Are you overwhelmed with all of your different Medicare options, parts, pieces, and plans? Think of Medicare as if you are building a train. Your Original Medicare is the engine, then you get to add different railroad cars on to the locomotive to complete your coverage.
Medicare is an archaic system compared to health plans of 2020. Developed in the 1960s, Medicare has been expanded, amended, and appended with a variety of different parts and pieces. Consequently, trying for figure out how to cobble together Medicare coverage can be more difficult than explaining quantum theory. In an effort to attempt to explain the Medicare parts and pieces in a more familiar concept, we can think of assembling Medicare coverage much like building a railroad train.
Original Medicare Train Engine
When you become eligible for Medicare, you will enroll in Original Medicare Parts A and B. Part A is your hospital coverage and Part B is your outpatient coverage for things like doctor visits, labs, test, imaging, durable medical, etc. Original Medicare is the train engine. Original Medicare Parts A and B are your locomotive. You are the train engineer and it will never be taken away from you.
But Original Medicare is not a complete train. There is no prescription drug coverage and you can be exposed to significant medical costs because there is no maximum out-of-pocket cap on Original Medicare. Also, Medicare has no coverage for routine dental or vision services.
Coupling Train Cars To Your Medicare Locomotive
Fortunately, you can couple on a variety of different train cars onto your Medicare engine. First, you need a Prescription Drug Plan, also known as Part D. If you don’t enroll in a Part D prescription drug plan you may get hit with penalties later on when you do finally enroll. Regardless, there are many different Part D train cars to choose from. You can visit medicare.gov to find a list of drug plans available to you sorted by your prescription medications.
You can hook up your locomotive to the Part D plan of your choice. With just your Original Medicare engine and a Part D prescription drug plan, you have a short little train that covers the basics. If you want a longer train, you can get an individual dental or vision train car. Usually, the dental and vision plans will technically be two separate plans or cars. Like the Part D prescription drug plan, they travel with your train across the United States.
As I mentioned earlier, Original Medicare has some short comings. Part A and B have deductibles and coinsurance that can reoccur mercilessly throughout the year. There is no cap on Medicare’s out-of-pocket costs like our modern health insurance plans. To bridge those gaps there are Medicare Supplement plans, also referred to as Medi-Gap plans.
The Medicare Supplement plans are referred to by letters (A, G, F, K, M…) All of plans have the same supplemental basics as set forth by the federal government, except for a few odd states. You can enroll in a Medicare Supplement plan and add that car to your train. Just like the Part D plan and the dental or vision plans, you own the supplement train car and it follows you around behind your Medicare locomotive.
Original Medicare is a giant PPO plan that spans the United States. As long as provider (doctor, hospital, urgent care, etc.) accepts Medicare Assignment, you can receive health care services and it will be billed to Medicare. You can take a train ride to another state and be fully covered.
The federal government built a new train car, kind of a Pullman car, for your train. These train cars are called Medicare Advantage plans, also referred to as Part C. Medicare Advantage plans usually combine both health and prescription drug coverage so you don’t need the Part D Drug plan in your train. Medicare Advantage plans are a little different. All the claims for medical services are handled by the Medicare Advantage plan.
Medicare Advantage plans usually have networks and many are HMO plans so you have to have a Primary Care Physician to refer you to a specialist. The Medicare Advantage train car can be uncoupled from your train every year during the Annual Enrollment Period. If you don’t like that train car, you can go find another one. You can’t have a Medicare Advantage health plan car and a Medicare Supplement car on your train.
The common denominator of all the different cars is that you must have the Original Medicare engine of Parts A and B before you can couple them to your train.
To summarize, your first train option is Original Medicare, Part D prescription, and any dental and vision train cars.
The second option is Original Medicare, Supplement, Part D, and any dental and vision.
Your third train option is Original Medicare, Medicare Advantage, and any trailing dental or vision train cars.
The great thing about Medicare is that you can build your train the way you want. You can change the train cars every year. But the important aspect is that you own the Medicare engine. You are the engineer and you can build your train the way you want it.
Medicare Education Train_ing 2020 Video
To watch a presentation of this blog with real train whistle effects and videos of trains go to my YouTube video below.