If you qualify for Medicare, you should be aware of all of your Medicare options. Your situation and your location will completely affect which plan is right for you. Benzinga put together this guide to Mississippi Medicare insurance to help you navigate your options.
The Best Mississippi Medicare
What is Medicare?
Medicare is a federal health insurance program. You may qualify for Medicare if you:
- Are 65 or older
- Have a disability
- Need dialysis or a transplant due to end-stage renal disease
Once you determine that you are eligible for Medicare insurance, you should familiarize yourself with the 4 parts of Medicare:
- Part A covers your hospital insurance, including inpatient hospital stays, hospice care, care in a skilled nursing home and some home health care.
- Part B covers your medical insurance needs, including outpatient care, medical supplies, preventive care and other types of medical service.
- Part C involves Medicare Advantage plans. These plans bundle Part A and Part B coverage and are offered by private insurance companies.
Medicare Part D plans can be added as a supplement to your Medicare plan to cover your prescription drug needs.
Legalities of Medicare in Mississippi
Medicare is a health insurance program that is offered and regulated by the federal government. Original Medicare coverage means you can typically visit any doctor you would like as long as they accept Medicare insurance plans.
Medicare Advantage plans are not regulated by the federal government. These plans are offered by private insurance companies that have been approved by Medicare. Many of these companies offer non-Medicare types of health insurance as well. The providers and plans vary by state and even by county.
Medicare Advantage providers can restrict a number of your plan’s factors. Most plans have a network of doctors and hospitals and they can restrict your coverage to only apply to their in-network members. Some Medicare Advantage plans may also require you to receive a referral from your primary care doctor if you want to have a specialist visit covered by your plan. When it comes to your prescription drug coverage, your Medicare Advantage provider can have a say in that as well. Some plans may only cover generic drugs. In some cases, insurance providers will extend coverage to brand-name drug treatments if the generic drug option did not work for you.
You should also be aware that you cannot carry a Medicare Supplemental Insurance plan with a Medicare Advantage plan. Medicare Supplemental Insurance plans are also known as Medigap insurance. Like Medicare Advantage, these plans are offered by private insurance companies. Medigap plans are designed to give you coverage when there are gaps in your Medicare coverage.
Types of Medicare Advantage Plans
Each insurance provider you encounter will likely offer a few different Medicare Advantage plan options. Here are some of the most common types that you should know about:
Health Maintenance Organization (HMO)
Health maintenance organization (HMO) plans offer combined coverage for Part A and Part B Medicare insurance. It also includes Part D coverage as well as vision, dental and hearing coverage.
Your coverage will only be extended to doctors and hospitals that are within your provider’s network if you select an HMO plan. The only exception to this rule is if you have an emergency situation and need to visit an out-of-network doctor or hospital. Your HMO plan provider may also require a referral from your primary care doctor before it extends coverage to a specialist visit.
Preferred Provider Organization (PPO)
A preferred provider organization (PPO) plan also offers combined coverage for Medicare Part A and Part B. It usually also includes prescription drug coverage as well as vision, dental and hearing coverage.
PPO plans also have a network of service providers, but it operates a little different than HMO plans. You can visit a doctor or hospital outside of your plan’s network with a PPO. However, you will likely have to pay more for your service if you visit an out-of-network provider. These plans usually do not require referrals to cover a specialist visit.
Here are a few health insurance terms you should become familiar with:
Deductible: Your health insurance plan will have a deductible attached to it. Your deductible is the amount you will have to pay out-of-pocket for your medical services until your insurance coverage kicks in. Once you’ve met your deductible, you will move on to only being responsible for your coinsurance or copays.
Coinsurance: This is the portion of your bills you are responsible for after you’ve met your deductible. Your coinsurance is a percentage of each medical bill you receive. You pay the coinsurance amount directly to your service provider. Your insurance provider then pays the remaining percentage to the service provider.
Copay: Similar to coinsurance, your copay is the amount of each bill you will be responsible for paying directly to your service provider. Copays are a set dollar amount that you are responsible for paying. This means that you will pay the same amount no matter how expensive the total bill is. After you’ve met your deductible, your insurance provider will pay the remainder of your bill directly to your service provider.
