What Do You Need to Know About Medicare in Starting a Business?

Hi. I’m Connie. As a serial “Grandmapreneur®”, I speak to retirees or soon-to-be retirees on the benefits of pursuing entrepreneurship in retirement. This blog post will help entrepreneurs understand Medicare, which you will need as you consider starting a business.

Business Owners and Medicare

People in their 50s and 60s (even those planning for retirement) own a lot of small businesses. According to the US Census Bureau, more than half of small business owners are 55 years old.

It means that millions of small business owners― Baby Boomers and Genxers― are now bombarded with emails and ads about Medicare plans.

So, if you’re a current business owner or an aspiring one― and whether you’re near 65 (the qualifying age), now’s the time to think about Medicare. The choice you make can cost or save thousands, if not tens of thousands, of dollars.

What Is Medicare?

Medicare refers to a medical program made by the government to provide basic healthcare coverage. Here are the three different types of Original Medicare:

• • Part A

This covers expensive stuff, including surgery, hospital bills, nursing facility care, and the like.

• • Part B

Medicare Part B covers preventive care, outpatient care, consultations, lab tests, and so on.

• • Part D

This covers prescription costs, including medicine, shots, and vaccines.

Medigap or Supplement Insurance

Unfortunately, Medicare doesn’t cover all the costs. You still have to pay about 80% of your healthcare expenses. Plus, you have to pay a premium for Part B and choose to pay extra for Part D.

Hence, you still have to pay expenses and gap in your Original Medicare coverage. To remedy this, you can buy a supplemental plan. Doing so decreases your out-of-pocket healthcare expenses.

Medigap or supplement insurance refers to plans that can cover the expenses not included in your Original Medicare plan/s. The costs also go higher as your coverage increases. You can check out Medicare’s website for more information about these plans.

Medicare Advantage Plans

Medicare Advantage refers to plans offered by private companies approved by the government. These plans wrap basic Medicare coverage into one package. They work well for those who want the coverage of Original Medicare but with more coverage.

Moreover, Medicare Advantage plans usually involve co-payments and a yearly deductible.

However, many of these plans offer a number of benefits not included in Medigap or Supplement plans, including vision and dental services. Some plans even offer gym memberships.

Medigap vs. Medicare Advantage: What’s the Difference?

Medigap or Supplement plans are more expensive than Advantage plans. Some Advantage plans are even free. But, of course, there’s a catch.

With a Medigap or Supplement plan, you can go to any hospital or doctor in the US that accepts Medicare. You also don’t need a doctor’s referral to consult a specialist.

That’s not the case with Advantage plans. They serve as PPOs (Preferred Provider Organizations) or HMOs (Health Maintenance Organizations). Hence, you should go to a hospital or doctor under your insurance provider’s network to get a referral for seeing a specialist.

In addition, any services outside the said network or your local area won’t likely be covered. So, if you move, you might not be covered by your Advantage plan.

The Best Way to Go: Medicare Suggestions

Given the information above, I suggest that you sign up for the best plan you can afford once you qualify for Medicare. Remember, insurers can’t reject you due to pre-existing conditions.

And if you can afford Medigap or Supplement plans, go for Plan F or Plan G. By doing so, you’ll get the best coverage.

Plus, if you have a pre-existing condition that calls for specialists or out-of-your-area hospitals, consider getting a Supplement plan.

However, if your budget is your biggest concern, choose an Advantage plan. It’s better to have any plan than to not have a plan at all.

Disclaimer: The material and information contained in this article are for general information purposes only. You should check with a financial advisor before making any business, legal, or other decisions.

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