Medicare Health Plans
Overview
Medicare Supplement and Medicare Advantage Plans for RVers and Nomads
Medicare Plan options For Nomads
There are 2 main ways to get your Medicare coverage—Original Medicare (Part A and Part B) and Medicare Advantage. Continue reading to learn more.
When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. We will help you choose the best option to maximize freedom, flexibility, and peace of mind so you can live the way you want without constantly thinking about wether your insurance covers certain situations or locations.
What is Original Medicare?
Original Medicare is one of your Medicare health coverage choices. You’ll have Original Medicare unless you choose a Medicare Advantage Plan or other type of Medicare health plan.
You generally have to pay a portion of the cost for each service Original Medicare covers. There’s no limit to what you’ll pay out of pocket in a year unless you have other insurance (like Medigap, Medicaid, or employee or union coverage).
Can I get my health care from any doctor, other health care provider, or hospital?
In most cases, yes. You can go to any Medicare-participating doctor, other health care provider, hospital, or other facility that accepts Medicare patients. Visit Medicare.gov to find and compare providers, hospitals, and facilities in your area.
Does it cover prescription drugs?
No, with a few exceptions, Original Medicare doesn’t cover most drugs. You can add drug coverage by joining a Medicare drug plan (Part D).
Do I need to choose a primary care doctor?
No
Do I have to get a referral to see a specialist?
In most cases, no, but the specialist must be enrolled in Medicare.
Should I get a Medicare Supplement (Medigap) policy?
You may already have Medicaid, military, or employer or union coverage that may pay costs that Original Medicare doesn’t. If not, you may want to buy a Medicare Supplement Insurance (Medigap) policy if you’re eligible.
How does Medigap work?
Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. Medicare Supplement Insurance (Medigap) policies sold by private companies, can help pay some of the remaining health care costs for covered services and supplies, like copayments, coinsurance, and deductibles.
Medigap policies cover the following out-of-pocket costs for people with Original Medicare:
- coinsurance
- copayments
- deductibles
Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. Generally, Medigap doesn’t cover long-term care (like care in a nursing home), vision or dental care, hearing aids, eyeglasses, or private-duty nursing.
IMPORTANT
Medigap plans sold to people who are new to Medicare aren’t allowed to cover the Part B deductible. Because of this, Plans C and F aren’t available to people who were newly eligible for Medicare on or after January 1, 2020. If you already have or were covered by Plan C or F (or the Plan F high deductible version) before January 1, 2020, you can keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these policies.
What are Medicare Advantage Plans?
A Medicare Advantage Plan is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D).
In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans, like our Medicare Advantage PPO plan, have a nationwide network you can access and/or offer out-of-network coverage. Other Medicare Advantage plans like the Medical Savings Account plans that we recommend for RVers allow you to see ANY Medicare-participating provider in the USA!
Remember, you must use the card from your Medicare Advantage plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. If you join a Medicare Advantage plan, you’ll still have Medicare but you’ll get most of your Part A and Part B coverage from your Medicare Advantage plan, not Original Medicare.
What are the different types of Medicare Advantage Plans?
- Health Maintenance Organization (HMO) – Limited and local networks only
- HMO Point-of-Service (HMO POS) – Limited networks only
- (Nomad-Friendly / WE OFFER) Medical Savings Account (MSA) plan – Maximum freedom and flexibility to see any Medicare doctor
- (Nomad-Friendly / WE OFFER) Preferred Provider Organization (PPO) plan – In and out of network coverage, some have national network
- Private Fee-for-Service (PFFS) plan – No networks but provider must be willing to accept plan terms
- Special Needs Plan (SNP) – Limited and local networks and for qualifying medical conditoins only
What do Medicare Advantage Plans cover?
Medicare Advantage Plans cover almost all Medicare Part A and Part B benefits. Plans must cover all emergency and urgent care, and almost all medically necessary services Original Medicare covers. However, if you’re in a Medicare Advantage Plan, Original Medicare will still cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies.
Our Medicare Advantage PPO plan also includes coverage for Part D prescriptions, dental, vision, hearing and more.
