“Why should I buy a private health plan?” I get this question a lot. Why pay extra for additional health coverage when you get Medicare coverage from the government? It’s true you get Medicare coverage from the government, called Original Medicare. But that’s the most basic coverage you can get. Think of Original Medicare as a one-size-fits-all T-shirt. When it comes to your health, a one-size-fits-all solution may not be the best option. It’s important to get the health coverage that fits your health and lifestyle.
Private Medicare health plans – like Medicare Advantage plans – often go beyond the basics offered by Original Medicare. Here’s what I tell people who are on the fence about buying a private plan.
1. Coverage for more services
There are a handful of services Original Medicare doesn’t cover that most private health plans do, including:
- Most dental care
- Most prescriptions
- Routine eye and hearing exams
- Services outside the U.S.
If you were to use these services with Original Medicare alone, you’d end up paying the whole bill. With a private plan, you’ll likely pay a much smaller copay or coinsurance. That could mean the difference between $200 and $20.
2. A limit on how much you spend
With most private plans, you have what’s called an out-of-pocket maximum. This is the most you’ll pay out of your pocket throughout your plan year.
Here’s how it works. If your plan’s out-of-pocket maximum is $4,000, the most you’ll spend in one plan year is $4,000. If you go over that, your plan picks up the tab. Original Medicare doesn’t have a spending limit. Yikes! That can get expensive.
3. Extra perks
Most private health plans offer extra perks. These can include travel coverage, fitness discounts and programs to keep you healthy.
4. Personal support
This is a biggie. I can’t stress enough the value of personal support. Most private health plans have a team of experts you can call with questions about your health or plan benefits.
Share this article with friends and family who are considering buying a private health plan.
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