More than 100,000 people are registered in Medicare plans in Alaska, and the number of available plans is rising. Comparing the various strategies is essential for selecting the optimal option.
Medicare in Alaska
Alaska offers multiple Medicare choices to Americans and permanent residents who are at least 65 years old. You successfully qualify if you are under 65, have ESRD or ALS, or have been handicapped for at least 24 months while receiving SSDI.
Original Medicare: Part A and Part B ((hospital insurance and medical insurance) make up the two portions of the program’s coverage. Hospitals, hospices, home healthcare, and skilled nursing care facilities are covered by Medicare Part A. Doctor’s appointments, outpatient services, urgent care, lab work, diagnostic testing, preventative care, and medical supplies are all covered in Part B. It may also pay for prescriptions that must be provided in a clinic or other settings and cannot be taken home.
Medicare Advantage Plan (Part C or MA): This is a private insurer-sold option to Original Medicare. Many plans offer greater coverage than Original Medicare by covering prescriptions as well as gym memberships, dental, vision, hearing, and transportation to doctor’s visits.
Medigap: Standardized Medigap policies are offered by private insurance firms. Plans are made to fill in the gaps in coverage left by Original Medicare in terms of cost.
Medicare Part D: Part D is an addition to Original Medicare or Medicare Advantage that covers prescription drugs. Private insurance providers provide the plans, but Medicare controls them.
Part A and Part B (medical insurance & hospital insurance) make up Original Medicare (basic coverage for Medicare recipients). Here are some specifics regarding the Original Medicare:
- Medicare Part A provides coverage for hospitals, home health, hospice, and skilled nursing facilities, among other services. After Part A has paid its share of your medical costs (up to 80%), the remaining 20% of those costs, together with any deductibles, copays, or coinsurance, are your responsibility to pay. If either you or your spouse have already paid the required Medicare tax, you normally won’t have to pay a premium for Part A. If you do not meet the Medicare tax requirements to be eligible for a free premium, then you may be required to pay a monthly premium for Part A that is as high as $499.
- Part B: Part B provides coverage for outpatient treatment, emergency services, lab work, diagnostic tests, and medical supplies. It may also pay for prescriptions that must be provided in a clinic or other settings and cannot be taken home. The cost of the Part B premium, which is dependent on the Income Related Monthly Adjustment Amount (or IRMAA), is typical $170.10 each month. After satisfying a $233 deductible per year, you will be accountable for 20% of your medical expenses (in 2022).
Who Original Medicare is ideal for: If you want greater flexibility, Original Medicare is a smart alternative. It covers a substantial portion of the country. If you have a number of medical issues, you might wish to combine Medicare and Medigap. Enrolling in a stand-alone medication plan is crucial because Original Medicare does not cover prescriptions. The out-of-pocket expense is a disadvantage of the plan if it isn’t combined with a Medigap.
ALASKA’S ORIGINAL MEDICARE:
- Pays 80% of the majority of medical bills
- You are responsible for the remaining 20% of expenditures, with no yearly cap on your out-of-pocket spending.
- To assist cover your share of the costs, you can purchase Medicare Supplement Insurance (Medigap) coverage.
- You can enroll in a separate Drug plan if you want coverage for prescription drugs (Part D).
- Can use any Medicare-accepting hospital or physician nationwide
Medicare Part C, also known as Medicare Advantage Plans, is an alternative to Original Medicare. They provide the same coverage as Part A and Part B but frequently include extra benefits.
Programs for Medicare Advantage in Alaska have networks and might only be accessible in specific state regions. Plan choices are determined by ZIP code. You are often responsible for copayments, deductibles, and out-of-pocket maximums under these plans. Plans, however, might begin with a $0 premium and increase from there. In Alaska, the typical monthly premium is $0 (in 2022).
The four different types of plans that make up the Alaska Medicare Advantage Program are:
Health maintenance organizations (HMOs): Except for medical emergencies, HMO plans typically only offer coverage to in-network doctors. Typically, you need a primary care physician (PCP) who can recommend you to specialists. The majority of HMO plans cover prescription drugs.
Preferred provider organization (PPO): These plans feature a network of medical facilities and providers where your care will be less expensive. Out-of-network providers are also an option, but the cost of your care will increase. In most cases, you can receive treatment or referrals to see specialists without a primary care physician. The majority of PPO policies cover prescription drugs.
Private fee-for-service (PFFS): These plans let you work with any Medicare-approved healthcare professional. Some PFFS plans feature provider networks where you can access less expensive medical care. In PFFS plans, you can consult experts without a referral, but not all prescription medications are always covered.
Plans for beneficiaries with special needs (SNPs): SNPs are for recipients who have certain illnesses or peculiarities. These plans tailor benefits and providers to the specific needs of the population they serve. You are typically constrained to the plan’s network of medical professionals, require a primary care physician, and must request specialist referrals. All SNP plans provide coverage for prescription drugs.
The Medicare Advantage Plan that perfectly suits your needs and aligns with your priorities in terms of costs, provider options, and accessibility is the one that you can enroll in. With Alaskans, Medicare Advantage has become more and more well-liked.
The ideal candidates for Medicare Advantage Plans are those with fixed incomes, good health, and a desire to avoid paying excessive premiums for coverage they won’t frequently use. The convenience of using just one card and the added benefits included in the package can be alluring. You must be registered in Medicare Parts A & B to qualify.
