of-pocket maximum.

Health Insurance Market Place vs. Medicare: Can You Use Both?

Yes, you can use both. As mentioned, you won’t qualify for any premium tax credits for the health insurance market place plan, but beyond that, you can use both plans to cover your medical expenses.

In fact, there are a few reasons you might want to use both, depending on your health situation.

Here are a few Medicare limitations where it would be useful to have a health insurance market place plan:

  • Hospital Stays: There is a $1,364 deductible per benefit period with Medicare, plus $341/day for days 61-90 of a hospital stay in a single benefit period. There may be an additional $682 per day after the 90-day mark, as well. Having a health insurance market place plan could help cover some of these costs.
  • Skilled Nursing Facility Stays: A skilled nursing facility stay can be expensive. While Medicare covers the first 20 days per benefit period, after that you pay $170.50 per day through day 100, then all costs after that. This would be an excellent scenario for having a health insurance market place plan in place to cover additional medical expenses.
  • Prescriptions: Unless you proactively purchase a Medicare Part D plan for prescriptions, you won’t have any prescription coverage with your Medicare plan. With a health insurance plan through the market place, prescriptions are typically covered as part of the plan. Use a health insurance market place plan to help cover high prescription costs.  

These are just a few situations in which you would be better suited to having both a health insurance market place plan and a Medicare plan.

Enroll Today

Using the health insurance market place vs Medicare doesn’t have to be a tough choice – it’s really a no brainer. Having both gives you the maximum coverage for medical situations, which can save you money in the long run. Here are three important takeaways about having both coverage types:

  • Health insurance will cover hospital stays, skilled nursing facility stays, and prescriptions – these are all critical to seniors.
  • Medicare requires you to purchase insurance in pieces – you may end up paying a hefty sum for all of the different coverage types you need.
  • Having both a health insurance market place plan and Medicare can be beneficial – you’re not disqualified from one if you have the other.

Of course, you need to compare plans and know about what your medical expenses will be each year, but there are tools available to help you with that.

Need help deciding which plan works best for you? Contact Fiorella Insurance Agency today to talk about the health insurance market place plans that will provide you with the most coverage.

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