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Medicare Plans in New Hampshire – Coverage and Benefits

Are you a New Hampshire resident who is currently enrolled or will soon enroll in the federal Medicare program? If so, then there is some essential information that you need to know about the benefits package. For starters, once you officially qualify for Medicare, you will start receiving benefits from Parts A and B of Original Medicare. The helpful chart below outlines what sort of benefits you can expect from each part.

You should also have a good idea of what your financial responsibility will be once you successfully enroll. Every beneficiary will have to pay an annual deductible and monthly premium in order to receive Part B benefits (the total cost of which can be found on this website). Unfortunately, some seniors may also be required to pay for Part A as well. If you have a short employment history of fewer than 40 quarters (or 10 years), there is a required premium that you must pay before you are allowed to receive any medical benefits from part A.

Medicare Part A (Hospital Coverage)

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
Medicare Part B (Medical Insurance)

  • Services from doctors and health providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services
Medicare Part C (Medicare Advantage)

  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • Run by Medicare-approved private insurance companies
  • May include extra benefits and services for an extra cost
Medicare Part D (Drug Coverage)

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies
  • May help lower your prescription drug costs and help protect against higher costs in the future

Medicare Plans in New Hampshire: Who Has What

More than a quarter million people in New Hampshire (231,444 residents) have successfully enrolled in the Medicare program. Of those, only 6% (or 13,866 people) have decided to purchase a Medicare Advantage insurance policy. And additional 65,632 beneficiaries (or 28%) prefer to supplement their benefits with a Medigap insurance policy. Which leaves a staggering two-thirds of all Medicare beneficiaries either getting supplemental coverage from some sort of employer-sponsored program, or with no protection at all from potentially expensive Medicare coverage gaps.

Remember, you have to be enrolled in Medicare and actively receiving benefits before you can start to look for a comprehensive Medicare supplement. Click the link above for important information about when and how to enroll.

Do New Hampshire Residents Need to Purchase a Medicare Supplement?

Technically speaking, there is no legal requirement that you purchase supplemental coverage in order to receive your Original Medicare benefits. However, it isn’t a bad idea. With the rising cost of health care, spending a little bit of money on a supplemental policy now can save you thousands of dollars in out-of-pocket medical expenses later on down the road. The chart illustrates the potential bills you might be required to pay due to gaps in Medicare coverage:

Medicare Part A Costs Medicare Part B Costs
  • $1,184 (as of 2014) Part A Annual Deductible for access to Basic Hospital Services
  • $296/day for an Inpatient hospital Stay between 61-90 days long
  • $147 Annual Deductible (as of 2014) for basic Part B Medical Coverage
  • 80/20 Coinsurance costs for all Medicare coverage; Medicare pays 80%, you pay 20% Out-of-Pocket

Choosing a Medigap Supplement Policy in New Hampshire

Fortunately, there are ways to protect yourself and your life savings from unexpected medical bills. The first is a form of supplement insurance called Medigap, and the other is through a Medicare Advantage policy. Don’t worry; we’ll go over each form of coverage in detail so that you can best decide which is right for you.

Private insurance companies and the federal government have teamed up to tailor a series of supplemental insurance policies to the needs of seniors who wish to protect themselves from notorious Medicare coverage gaps. These policies do not replace your Medicare benefits, but act as a separate form of health insurance which covers the expenses which Traditional Medicare does not. There are 10 plans: A-D, F, G, and K-N. Each plan is the same across all 50 states, which means that you only have to worry about finding the right company and an affordably-priced policy.

For more details on each plan, review this helpful table:

[chart category=”supplement” name=”planTypes” state=”NH” zipcode=”03103″]

Medicare Advantage Plans in New Hampshire

Medicare Advantage is another popular way to supplement your Medicare benefits in a way that protects you from expensive coverage gaps. Unlike Medigap insurance, Medicare Advantage actively replaces your federal benefits with a private insurance policy which is legally required to deliver “equal or greater” coverage. For a slight additional cost, you may even be able to add extra benefits – such as prescription drugs or vision care – to the same policy.

While some clients prefer Medicare Advantage due to its simplicity, there are certain risks associated with switching from government-guaranteed health insurance to coverage from a private institution. There is the obvious volatility of the health care market, which private companies are more vulnerable to than government. There is also the provider network to consider. Many different companies like to keep costs low by restricting their network of doctors and hospitals. For you, this could mean that you will have to switch doctors in order to receive your Advantage policy benefits.

