Trying to understand Medicare can be really confusing. You’re probably coming up on age 65, or you may be dropping off your employer health plan because you’re retiring. Whatever your situation, there’s some basic information you need to know- Medicare has 4 parts: Part A, B, C and D, plus something called Medicare Supplemental or "Medigap".
Medicare Part A (hospital insurance): This covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health care. You get it by signing up for Medicare. Most people get it automatically and for most beneficiaries there is no monthly premium.
Medicare Part B (medical insurance): This covers doctor visits, outpatient services, medical supplies, and preventive care. There is a monthly cost associated with Part B, and it can be deducted automatically from your social security check each month.
Medicare Part C (medicare advantage): Medicare Advantage combines Part A and Part B and these benefits are paid by the Plan and not Original Medicare. It can also include a Part D Drug plan. These plans are run by private insurance companies. Most Advantage plans have deductibles, copays, and co-insurance as part of their plans. You also have to use providers in the network and may pay more for services if you go out of network.
Medicare Part D (prescription drug coverage) : Prescription drug coverage can be bought as a stand-alone plan (in addition to a Medicare Supplement) or included in a Part C Medicare Advantage plan.
Medicare Supplements (Medigap): Medicare Supplement, or Medigap plans are lettered A-N. You would get this in addition to Parts A & B ("Original Medicare"). Supplement plans cover the gaps in Parts A & B. There is a premium each month for the plan. You may or may not have a deductible depending on the plan you choose. You can see any doctor in the country who accepts Medicare -there are NO networks. You can also get a stand -alone Part D prescription plan to cover your medications, as Medicare Supplement plans do not include this coverage (except for what is covered under Part B of Medicare in a Dr.’s office, hospital, or outpatient treatment). We can assist you in finding plans in your area for your specific prescription needs.
All Supplement plans are standardized by law, but there are a few things to consider when shopping for a plan. Different insurance companies may charge different premiums for the same exact policy. You should also look at the rate increase history and stability of the company. This is where a good agent or broker will come in handy; to help you find the best options in your area.
What’s Great About Medicare Supplement (Medigap) Plans:
Guaranteed Renewable: No worries of reduced benefits or cancelled coverage for the life of the policy, as long as the premiums are paid on time.
Covers the Gaps in Original Medicare (Parts A&B)- Your Medicare Supplement policy can help cover some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.
Freedom to Choose Your Doctors: You control and choose the physicians who you trust for your care. You can see any provider in the country who accepts Medicare; no HMO or PPO networks to worry about!
Benefits Stay the Same: You always know what your benefits are with this standardized plan…no surprises or re-evaluations year-after-year.
Portable Coverage: You are not restricted to use a network of health care providers. If you move, your coverage goes with you. Most plans have Foreign travel emergency coverage too.
Standardized Plans- All 11 plans must follow federal and state laws designed to protect you. These plans are sold by private insurance companies. The benefits for each plan offered are exactly the same. The only difference is price. As written in the Medicare and You Guidebook, “Different insurance companies may charge different premiums for the same exact policy”. A Plan F is a Plan F, but Company X may charge more than Company Y for the same plan F. (It helps to have an Independent Insurance agent who represents many carriers to show you the options available in your area.)
Can Switch Plans at Any Time- With a Medicare Supplement you can switch plans at any time of the year. You do not have to wait for an Annual Enrollment period to change plans (like the HMO & PPO “Medicare Advantage” plans). Although, you will need to answer health questions on the application if you are outside of your Open Enrollment period (after 6 months of getting part B). As long as you can qualify, then you can change the plan or company at any time of year. We’ve saved customers up to $100 per month or more for the same exact plan.
More Info Regarding Medicare Supplement (Medigap) Plans:
*Most carriers allow you to submit your application for a Medicare Supplement plan up to 6 months prior to your Medicare Part B effective date. The benefit of doing this early is so you can possibly lock in a lower rate, which will be effective the same date you get Part B. You have 6 months from your Medicare Part B effective date to enroll in a plan without going through medical underwriting or answering health questions. This is called Your Open Enrollment period. After this enrollment period you can apply for a Medigap policy but you will have to qualify medically. It is not recommended that you wait until your enrollment period expires because you may not be able to get any other plan until the Annual Enrollment from October 15-December 7th.
To contact us please call (800) 783-5901 or send an email to Info@usamedicareplan.com
Source: 2017 Choosing a Medigap Policy: Guide to Health Insurance for People with Medicare