2 Major Ways Medicare Is Different Than Private Health Insurance

As you reach your 65th birthday, not only are you able to celebrate living for six and a half decades, but you are also able to enroll in Medicare. Despite the fact that everyone over 65 qualifies for Medicare, signing up can still be a daunting process. Here are a few things you should understand about Medicare insurance.

Family Plans Don't Exist Under Medicare

With traditional insurance offered through private employers, you can get some type of family plan. Traditionally, health insurance plans throughout your adult life cover you and your spouse, as well as your children.

This is not true with Medicare. With Medicare, it is all about a single individual. The health plan that you have is separate and different than your spouse's plan. Even if both you and your spouse purchase the same type of health insurance through Medicare, you are on different plans, with different premiums.

One of the benefits of this is that you can choose different health plans for you and your spouse that take care of both of your needs. One disadvantage is that you are going to have to pay two premiums and potentially understand the ins and outs of two different insurance policies.

Out-of-Pocket Caps Are Not Necessarily in Place

With traditional insurance plans offered through private employers, there is a cap on how much money that you have to pay out of pocket. This is pretty much built into all private insurance plans.

However, this is not true with Medicare. If you sign up for an original Medicare plan, you have to pay a portion of your expenses, and Medicare pays the other part. However, there is no cap. No matter how much medical care costs you add up, you have to pay your part.

If you sign up for a Medigap plan or decide to sign up for a Medicare Advantage plan, there is a cap in place, so you are not going to ever be caught paying more than you expected. If you are worried about having high medical care costs, it can be worth it to sign up for a Medigap or Medicare Advantage policy, where the amount you will have to spend each year is limited.

When it comes to Medicare, you need to understand how it is different from the private insurance you have had experience with the rest of your life. Medicare is an individual plan. Even if you and your spouse are both over 65, you are each going to be on your own separate plans. If you stick with original Medicare, you will also not have a cap on your yearly spending.