The networks which Medicare Advantage plans usually work through are referred to as Preferred Provider Organizations (PPOs) or Health Maintenance Organizations (HMOs). If you require medical care from a doctor or facility outside of your HMO or PPO network, it will likely end up costing a lot of money.

[chart category=”advantage” name=”topHMOPlans” zipcode=”03103″ state=”NH”]

[chart category=”advantage” name=”topPPOPlans” zipcode=”03103″ state=”NH”]

Medigap and Medicare Advantage in New Hampshire: What’s the Difference?

To get a good idea of what each form of coverage has to offer you, it’s a good idea to compare the two side-by-side. Out chart below does just that, by asking some of the most common questions people have about Medicare Advantage and Medigap policies:

Questions Medicare Advantage Medicare Supplement
How are the plans funded? Medicare will pay your insurance company a fixed amount based on average healthcare costs for your region. You may also be required to pay a premium based on your location and insurance company. Your monthly premium takes care of the majority of your expenses.
Do I continue paying for Part B? Yes Yes
What does it cost me? Some plans offer a zero-dollar premium (because the government subsidy covers the full cost). Other plans may cost up to 0-0 monthly. While each plan does require a monthly premium, many of them are affordably priced.
What does the plan cover? Depending on your plan, it will cover at least the same benefits offered by Medicare parts A & B. Possibly other benefits; but the more benefits you sign up for, the higher your out-of-pocket expenses may be. All eligible expenses are split between Medicare, and your Medicare Supplement plan. If you have a comprehensive plan, such as Plan F, 100% of eligible expenses not covered by Medicare will be covered by your supplement insurance.
Can I budget my health care expenses? It’s challenging; the more often you require medical care, the more often you may be required to pay out-of-pocket. Budgeting is much easier with a Medicare supplement. You have fewer out-of-pocket expenses, and one simple monthly premium.
Can my plan be cancelled? Yes. Unfortunately, your health insurance company has the legal right to review their Medicare Advantage services annually and decide whether or not they wish to continue providing coverage. No – not unless you fail to pay your monthly premium, or your insurance company goes bankrupt. Only under such extenuating circumstances could your plan be cancelled.
Are pre-approvals or pre-certifications required? Unfortunately, yes. These Plans usually require pre-certification or other qualification for some specific types of care. No pre-approvals are required. If you qualify for Medicare, you will qualify for a Medicare supplement plan.
Can I use any doctor or hospital? Usually, you choose from a network of pre-approved providers. These networks can fluctuate over time. Yes. You are free to choose any doctor and/or hospital in the U.S. which accepts Medicare.
Can drug, vision, or dental coverage be included in the policy? Yes. No. These forms of coverage must be purchased separately.
Who is this plan type generally best suited for? If you are relatively young, healthy, live in an urban area, and have a limited income, a Medicare Advantage plan could work for you. If you live in a rural area without easy access to provider networks, if you like to budget your finances, or if you want comprehensive coverage, you might prefer a Medicare supplement plan.

Helpful Medicare Resources in New Hampshire

Any further questions you have should be directed to your local Medicare experts. Feel free to use the directory on this page to get access to some valuable contact information. The employees at the offices listed in our directory are here to help you make the most informed decision possible about your health care needs.

[chart category=”general” name=”usefulContacts”]

Important Medicare-Related Healthcare Terms

  • HMO: Health Maintenance Organization, this refers to a network of doctors and hospitals with a plans’ network.
  • PPO: Preferred Provider Organization, this refers to a network of doctors and hospitals with a plans’ network.
  • Co-Pay: Amount of money charged per visit to doctor, specialist, etc.
  • Co-Insurance: A percentage required by the policyholder to pay out-of-pocket. For example, 80/20 coinsurance means the insurance company will cover 80% of the charges, and the policyholder pays the remaining 20% of the charges.
  • Deductible: This is the amount of money required out-of-pocket by the policyholder before the insurance will kick-in and pay for any remaining charges. For example, a policy with a $1,000 deductible means that you must pay full healthcare costs out-of-pocket up to $1,000 before the plan will start coverage.

Compare Medigap Plans Online

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