Friday, January 20, 2012
Deciding What Medicare and Medigap Supplemental Insurance Coverage Suits Participants
Medicare is a government issued program created to provide seniors, 65 and older, with medical coverage. The main issue with Medicare and the supplemental insurance programs associated with it is that it is hard to decipher what is covered by each plan and what is needed by each participant. It is apparent that Medicare Part A and B will only cover the basics of what most seniors need. For this reason Medicare supplemental insurance plans can be purchased to cover the gaps in Medicare coverage. Understanding what is offered by each individual plan and deciding if the cost to the participant is justified is often difficult for participants. It is important when participants are nearing the golden age of 65 that they research and review their needs against the different supplemental insurance plans.
First it is important to look at what is covered by the bare bones of Medicare Part A and B. This is what is provided by the government, for free, to individuals who qualify. Medicare Part A is the piece of the insurance plan that assists with the fees related to inpatient care for hospitals, skilled nursing, hospice facilities and home health care. Medicare Part B participants pay a small premium each month which covers two basic services; medically necessary services and preventative services. Part B covers services and supplies needed to diagnosis and treat medical conditions through approved methods. Preventative services include things such as flu shots, vaccines or test that would offer early detection of an illness when it is relatively inexpensive to treat.
Medicare supplemental insurance plans often covered Medigap, because it is the Medicare insurance that fills in the gaps left with Medicare Part A and B. If purchasing options to fill the void in Medicare coverage is not of interest to participants there is still one more choice offered by the government; Medicare Advantage Plan or Medicare Part C.
There are advantages and disadvantages to Medicare Advantage Plan as with any insurance program. With Plan C participants are able to seek care through only providers willing to participate with this type of coverage. For some participants this may mean driving a great distance to receive care from providers who will work with your plan. Specialist may only be seen through a referral this is only one of the rules that is laid forth. If a provider the participant is going to suddenly stops participating in the Advantage Program the care is no longer covered and will need to be sought by a participating provider. This may be a difficult transition if during existing treatment.
As with Medicare Part A and B with supplemental add-ons there are different Advantage programs to choose from as well; HMO, PPO, PFFS and SNP. It is important to for participants to look into all angles and options before signing up for any of the government insurance plans to ensure that the coverage you are taking on meets the need of the participant. The rules that surround Medicare are often difficult to understand and may take a professional to help. Thankfully there are many Medicare supplemental insurance professionals who will review what services are needed and desired and fit a plan specially designed to each participant. Through the internet search on Medicare supplemental insurance and several companies should pop up across the country that can offer free services to assist in participant understanding of the Medicare program.