Are you a New Hampshire resident who is currently enrolled or will soon enroll in the federal Medicare program? If so, then there is some essential information that you need to know about the benefits package. For starters, once you officially qualify for Medicare, you will start receiving benefits from Parts A and B of Original Medicare. The helpful chart below outlines what sort of benefits you can expect from each part.
Coverage and Benefits
You should also have a good idea of what your financial responsibility will be once you successfully enroll. Every beneficiary will have to pay an annual deductible and monthly premium in order to receive Part B benefits (the total cost of which can be found on this website). Unfortunately, some seniors may also be required to pay for Part A as well. If you have a short employment history of fewer than 40 quarters (or 10 years), there is a required premium that you must pay before you are allowed to receive any medical benefits from part A.
New Hampshire residents interested in Medicare can qualify for the healthcare as soon as they turn 65 years of age. Residents that sign up for Medicare will automatically be enrolled in Part A, which offers coverage for inpatient care, hospice and home healthcare and nursing facility care. Part A coverage won’t cost you anything if you’ve worked 10 years or 40 quarters throughout your lifetime. For a more comprehensive level of coverage many Medicare recipients opt to receive Part B as well for an added cost. With Medicare Part B, more coverage is available for outpatient care, and there is coverage for better medical equipment and more doctor services.
Outside of Parts A and B you can get additional coverage by working with private insurance companies through Medicare Part C (Medicare Advantage). With this service you can get additional coverage items added to a policy. You could have access to dental, vision, prescription coverage and other services with Medicare Part C. Finally, there is Medicare Part D, which is for prescription coverage specifically. This can help you avoid paying for medical prescriptions. You must have Medicare Parts A and B to qualify for Parts C or D.
|Medicare Part A (Hospital Coverage)
||Medicare Part B (Medical Insurance)
|Medicare Part C (Medicare Advantage)
||Medicare Part D (Drug Coverage)
Medicare Plans in New Hampshire: Who Has What
More than a quarter million people in New Hampshire (231,444 residents) have successfully enrolled in the Medicare program. Of those, only 6% (or 13,866 people) have decided to purchase a Medicare Advantage insurance policy. And additional 65,632 beneficiaries (or 28%) prefer to supplement their benefits with a Medigap insurance policy. Which leaves a staggering two-thirds of all Medicare beneficiaries either getting supplemental coverage from some sort of employer-sponsored program, or with no protection at all from potentially expensive Medicare coverage gaps.
Remember, you have to be enrolled in Medicare and actively receiving benefits before you can start to look for a comprehensive Medicare supplement. Click the link above for important information about when and how to enroll.
Do New Hampshire Residents Need to Purchase a Medicare Supplement?
Technically speaking, there is no legal requirement that you purchase supplemental coverage in order to receive your Original Medicare benefits. However, it isn’t a bad idea. With the rising cost of health care, spending a little bit of money on a supplemental policy now can save you thousands of dollars in out-of-pocket medical expenses later on down the road.
Healthcare costs in New Hampshire are increasing year-after-year, and as those costs rise it becomes difficult to get the quality care that you need. To help combat the cost of quality health care many residents are looking for additional coverage options available to them.
Supplemental health insurance is a common option that residents decide to go with. This special supplemental insurance will help cover costs that aren’t complete covered by Medicare. For some added cost every month you can avoid additional out-of-pocket costs from things left over by Medicare.
There are coverage gaps with every single Medicare plan offered today. With these gaps you have leftover costs that you are expected to pay out of your own personal savings. An additional insurance policy will help fill in those gaps, so you don’t get stuck paying a bunch of added fees that you aren’t ready for.
If you decide that you want a supplemental insurance policy to add to your Medicare plan or to replace it entirely, you have two options available to you to choose from. You can go with Medicare Advantage or a Medicare Supplement (or Medigap) policy. But before you select either policy you will need to learn their major differences and what sort of experience you can expect with each.
The chart illustrates the potential bills you might be required to pay due to gaps in Medicare coverage:
|Medicare Part A Costs||Medicare Part B Costs|
Choosing a Medigap Supplement Policy in New Hampshire
Fortunately, there are ways to protect yourself and your life savings from unexpected medical bills. The first is a form of supplement insurance called Medigap, and the other is through a Medicare Advantage policy. Don’t worry; we’ll go over each form of coverage in detail so that you can best decide which is right for you.
Private insurance companies and the federal government have teamed up to tailor a series of supplemental insurance policies to the needs of seniors who wish to protect themselves from notorious Medicare coverage gaps. These policies do not replace your Medicare benefits, but act as a separate form of health insurance which covers the expenses which Traditional Medicare does not. There are 10 plans: A-D, F, G, and K-N. Each plan is the same across all 50 states, which means that you only have to worry about finding the right company and an affordably-priced policy.
For more details on each plan, review this helpful table:
Medicare Advantage Plans in New Hampshire
Medicare Advantage is another popular way to supplement your Medicare benefits in a way that protects you from expensive coverage gaps. Unlike Medigap insurance, Medicare Advantage actively replaces your federal benefits with a private insurance policy which is legally required to deliver “equal or greater” coverage. For a slight additional cost, you may even be able to add extra benefits – such as prescription drugs or vision care – to the same policy.
