Medicare is the federal program put up by American government for the people 65 years and older and if you are younger and have any disability or renal failure than you are also eligible for this program. This program covers health coverage and prescription drug coverage. Medicare is made up of various parts.
It simply means who pays what part of the bill for you. These are designated in letters. The parts of Medicare are:
- Medicare part A
- Medicare part B
- Medicare part C or medigap insurance plan
- Medicare part D
Now let’s discuss them briefly.
- Medicare part A is hospital insurance. It covers hospital stays, care in skilled nursing facility, hospice care and any home care.
- Medicare part B is medical care which you mostly use. It includes doctors visit, outpatient procedures, medical supplies and preventative services.
- Medicare part C which is Medicare advantage plan. You could have that or Medicare supplement plan which goes along with original plan.
- Medicare part D is prescription drug coverage plan that goes along with original coverage plan.
Medicare part A and B are also called original Medicare which is hospital coverage and doctors’ visits respectively but it still does not cover all the bills. There are deductibles as well as co-insurance to pay. That’s where comes in the Medicare supplement plan or Medigap plan or some people choose to apt for private Medicare advantage plan.
Now the question is what’s advantage plan?
Advantage plans are the managed care plans which enroll out of original Medicare plan. These cover minimum what original Medicare covers. But they have some rules. These plans have a network which you have to choose working in your area. But you have to choose from doctors on the list in order to get full coverage from the plan. They can also cover beyond the original Medicare plan. Many of them include prescription coverage in the plan and some don’t.
Medical advantage plans can be HMO (health maintenance organization) or PPOs (Preferred Provider Organization) or private fee for service. The IMPORTANT thing is that you still have to pay monthly premium of Medicare part B to enroll in Medicare advantage plan. So, the Medicare part C is which choose out of the original Medicare plan.
So the pros and cons of the advantage plan are:
- It may include prescription drug coverage.
- It may also include additional benefits such as dental and hearing.
- Low premium can be zero-dollar premium plan.
- You have to stay in the network of your area.
- Choose from doctors on the list.
- You need referral to go to specialist.
One thing to remember with Medicare advantage plan is that sometimes it doesn’t always pay your claims. They only cover the original Medicare care plan and what’s beyond original Medicare plan it’s up to them what they will cover and what they will not.
So the solution for this situation is to enroll in Medicare supplement plan. But you still need to enroll inMedicare part A and B then you can add Medicare supplement or medigap plan. If you stay with original Medicare part (A and B) and medigap plan you don’t need any referral to go to any specialist as long as they take Medicare and there is no need of network as well.
Medical supplement or medigap plan covers the expenses which is not covered by original Medicare plan. Medical supplement plan has
- Plan G
- plan F
- plan N
most popular is plan G which includes great coverage, one small deductible is certain amount paid by you before your insurance starts.
Plan N needs to pay for Medicare part B deductible, small co pay per doctor visit but it will never be more than 20 dollars.
You should remember that every company has same plans and benefits with different rates.
Medisupps are independent agents which shop rates every year of all the companies for the clients and they make sure their customer gets best company with lowest premiums. They offer free services to the clients.
You are only one call away to get Medicare supplement plan from