Medicare Plan Options
Once you’re ready to enroll in Medicare, you have several options for customizing your coverage. Original Medicare is the same for everyone and has basic coverage that may be a good fit if you have limited health needs. For those seeking more robust coverage, private health insurance companies sell plans that add to Original Medicare’s coverage and benefits. Currently, Alaska’s Medicare Advantage program doesn’t have any plans.
Original Medicare is the basic health insurance coverage that’s administered by the Centers for Medicare & Medicaid Services. You qualify for this program if you’re at least 65 years old and a U.S. citizen or a permanent legal U.S. resident. This program features two parts. Part A covers inpatient care in a hospital or nursing home, hospice, and some home health care services. Part B covers medically necessary services, preventative and routine services, durable medical equipment, and mental health services. You can go to any health care provider that accepts Medicare, and you usually don’t need a referral to see a specialist.
Medicare Advantage Plans
Medicare Advantage Plans, also known as Part C, are sold by private health insurance companies and provide the same benefits as Parts A and B. These plans also usually include prescription drug coverage, and many plans have additional benefits, such as vision and dental coverage, homemaker services, and assisted living. Unlike Original Medicare, most Medicare Advantage Plans have out-of-pocket limits, which can help you control and plan for medical costs. All enrollees pay the Part B premium and depending on your plan, you may have an additional premium that you pay separately. Rules regarding choosing a doctor, seeing in-network providers, and getting referrals to see specialists vary based on your plan.
Medicare Prescription Drug Coverage Plans
Medicare prescription drug coverage, or Part D, covers the cost of medications your doctor prescribes. All plans cover a range of prescription drugs that people with Medicare are likely to take, including medications in certain protected classes, such as drugs to treat cancer. Most drug plans have formularies, which are lists of medications the plan covers. Medications are divided into tiers that determine how much the insurance policy pays out for a drug and how much you pay towards the cost. Out-of-pocket fees, such as premiums, annual deductibles, and copays, and coinsurance, vary depending on the plan you choose.
Medicare Supplement Insurance Plans
Medicare Supplement Insurance Plans, also called Medigap plans, help cover some of the costs that Original Medicare doesn’t cover, such as copays, coinsurance, and deductibles. Some Medigap plans also cover emergency medical care you get when traveling outside of the United States. There are 10 Medigap plans, and benefits are standardized, meaning every plan type has the same benefits, regardless of the company you buy it from. Any standardized Medigap plan is guaranteed renewable, meaning that as long as you pay your premium, the insurance company can’t cancel the plan, even if your health needs change.
Medicare in Alaska by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|103,801||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in Alaska
Medicare is a complex program that’s designed to meet a wide array of health needs and budgets, and navigating this system can be a challenge. To help you sign up for the right program for your needs, the state has legal professionals and trained volunteers who can help you evaluate your needs and budget. The following agencies can also help you resolve issues related to your coverage, such as Medicare fraud or waste, denied claims, and canceled policies.
Alaska State Health Insurance Assistance Program
The Alaska State Health Insurance Assistance Program is a free statewide program that provides unbiased, confidential health insurance options counseling for Medicare beneficiaries. It’s staffed primarily by volunteers who are trained to answer questions regarding Original Medicare’s scope of coverage, prescription drug plans, and cost-saving programs. Counselors can also help you compare available Medigap and Medicare Advantage Plans, so you can sign up for one that best fits your needs and budget.
Contact Information: Website | 800-478-9996
Alaska Division of Insurance
Through the Alaska Division of Insurance, you can get tips on choosing a health plan, estimating health care costs, and enrolling in Medicare. The division houses the Alaska Medicare Information Office, which provides comprehensive information on available Medigap plans sold in the state and the insurers that sell these plans. You can also request an external review of health insurance determination through this division if you believe that a claim wasn’t handled properly.
Contact Information: Website | 800-467-8725
Alaska Legal Services
Alaska Legal Services is a nonprofit legal agency that provides advocacy, information, and representation for state residents aged 60 and over. Its legal professionals can help you obtain public benefits, such as Medicare and income-based savings programs, to lower health care expenses. They can also help you resolve issues related to your health coverage, including denied claims, unfair practices, canceled policies, or billing errors.
Contact Information: Website | 907-272-9431
Aging & Disability Resource Center
The Aging & Disability Resource Center is a statewide program that helps you connect with programs and services for seniors. Through your local ADRC, you can connect with a SHIP counselor for free, unbiased health insurance options counseling. SHIP counselors can help you assess your current and future health needs, available Medigap and Medicare Advantage Plans, and Original Medicare’s scope of coverage to enable you to make educated decisions regarding your coverage.
Contact Information: Website | 907-343-7770
Learn More From Our Sources
- CMS | Medicare Program – General Information | Last accessed June 2021
- Medicare | Medicare Advantage Plans | Last accessed June 2021
- Medicare | What Medicare Part D drug plans cover | Last accessed June 2021
- Medicare | How to compare Medigap policies | Last accessed June 2021
- Alaska Department of Health and Social Services | Last accessed June 2021
- Department of Commerce, Community and Economic Development | Division of Insurance | Last accessed June 2021
- Alaska Law Help | Medicare, Medicaid & Other Health Issues | Last accessed June 2021
- Municipality of Anchorage | Aging & Disability Resource Center | Last accessed June 2021