Medicare Supplement Plans – How They Work

Medicare Supplement plans are plans that are designed to fill in the “gaps” in “original” Medicare. “Original” Medicare includes Medicare Part A (hospital inpatient) and Part B (outpatient/doctor). These plans are consistent across companies – all companies are required to provide the same standardized benefits. This makes it very easy to understand the plans and how they work. Here are the top three things that you must know when looking at Medicare Supplement plans:

Medicare Supplement plans (also called Medigap) are Federally-standardized. The plans all provide equal coverage for “like” plans. What this means is that a Plan F with one company is the exact same as a Plan F with another company. Because of this, it is important to compare the plans on the basis of monthly premium and company rating or reputation. Price being equal, it is preferable to be with a company that has a long track record of involvement in the senior insurance marketplace and/or a high financial strength rating.

Medigap plans can be used at any doctor or hospital, nationwide, regardless of which company sells you the plan. Many types of insurance are network-based; however, this does not apply to medicare supplement plans Wisconsin. Even some types of Medicare plans – Medicare Advantage plans – are network-based in most cases. On the contrary, Medigap plans give you the flexibility of using the plan anywhere in the country that takes Medicare. This flexibility, particularly for someone that travels, is one of the many reasons that these plans have become increasingly popular as a way to supplement Medicare coverage.

Medigap plans all pay claims through the Medicare “crossover” system. There is no variation in how quickly or how efficiently one company pays claims versus another. While some companies may use the selling point of their timeliness in paying claims, this is not altogether accurate when it comes to this type of insurance. Because the plans are Federally-standardized and pay claims this “crossover” system, you can be assured that, regardless of the company, the claims are going to be paid in a timely manner and with minimal (usually no) involvement from the insured. Once you have a plan, you just need to present your plan identification card with your red, white and blue Medicare card when receiving services from a doctor or hospital.

Altogether, Medicare Supplement plans continue to be a viable option for those on Medicare, who wish to limit their exposure to out of pocket expenses. With only Medicare, you are subjected to paying approximately 20% of all medical costs. With a Medigap plan, however, you can greatly reduce or, with some plans, completely eliminate your out of pocket costs.

Medicare Supplement Plans – 3 Reasons Why Seniors Need Them

For those of you who are 65 years of age or older, you probably already know that Medicare parts A&B are available to you to take care of medical costs. However, even though it covers much of the expenses incurred by hospital visits, or doctor visits, or prescription drug charges, it does not cover everything. This is where Medicare Supplement Plans come in. They fill the deductible, coinsurance, co pay, and excess charges gaps that are not covered by Medicare. Even after seeing this, many people still don’t realize the need to pursue a Medicare Supplement, in order to protect themselves from unnecessary expenses. To better help you understand, here are some helpful pointers:

medicare supplement plans Wisconsin pick up expenses where Medicare leaves off. There are 12 different types of plans, and each one offers a different type of coverage with different benefits to suit your needs. For those who are needing medical care, and live on a fixed monthly income, then a Medicare Supplement Plan is in your best interest.

– Medicare Supplement Insurance is very affordable, and each plan has different coverage to choose from if you are not in a good financial situation. Since all plans are government regulated, it does not what company you decide to go with, the only difference will be the price you pay for that plan (assuming you’re comparing the same plan letter from each company). No matter what your budget might be, there is a plan out there to suit your needs with the right benefits. Plus, getting a quote is free, so might as well take advantage of it!

– A Medicare Supplement takes all the guesswork out of getting health care coverage. Instead of having to choose from countless numbers of options and coverage, all you need to focus on is your budget, your health, and then choose which plan out of the 12 work the best for your situation. If later on down the road things change, then you can apply to switch plans, and a good agency should make that task very easy for you by contacting you every year to make sure you are getting the best rate available to you.

It really isn’t hard to apply for a Medicare Supplement. After taking a look at some of these key factors of why you need one of these plans, you will soon realize that you need it more than you thought. Some plans may offer extra benefits like preventative care and foreign travel emergency coverage, which is very essential to those who would like to live a full and happy life but don’t want to deal with the typical health insurance hassles.

Medicare Supplement Plan G

What is a Medicare Supplement Plan G?

Medicare Supplemental Insurance, also known as Medigap, is a form of health insurance provided by independent insurance agencies in order to make up for the gaps that are left in traditional Medicare. These gaps take the form of a copay, coinsurance, deductibles, and other hidden fees that are not covered by Medicare Parts A and B.

A Medicare Supplement Plan is an added coverage that goes on top of Parts A and B, rather than replacing them. You can’t get it if you have a Medicare Advantage Plan (Part C). Furthermore, it is paid for separately from other Medicare parts.

This post will go into detail about one of the many Medigap options available to you: Medicare Supplement Plan G.

Plan G Benefits

All Medigap plans are universal regardless of provider. So Plan G benefits are the same at one agency as they are at another. Plan G covers almost all of the benefits available to Medigap recipients. Here is a quick overview of them.

Medicare Part A Deductible. Part A has a pretty hefty deductible that you might have to pay multiple times a year. Plan G protects you from these potential thousands of dollars in expenses.

Medicare Part A Coinsurance and Hospital Costs. When you visit the hospital, it uses your Part A benefits. However, you’ll still be responsible for paying a coinsurance. Plan G has you covered on these.

Part A Hospice Care Coinsurance or Copayment. Your Part A also covers stays at hospice care. With Plan G, you won’t need to pay the coinsurance for this.

Skilled Nursing Facility Coinsurance. If you need to stay in a SNF, Plan G will pay for the coinsurance that you would have been responsible for on Traditional Medicare.

Medicare Part B Coinsurance or Copayment. Part B covers your regular medical appointments, but still leaves you with some out of pocket expenses, but not when you have Medigap G.

