Medicare Plans in Cook County
Introduction
Medicare is a federal health insurance program for adults who are 65 or older. Individuals with qualifying disabilities are also eligible. When choosing the right type of Medicare, you may hear about Medicare “parts” as well as Medicare “plans.” Although some laypersons use the terms interchangeably, these categories have distinctive differences in the type of coverage and benefits included. Whether you need full coverage for hospitalizations and full medical equipment or simply want to ensure access to prescription drugs, it is important to remain educated on the kinds of health insurance provided for Illinois residents. A look at the Medicare options available in Cook County, Illinois can help you make an informed decision for yourself and your family.
Understanding Medicare Parts
Medicare consists of four categories or parts: A, B, C, or D. Part A and Part B are the primary categories and are also referred to as Original Medicare. Individuals with Part A receive coverage for inpatient hospital stays. Part A may also cover skilled nursing, home health, and hospice care. Individuals with Part B receive coverage for general medical expenses and outpatient care. For example, this coverage can include durable medical equipment (DME) like canes, walkers, mobility scooters, or wheelchairs. It can also cover prosthetic devices and most lab tests.
Part C refers to private health insurance that meets or exceeds the requirements of Original Medicare, and seniors pay a monthly premium. In the healthcare marketplace, Part C is also called the Medicare Advantage plan. Part D refers to prescription drug coverage in which you pay a small premium for medication. Another name for Part D is the Medicare Prescription Drug Plan (PDP). They are plans because you pay a premium for an outlined policy with additional benefits.
Understanding Medicare Plans
The three types of Medicare plans are the Medicare Advantage Plan (Medicare Part C), Medicare Prescription Drug Plan (PDP or Medicare Part D), and Medicare Supplement Insurance Plans (Medigap). Supplemental or Medigap plans also come with identifiable letters such as F, G, K, L, M, and N. These letters help seniors understand the varying costs and benefits included.
Specifically, Medicare Advantage Plans replace Original Medicare. These plans cover all the benefits of Original Medicare but may also include extra coverage like urgent care, vision, hearing, or dental insurance. Individuals sign up for Medicare Advantage through private insurers who then provide a list of facilities included in the healthcare network. This network can help manage or lower copays, coinsurance, deductibles, or premium costs. Bundles within Medicare Advantage may include Health Maintenance Organization (HMO) plans that require you to visit doctors within the plan’s network, Point of Service (POS) plans that lets you visit doctors outside of the network for a fee, or Preferred Provider Organization (PPO) plans that charge less for in-network visits but still enable flexibility if you need out-of-network care.
In comparison, Medicare Prescription Drug Plans (PDP) go beyond Original Medicare to help pay for prescription medication. Some providers refer to these plans as MedicareRx. Most PDPs participate in nationwide pharmacy networks. This means you can pick up your prescription in pharmacy locations across the country.
Medicare Supplement Insurance Plans or Medigap plans are different from Medicare Advantage or Medicare PDPs. As the name implies, Medigap plans “supplement” or bridge the “gap” of coverage offered in Original Medicare. While Medicare Advantage plans are insurance policies that replace Original Medicare, a Medigap or supplemental plan is extra insurance that helps pay your share out-of-pocket costs for an existing Original Medicare account. In Illinois, if you enroll in Medicare Advantage plan, you would not purchase a Medigap plan. Fortunately, Illinois is also a guaranteed issue state for people who need a supplemental plan to help with their existing Original Medicare. This means that anyone over the age of 65 in any health condition cannot be declined for a supplemental plan if necessary to achieve health insurance coverage.
Medicare Plans in Cook County
Medicare beneficiaries in Cook County have a plethora of options for healthcare plans. Cook County residents can sign up for Medicare Advantage plans through private insurers as an alternative to Original Medicare. Other options include signing up for a PDP to work in conjunction with Original Medicare benefits or choosing a supplemental plan to buffer out-of-pocket expenses. There are currently around 70 private companies that offer Medicare Advantage plans in Cook County. Examples include Aetna, Cigna, Humana, and UnitedHealthcare. In addition, there are approximately 10 companies that offer supplemental plans in Cook County. Examples include State Farm, Blue Cross Blue Shield, and AARP. A licensed agent can help select the insurer and plan that is right for you.
Conclusion
According to the Centers for Medicare & Medicaid Services, Illinois has around 2.4 million Medicare beneficiaries. With the bombardment of information about Medicare, finding the right plan can feel overwhelming. Working with a licensed health insurance agency is best way to get started and sign up for the best policy for you. K&B Financial offers no-obligation consultations for Illinois residents. We offer enrollment assistance and can help you determine the most suitable Medicare Advantage, PDP, or supplemental plan for your situation. Reach out to K&B Financial today for all insurance needs.
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