While some clients prefer Medicare Advantage due to its simplicity, there are certain risks associated with switching from government-guaranteed health insurance to coverage from a private institution. There is the obvious volatility of the health care market, which private companies are more vulnerable to than government. There is also the provider network to consider. Many different companies like to keep costs low by restricting their network of doctors and hospitals. For you, this could mean that you will have to switch doctors in order to receive your Advantage policy benefits.
The networks which Medicare Advantage plans usually work through are referred to as Preferred Provider Organizations (PPOs) or Health Maintenance Organizations (HMOs). If you require medical care from a doctor or facility outside of your HMO or PPO network, it will likely end up costing a lot of money.
Medigap and Medicare Advantage in New Hampshire: What’s the Difference?
The first difference that you’re likely to see between Medicare Advantage and a Medigap policy is how each of the two options handles insurance claims and medical cost coverage. When you make use of a Medigap policy your insurance company doesn’t pay any of your medical costs until after Medicare has covered their share. After Medicare covers some of your policy, your Medigap policy will step in and cover some more. Finally, you are responsible for anything, if at all, that Medigap doesn’t cover for you. By paying a little more monthly, you will enjoy better coverage.
Each of the two policy types come from private insurance companies, but they do things differently. When you go with a Medigap policy, you’ll enjoy standardized coverage no matter what company you work with. That means you can move from one company to another and know what sort of coverage you are getting if you pick a policy that’s named the same. This makes it easy to compare options and avoid paying too much for insurance.
With Medicare Advantage you receive more coverage and more benefits, but you have to go through a much more complex system for that coverage and try and understand what you are getting. Medicare Advantage plans replace Medicare Part A and Medicare Part B, while a Medigap policy just helps cover the costs leftover from those policies. Medicare Advantage plans offer added coverage options as well that Medicare A and B won’t cover at all.
A Medigap policy usually offers simpler pricing compared to a Medicare Advantage policy. You’ll be held responsible for just a single premium each month and then pay any remaining balance from a medical service. Medicare Advantage will leave you with a premium, different co-payments, special terms and conditions and different variable costs depending on your situation. It’s all these different variables that make it difficult to figure out exactly what you’ll be spending on your insurance with an Advantage plan.
Those are the key differences between the two major supplemental Medicare policies. Each is useful, but they function in very different ways. We outline even more differences in our table down below. If you want to learn more about Advantage or Medigap policies, talk with one of our representatives today and find out what we can do for you.
|Questions||Medicare Advantage||Medicare Supplement|
|What expenses do these plans cover?||Medicare Advantage estimates how much healthcare costs in your area then calculates a premium and co-pay rules determining what it covers and what you cover. The Advantage plan pays your medical costs, then Medicare covers some of those costs and you pay the rest.||Medigap pays the remaining cost that’s not covered by Medicare Parts A and B. Medicare pays first, then you pay the remaining balance after Medigap pays its share. A comprehensive policy covers the entire remaining balance for you but has a higher premium.|
|Do I still pay for Part B with this plan?||Yes||Yes|
|What will I pay for this plan?||You’ll pay a fluctuating rate that’s difficult to determine. The rate depends on the total coverage you get, where you live and your health needs.||You pay the monthly premium for this plan and that’s it.|
|What does this policy cover for me?||This policy offers coverage for items in Medicare A and B, but also adds additional items specified on each plan. You can get additional coverage that you want with this plan.||This plan only covers items covered by Medicare A and B. Any additional items of coverage you want must come from a different policy.|
|Is budgeting simple when using this policy?||No, budgeting is difficult because costs are variable. Advantage plans tend to cost more unless you have few healthcare needs.||Yes, budgeting is usually simple with a Medigap policy. You pay your premium and leftover medical expenses. If you have a comprehensive policy, you only pay your premium.|
|Am I guaranteed to be able to keep this policy?||No, you are not guaranteed. There is a chance you will be removed from your policy during the renewal period.||Yes, pay your premiums and you are guaranteed to keep your policy as long as your insurer stays in business.|
|Do I need approval to use this policy?||Yes, Advantage policies have an approval process you need to go through.||No, if you qualify for Medicare you are approved for Medigap.|
|Must I see specific doctors or use certain hospitals?||Yes, there is a limited network that you’re expected to use.||No, see any doctor as long as they approve Medicare as a payment option.|
|Who is this plan best for?||An Advantage plan is best if you have lower medical care needs and you live in the city where many options are available for care.||Medigap is best if you have high care costs, or you live in an area with few doctors and hospitals you can work with.|
Helpful Medicare Resources in New Hampshire
Any further questions you have should be directed to your local Medicare experts. Feel free to use the directory on this page to get access to some valuable contact information. The employees at the offices listed in our directory are here to help you make the most informed decision possible about your health care needs.
Important Medicare-Related Healthcare Terms
- HMO: Health Maintenance Organization, this refers to a network of doctors and hospitals with a plans’ network.
- PPO: Preferred Provider Organization, this refers to a network of doctors and hospitals with a plans’ network.
- Co-Pay: Amount of money charged per visit to doctor, specialist, etc.
- Co-Insurance: A percentage required by the policyholder to pay out-of-pocket. For example, 80/20 coinsurance means the insurance company will cover 80% of the charges, and the policyholder pays the remaining 20% of the charges.
- Deductible: This is the amount of money required out-of-pocket by the policyholder before the insurance will kick-in and pay for any remaining charges. For example, a policy with a $1,000 deductible means that you must pay full healthcare costs out-of-pocket up to $1,000 before the plan will start coverage.