Medicare prescription drug coverage
Private insurance companies offer Medicare Part D, but Medicare regulates it. A Medicare Advantage Plan or a stand-alone PDP can include Part D in its coverage (MA-PD).
Alaska Part D monthly rates begin at $7.30.
Alaska currently has 20 independent PDPs. Seven stand-alone and 0 Medicare Advantage Plans with prescription drug coverage apply the Senior Savings Model to reduce out-of-pocket insulin costs.
Who Part D plans are suitable for: Even if you don’t take any prescription medications, Part plans are still the right solution. If you do not participate in the program as soon as you become eligible, you will be subject to a monthly cost that you do not enroll.
Alaska Medicare Supplement Plans
Private insurance firms offer standardized Medigap policies. These plans are designed to financially fix the Original Medicare coverage gaps. In Alaska, nine standardized plans are offered, each identified by a different alphabet (A, B, C, D, F, G, K, L, and N). Only Medicare-eligible individuals before January 1, 2020, are eligible for Plans C and F.
In Juneau, the cost of a Plan G for a nonsmoker female of 65 years ranges somewhere between $111 to $343 each month. The $233 Part B deductible is also your responsibility.
Who Medigap plans are ideal for: Medicare Supplement Insurance, or Medigap, is an excellent alternative for you if you make frequent use of your benefits, do not wish to be limited to a small coverage area, and prefer to choose your own provider. You should not select a supplement if you are unable to pay the monthly payment but are interested in the additional benefits provided by Medicare Advantage. These benefits include having the Prescription Drug Plan (PDP), dental, vision, and hearing treatments covered.
What is the estimated cost of Medicare in Alaska?
Original Medicare: The amount of your monthly premium for Part A might be anywhere from $0 to $499. The hospital deductible for Medicare Part A is $1,556 for each and every benefit period. The typical monthly payment for Medicare Part B is $170.10, and the deductible for Part B is $233.
Medicare Advantage Plans: In Alaska, a Medicare Advantage Plan will typically cost $0 in 2022. Some plans have $0 premiums at the outset.
Plans under Part D: The starting monthly premium is $7.30.
In Juneau, the cost of a non-smoking female 65-year-old Plan G ranges from $111 to $343.
Advice from experts on Medicare enrollment in Alaska
- Beware of late fees:If you do not sign up for Medicare Parts A, B, & D as soon as you’re eligible, you’ll be charged a fee. If you want to avoid paying late enrollment fees, you need to have coverage that is acceptable through group health insurance or the US. The Veterans Affairs Agency for Services (VA). You will only be liable to a Medicare Part A penalty if you are not eligible for coverage that does not require payment of a premium and fail to enroll in a plan when you first become eligible for it.
- Choose the right plan:Pay attention to your coverage region, the medical professionals you visit, and your total healthcare requirements. Verify that the plan you select is in-network with the doctors and hospitals you regularly use and prefer. Consider whether they will be covered if your medical condition compels you to visit specialty clinics outside of your state. Just check for options that are tailored to your coverage area while shopping for them. If you travel frequently, you might choose a plan that covers a wider area and is accepted outside of Alaska.
- Your prescription medications and the pharmacy:You should know what you need and will use before considering prescription drug coverage. Make a list of all the medications you already take. You can find tools on Medicare.gov or registered agents to assist you in determining which plan will cover the price of your medications the most effectively and whether or not your current pharmacy will be part of the plan’s network. Even while you would believe that all prescription drug plans (PDPs) are the same, the truth is that each one has its own distinct formularies and network of suppliers.
- Avoid putting things off because if you do, you can forget to do something crucial. Know the deadlines and enrollment dates. A smart time to start comparing plans, enrolling in classes, and getting ready is three months before your qualifying month.
- Ask if you don’t know! Never hesitate to seek assistance. Pose inquiries. Use the resources offered when you have inquiries.
While some people will be enrolled in Medicare automatically, the majority must do so during the proper window.
Initial enrollment: Three months before your initial enrollment period, you will turn 65. It goes on during the entire birthday month and the three months after.
Open enrollment (run between October 15 – December 7): If you get Medicare Advantage plans in your region, you can review your coverage during open enrollment each year and switch between original Medicare and those plans. Additionally, you can modify, add, or remove your Part D coverage.
General enrollment (run between January 1 – March 31): If your initial enrollment deadline was missed, you could re-enroll at the start of the year during general enrollment. However, be aware that your coverage won’t start until July 1.
Special enrollment: You will have a special enrollment period (SEP) to register yoursel for Medicare or switch plans if you lose coverage under your existing plan for specific reasons, such as losing an employer-sponsored plan or relocating out of your current plan’s service region.
Medicare resources in Alaska
You can get assistance from Medicare Alaska resources if you have enrollment, plans, and coverage inquiries. As follows:
- The SHIP or State Health Insurance Assistance Program and Alaska’s Medicare Information Office (800-478-6065) provide Medicare counseling services.
- Through SHIP funds, the community-based nonprofit organization Access Alaska (907-479-7940) provides Medicare counseling and assistance.
- Access the “Medicare and You” manual online.
- More than 108,000 Alaskans have Medicare coverage.
- Alaska will offer two Medicare Advantage plans in 2022.
- If you live in Alaska and are seeking supplemental coverage, there are 11 Medigap plan choices.
Visit our website NewMedicare.com to learn more.