We here at Nomad Insurance Group recommend only two types of Medicare Advantage plans for RVers and nomads: Medical Savings Account (MSA) and Medicare Advantage PPO (with national network, NOT regional!). The MSA plan is the most ideal for RVers because:
No Premium
No Networks
No Copays
No Referrals
No Prior Authorizations
No Health Questions
Comparison between Original Medicare and Medicare Advantage
When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get Medicare as outlined below:
Original Medicare
Medicare Advantage
OVERVIEW
- Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
- If you want drug coverage, you can join a separate Medicare drug plan (Part D).
- To help pay your out-of-pocket costs in Original Medicare (like your 20% coinsurance), you can also shop for and buy supplemental coverage.
- Can use any doctor or hospital that takes Medicare, anywhere in the U.S
- Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
- Plans may have lower out-of-pocket costs than Original Medicare.
- In many cases, you’ll need to use doctors who are in the plan’s network.
- Most plans offer extra benefits that Original Medicare doesn’t cover—like vision, hearing, dental, and more
Part A
Yes
Yes
Part B
Yes
Yes
Part D
Optional
Yes - in most plans
Extras
No
Yes
Medigap
Optional
Doesn't apply
Original Medicare
Medicare Advantage
Doctor& Hospital choice
You can go to any doctor or hospital that takes Medicare, anywhere in the U.S.
In most cases, you don’t need a referral to see a specialist.
In many cases, you’ll need to use doctors and other providers who are in the plan’s network and service area for the lowest costs. Some plans won’t cover services from providers outside the plan’s network and service area. This is not the case with our MSA and PPO plans.
You may need to get a referral to see a specialist. This is not the case with our MSA and PPO plans.
Cost
For Part B-covered services, you usually pay 20% of the Medicare-approved amount after you meet your deductible. This is called your coinsurance.
You pay a premium (monthly payment) for Part B. If you choose to join a Medicare drug plan (Part D), you’ll pay that premium separately.
There’s no yearly limit on what you pay out of pocket, unless you have supplemental coverage—like Medicare Supplement Insurance (Medigap).
You can get Medigap to help pay your remaining out-of-pocket costs (like your 20% coinsurance). Or, you can use coverage from a former employer or union, or Medicaid.
Out-of-pocket costs vary—plans may have lower out-of-pocket costs for certain services.
You may pay the plan’s premium in addition to the monthly Part B premium. (Most plans include drug coverage (Part D).) Plans may have a $0 premium or may help pay all or part of your Part B premiums
Plans have a yearly limit on what you pay out of pocket for services Medicare Part A and Part B covers. Once you reach your plan’s limit, you’ll pay nothing for services Part A and Part B covers for the rest of the year.
You can’t buy and don’t need Medigap.
Coverage
Original Medicare covers most medically necessary services and supplies in hospitals, doctors’ offices, and other health care settings. Original Medicare doesn’t cover some benefits like eye exams, most dental care, and routine exams.
You can join a separate Medicare drug plan (Part D) to get drug coverage.
In most cases, you don’t have to get a service or supply approved ahead of time for Original Medicare to cover it.
Plans must cover all of the medically necessary services that Original Medicare covers. Most plans offer extra benefits that Original Medicare doesn’t cover—like some vision, hearing, dental, routine exams, and more. Plans can now cover more of these benefis.
Drug coverage (Part D) is included inmost plans. In most types of Medicare Advantage Plans, you don’t need to join a separate Medicare drug plan.
In some cases, you have to get a service or supply approved ahead of time for the plan to cover it.
Travel
Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy a Medicare Supplement Insurance (Medigap) policy that covers care outside the U.S.
All Medigap plans cover you nationwide when traveling in the U.S.
Medicare Advantage plans generally don’t cover care outside the U.S.
Medicare Advantage plans also limit your coverage when traveling outside of your plan’s service area unless you have a Medical Savings Account (MSA) plan or a Medicare Advantage PPO plan like what we offer.
What does Part A cover?
