Monday, November 21, 2011
Understanding Medicare and Medigap
So much confusion surrounds Medicare and the different supplemental Medigap supplemental plans. It is hard to look at the information coming in and decipher what it means to your health care coverage. In terms understood by many it breaks down to this; Medicare part A and Medicare part B. From here it is up to the individual to decide if a Medigap supplemental insurance policy is needed. These plans are paid for by the individual and are for easing the out of pocket amount paid each year in deductibles, copayments and coinsurance plans.
The gap between what is covered and not covered by Medicare is Medigap. Here is one of the many tricky parts. Medigap only can be purchased along with an original Medicare plan, part A or part B. That is correct, reread the last statement. Medigap supplementalinsurance plans are not available with Medicare part C, part D, private health insurance, Medicaid, TRICARE or Veterans’ Admin benefits.
Purchasing Medigap supplement insurance is just as tricky as figuring out if you can buy it. The one thing that stays true no matter where you purchase the insurance from is that because it is regulated by the laws of the state and Federal government the benefits available are the same to everyone. Although the coverage remains the same no matter the provider there are differences amongst the insurance companies themselves. The differences will be in price, administrators of the plan and the available Medigap options.
Medigap insurance supplements are each unique and will want to be picked based upon the need of the individual. For instance, clients who need help with copayment and deductibles for basic benefits will want to choose Medigap plan A for those are the items that it helps cover. This plan is attractive for it is the least expensive plan available and is accepted by all doctors who accept Medicare. Drawbacks come with each and every plan available. The major drawback to plan A is that it covers basic necessities and not items such as long term care, skilled nursing, vision care amongst several other major areas of expense.
Another option to all of this confusion is Medicare Advantage Plan. This plan is in place of Medicare plan A and Medicare plan B, as well as any Medigap insurance. Medicare Advantage deals with HMO’s, PPO’s and other options. The thing to remember is that Medicare Advantage is an option that also allows doctors and hospitals to choose. They don’t have to take this coverage. It is a private option not through the government but rather run through private insurance companies.
In the year before you turn 65 it is wise to sit down and go through all of the different options. You will want to review your needs in the past five years to see medically where money was spent. This will help you narrow down what options you will need to further discuss with an insurance agent. They will can help determine what supplement will maximize your benefits while minimizing the out of pocket expense you concur.