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Medicare Scenarios

Medicare Supplement Insurance Plan

Paul will be 65 soon. He likes to run and swim. He’s kept himself in great health. He’s never had a major illness or even broken a bone. Paul knows that streak is unlikely to continue as he gets older. Paul wants to be protected, just in case.

Paul knows that he needs to sign up for Medicare Parts A and B as soon as he’s 65. He also knows there are some costs that Medicare doesn’t cover if he gets sick. Paul’s going to make sure that he’ll be covered for those costs with a Medicare Supplement Insurance Plan.

Medicare Prescription Drug Plan

Deborah is 65 and planning to retire soon. She and her partner worked hard and planned well for their future. They want to travel the world in their retirement. Deborah takes a few prescription drugs and has been admitted to the hospital a couple times over the last few years. She really likes her doctor and wants to keep going to her.

Deborah’s going to get a Medicare Supplement Insurance Plan and a Prescription Drug Plan (PDP). A Medicare Supplement Insurance Plan will take care of the costs that Medicare doesn’t pay and allow her to continue seeing her doctor. She’ll also be covered if she gets sick while traveling. With a PDP, she’ll get discounts on her prescription drugs and be confident if she needs another medication in the future.

Medicare Advantage Plan

Rachel is 68 years old. When she turned 65, she was in great health but still decided on a prescription drug plan just to be prepared. That worked well for a while. However, within the last year she has been diagnosed with osteoporosis and depression. Now she takes prescription drugs for both conditions. Since her health has changed, she’s thinking about changing her coverage.

Rachel’s been reading a lot about other plans and what they offer. She thinks a Medicare Advantage Plan is her best option. With this plan she’ll be covered for medical costs and prescription drugs. It also includes a fitness program that’ll help with both of her medical conditions. Plus, her doctor and a nearby hospital are already in the plan’s network.

Medicare Advantage Special Needs Plan

Kash is turning 65 next month. In his career as a rodeo clown, he took a few tumbles. He’s had a handful of surgeries and takes a lot of medications. Sometimes he can’t afford to go to the pharmacy, even though he qualifies for Medicaid. Now, at 65, Kash needs help managing his health. He’d like to lose some weight to ease the pain on his back and knees.

Kash’s choice is a Medicare Advantage Special Needs Plan. With this option, he can get Medicare benefits and prescription drug coverage from one plan. He’ll also have access to a care manager who can work with him on a program for a healthier lifestyle. And he can get information about financial assistance for Medicare costs, including discounts on prescription drugs.

Undecided Between Medicare Part A and Medicare Part B

Chris just turned 65. He’s lived by the motto ‘Live fast, die young and leave a good-looking corpse’, so he’s sort of surprised he made it this long. He’s still working and plans to defer Medicare Part B until he retires since his employer health plan offers good coverage. He’s relatively healthy but takes a medication to keep his blood pressure in check. It was high and he didn’t even know it until recently.

Since Chris is still covered by his group plan, he doesn’t need to decide about Medicare coverage yet. But he still signed up for Medicare Part A to cover the Medicare-eligible hospital costs that his employer insurance doesn’t. Once Chris retires, he’ll have 8 months to sign up for Medicare Part B without penalty. Then he can re-evaluate where he is and which plan works best for him.

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Last Updated: March 23, 2022