Part A (Hospital Insurance) helps cover:
- Inpatient care in a hospital
- Inpatient care in a skilled nursing facility (not custodial or long-term care)
- Hospice care
- Home health care
- Inpatient care in a religious non-medical health care institution
What do I pay for services Part A covers?
Copayments, coinsurance, or deductibles may apply for each service listed on the following pages. Visit Medicare.gov later this fall to find out how much you’ll pay in 2021.
If you’re in a Medicare Advantage Plan or have other insurance (like Medigap, Medicaid, or employer or union coverage), your copayments, coinsurance, or deductibles may be different.
Part A-covered services
- Blood
- Home health services
- Hospice care
- Inpatient hospital care
- Religious non-medical health care institution (inpatient care)
- Skilled nursing facility care
What does Part B cover?
Medicare Part B (Medical Insurance) helps cover medically necessary doctor’s services, outpatient care, home health services, durable medical equipment, mental health services, and other medical services. Part B also covers many preventive services. See pages 30–51 of the Medicare & You booklet for a list of common Part B-covered services and general descriptions. Medicare may cover some services and tests more often than the timeframes listed if needed to diagnose or treat a condition.
Medicare Part B – covered services
- Abdominal Aortic Aneurysm Screening
- Ambulance Services
- Blood
- Bone Mass Measurement (Bone Density)
- Cardiac Rehabilitation
- Cardiovascular Screenings
- Chiropractic Services (limited)
- Clinical Laboratory Services
- Clinical Research Studies
- Colorectal Cancer Screenings
- Defibrillator (Implantable Automatic)
- Diabetes Screenings
- Diabetes Self-Management Training
- Diabetes Supplies
- Doctor Services
- Durable Medical Equipment (like walkers)
- EKG Screening
- Emergency Department Services
- Eyeglasses (limited)
- Federally-Qualified Health Center Services
- Flu shots
- Foot Exams and Treatment (Diabetes-related)
- Glaucoma Tests
- Hearing and Balance Exams
- Hepatitis B Shots
- HIV Screening
- Home Health Services
- Kidney Dialysis Services and Supplies
- Kidney Disease Education Services
- Mammograms (screening)
- Medical Nutrition Therapy Services
- Mental Health Care (outpatient)
- Non-doctor Services
- Occupational Therapy
- Outpatient Medical and Surgical Services and Supplies
- Pap Tests and Pelvic Exams (includes clinical breast exam)
- Physical Exams
- Physical Therapy
- Pneumococcal Shot
- Prescription Drugs (limited)
- Prostate Cancer Screenings
- Prosthetic/Orthotic Items
- Pulmonary Rehabilitation
- Rural Health Clinic Services
- Second Surgical Opinions
- Smoking Cessation (counseling to stop smoking)
- Speech-Language Pathology Services
- Surgical Dressing Services
- Telehealth
- Tests (other than lab tests)
- Transplants and Immunosuppressive Drugs
How does Medicare drug coverage (Part D) work?
Medicare drug coverage helps pay for prescription drugs you need. Even if you don’t take prescription drugs now, you should consider getting Medicare drug coverage. Medicare drug coverage is optional and is offered to everyone with Medicare. If you decide not to get it when you’re first eligible, and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty (1% for every month you did not have coverage) for as long as you have Medicare drug coverage. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered.
There are 2 ways to get Medicare drug coverage:
- Medicare Part D drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee-for-Service plans, and Medical Savings Account plans. You must have Part A and/or Part B to join a separateMedicare drug plan.
- Medicare Advantage Plans or other Medicare health plans with drug coverage. You get all of your Part A, Part B, and drug coverage, through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.
INSIDER TIP >> Keep your Medicare health plan and drug plan separate. This way you can annually shop for and change to a drug plan that covers your specific medications without having to change your health plan.
Hospital Insurance Coverage
- Inpatient care in a hospital
- Skilled nursing facility care
- Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
- Hospice care
- Home health care
Learn More >
Medical Insurance Coverage
- Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
- Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
Learn More >
Medicare Advantage Coverage
- A Medicare Advantage Plan is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
- Most include Medicare prescription drug coverage (Part D).