Part B Excess Charges. In the rare case that your doctor charges more than Medicare assigns, you won’t have to pay the extra fees.

Foreign Travel Emergency. When you are travelling out of the country, Medigap Plan G let’s you take some of your Medicare benefits with you. This lets you travel with peace of mind.

First 3 Pints of Blood. Medigap plan G will pay for up to 3 pints of blood every year.

What’s Not Covered With Plan G

The only benefit that Medicare Supplement Plan G doesn’t include is the Medicare Part B Deductible. This isn’t much of an issue though because the deductible is really not that expensive – less than $200 per year.

Medigap G is one of the best options out there. While the premiums might be high, you’ll almost never have to pay a medical bill. This makes your healthcare expenses incredibly predictable from month to month and year to year. While some people might suggest Plan F, the increase in monthly costs really aren’t worth the minimal increase in benefits. The only difference is that Plan F covers the measly deductible for Medicare Part B.

Medicare Advantage Plans

What is a Medicare Advantage Plan

Medicare Advantage PlansA medicare advantage plan refers to medical and hospital insurance for the elderly or other Medicare-eligible persons that is offered by private companies as opposed to the federal government. These private companies are paid by Medicare in order to cover your medical benefits. A medicare advantage plans also referred to as “part C” plans provide the same Medicare part A (Hospital Insurance) and Medicare Part B (Medical Insurance),with the exception of hospice care.  Please be aware, a Medicare Advantage Plan is not a Medicare Supplement or Supplemental Insurance.

Different Types of Medicare Advantages Plans.

Medicare Advantage plans come in different forms and types; benefits also vary according to the individual plans. The different types of Medicare Advantage plans include:

  1. Health Maintenance Organisation. (HMO)

    In HMO plans, patients are only required to visit doctors, healthcare providers, and hospitals that are contained in the plan’s network with the exception of during emergency or urgent situations.  Most importantly, you need a referral from your primary healthcare provider for tests or to see other specialists or doctors.

  2. Preferred Provider Organization Plans (PPO)

    Patients covered in the PPO plan usually pay less when they visit hospitals, specialists and other healthcare providers that are covered in the plan’s network. On the other hand, when they visit specialists, hospitals and healthcare providers outside of the network, they are required to pay more.

    3.Private Fee-for-Service Plans (PFFS)

    PFFS plans are very similar to original Medicare; whereby one can visit any specialist, hospital and healthcare provider as long as they accept the payment terms contained in the plan. This plan will normally have set a predetermined pay rate for specialist, hospitals and healthcare providers as well as how much one is required to pay to get medical care.

    4.Special| Needs Plans (SNPs)

    SNPs provide cover for people requiring specialized and focused healthcare such as those having both Medicaid and Medicare, living in nursing homes, or suffering from chronic medical
    conditions.

    5.HMO Point-Of-Service Plans (HMO/POS)

    HMO plans allow patients to seek some services outside the confines of the plan’s network for a higher coinsurance or copay.

    6.Medicare| Savings Account Plans (MSA)

    In the MSA plan, a bank account is combined with a high-deductible health plan. In the MSA plan, Medicare normally deposits a certain amount of money into the account, out of which you can use to pay for your health care throughout the year. Typically, MSA Plans don’t usually cover for prescription drugs; this can only be taken care of by joining a Medicare Prescription drug Plan.

What is Covered by Medicare Advantage Plan?

First and foremost Medicare advantage plan covers all the services that the Original Medicare covers apart from hospice care. Additionally, medical advantage plans offer urgent and emergency care coverage outside of the plan’s network area but not outside the USA.

In addition to your Medicare part B premium users of Medicare Advantage plan are also required to part with a single monthly charge to cater for medical and prescription drug coverage. Medicare Advantage plans will also generally cover Medicare Part D (prescription drug) as well as other benefits such as dental, travel coverage, wellness benefits, and vision coverage.

Who is Eligible to Join a the Medicare Advantage Plan?

For you to be eligible for enrollment in the Medicare advantage plan one needs to have already subscribed for Medicare Parts A and B. Additionally, you must live within the plan’s service areas and should not have been diagnosed with End-Stage Renal Disease or permanent Kidney failure.

Medicare What is a Medicare Advantage PlanAdvantage plan can only be joined at certain times of the year ie. from October 15 December 7th. Enrollment into the plan is also available when you qualify for a special election period or when you first join the Medicare program.

Advantages of the Medicare Advantage Plan.

So, is the Medicare Advantage plan the right one for you? In order to answer this question, you have to consider your particular situation as well as the specific plan than you are looking to enrolling.
The following are some of the advantages of the Medicare Advantage plan that you need to know about:

  1.  Some private insurance companies offer $0 premium cost for their Medicare Advantage plans. Such Medicare Advantage plans will be dependent upon the state or county in which you reside.
  2.  Medicare Advantage plans generally offer other additional benefits over and above those offered by original Medicare eg. Dental or vision coverage.
  3.  Each Medicare Advantage plan offers a maximum out-of-the-pocket limit of how much money you can spend on health care each year. If this limit is reached, the patient does not pay any more additional costs for the covered services.

Medicare – What is it?

What is Medicare?

What is Medicare

Many people have an idea of what Medicare is, but do not understand the details or the costs.  Medicare is the Federal health insurance program for disabled and senior citizens who are over 65 and no longer covered by another insurance plan.

Medicare is made up of four distinct parts, but only 2 of them are delivered from the government, Part A and Part B.  The other two parts are purchased from a private insurance company, but those plans must follow federal and state guidelines.  At the bare minimum you will need to have parts A, B and D to avoid any Medicare penalties.  There are late enrollment penalties for Medicare Part A, Medicare Part B and Medicare Part D.  These penalties will last the entire time you are on Medicare. Continue Reading →