How to Sign Up for Medicare in Mississippi
There are a few ways you can sign up for Original Medicare coverage. You can:
- Enroll online.
- Call Social Security at 800-772-1213 on weekdays from 7 a.m. to 7 p.m.
- Visit a local Social Security office
Here’s what you can do to explore Medicare Advantage plans available in your area:
- Plans vary by state and even by county, so be sure that each plan you consider is available in your ZIP code.
- Visit the insurance provider’s website. Many providers will allow you to enroll in a Medicare Advantage plan online. If you’re unable to enroll online, you can also contact the company to request a paper enrollment form.
- Enroll in Medicare Advantage plans by calling 1-800-MEDICARE (1-800-633-4227).
Average Cost of Medicare Advantage Plans in Mississippi
The cost of Medicare Advantage plans can vary widely because the insurance companies set the premiums — it also depends on the amount of coverage you want. Be sure to compare the coverage (as well as the costs) to identify the right plan for you.
Best Medicare Insurance Providers in Mississippi
Familiarize yourself with the insurance providers that are available in your area. Remember, not every plan and provider listed is available in every area of Mississippi. Here are some of our favorite Mississippi Medicare providers.
1. Best Overall in Mississippi: WellCare
WellCare offers all of the benefits you would want to see in your Medicare plan. It’s well known for its accessibility and customer service to help with the appeals process. WellCare can offer you plans with $0 deductibles and $0 premiums on your coverage in Mississippi.
Some plans even offer $0 copays when you visit primary doctors’ offices. WellCare can also offer you coverage for vision, hearing, dental and worldwide emergency services.
2. Most Affordable in Mississippi: AllWell
AllWell offers some of the most affordable Medicare Advantage plans you can get in Mississippi. It can offer $0 premiums and deductibles so you can start taking advantage of your coverage as soon as it begins.
It also offers drug deductibles as low as $300. AllWell offers coverage for vision, dental and hearing and emergency response devices. You can also benefit from copays as low as $0 with some AllWell plans.
3. Best for Telehealth Benefits: Humana
Humana is an insurance provider that has offered Medicare Advantage plans for as long as the program has been around. Humana has built up a strong network of doctors and hospitals to help its members. Humana also offers the benefit of telehealth access with some of its Medicare Advantage plans.
Telehealth is a great resource to help you with minor illnesses and injuries. Instead of visiting your doctor or urgent care in person, speak with a board-certified doctor with a secure video or phone appointment. This service is available 24/7 to Humana members.
4. Best for Dual Eligibility: Cigna
Cigna is another insurance provider that has been in business for a long time. It offers several Medicare Advantage plan options, including vision, hearing and dental benefits.
Cigna also offers Medicare Advantage plans with copays as low as $0 for both primary doctor and specialist visits. Cigna may be a good option for you if you’re eligible for Medicaid and Medicare. This provider may be able to offer you a plan that can lower your out-of-pocket costs.
5. Best for Medical Savings Accounts: Lasso Healthcare
Some Medicare Advantage plans offer medical savings accounts to help you manage your health care costs. These plans can combine a high-deductible insurance plan with your medical savings account. You can use your medical savings account to pay for your health care services until you meet your deductible.
Once you’ve met the deductible, your insurance provider will pay for your coverage as needed. Lasso Healthcare offers this option to allow you to receive the benefits of a high-deductible insurance plan without worrying about the higher out-of-pocket costs.
Which Medicare Plan is Right for You?
When it comes down to it, the right Medicare plan for you is the one that allows you to receive the best coverage possible. To make sure you’re getting the right plan for you, there are a few things you should consider:
- Are your preferred doctors and hospitals within your plan’s network?
- Will your Medicare plan cover the prescription drugs that you take regularly?
- Do you need to receive a referral before your insurance will cover a specialist visit?
Once you have answers to these questions, you should compare insurance plans. You’ll probably want to select a plan that has low copays or coinsurance if you visit the doctor often. You may want to be more careful when you select a plan that has fewer drug coverage restrictions if you have specific drug coverage needs.
At the end of the day, the right plan is the one that works for you. Don’t be afraid to ask a lot of questions before you choose your insurance provider.
Frequently Asked Questions
What are the different parts of Medicare?
Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
Is Medicare free?
Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
Do I need to sign up for Medicare?
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.