Medicare Supplement Insurance

Todays senior citizens are faced with many options when it comes to health care after age 65. Neither, the Medicare program nor managed care were intended to pay the entire hospital, doctor or nursing home bill. Many seniors will need supplemental insurance to pay on expenses not covered by Medicare. Supplement insurance is available from many different sources and we have listed some of the options below. Neither Medicare nor Medicare supplement policies cover most long-term care expenses.

Medicare Supplement Options:

Original Medicare with Medicare Supplement
Managed Care (HMO,PPO,POS,Cost Plan)
Medical Savings Account Plan (MSA)
Religious Fraternal Benefit Society Plan
Private Fee-For-Service Plan

 

Original Medicare Plan

The Original Medicare plan is run by the federal government. It is a traditional pay-per-visit health plan that lets you go to any doctor, hospital, or other health care provider who accepts Medicare. You pay the deductible. Medicare pays its share of the Medicare-approved amount, and you pay your share. The Original Medicare Plan has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).

• Part A (Medicare)
  Hospital insurance that covers hospice care, home health care, skilled nursing facilities, and inpatient hospital stays.
   

• Part B (Medicare)
  Medical insurance that helps pay for doctors' services, outpatient hospital care, durable medical equipment, and some medical services that are not covered by Part A.
   
• Cost
  You pay the $54.00 Part B premium, the Part A and Part B deductibles, and the coinsurance.

   

Supplemental Insurance

There are many types of private health insurance/coverage that you can buy to supplement, or fill the gaps, in your Medicare coverage. This supplemental insurance will pay for some or all of your health care costs that are not covered by Medicare. These types of private health insurance/coverage include:

• Employee or Retiree Coverage
  (from your employer or union)
• Medigap Insurance
  (from a private company or group).

People often refer to all of these types of private health insurance/coverage as "supplemental insurance." However, "Medicare Supplemental" or "Medigap" insurance is a specific type of private insurance that is subject to Federal and State laws.

Medigap

Medicare supplemental insurance policies that are sold by private insurance companies to Medicare beneficiaries to fill the "gaps" in Original Medicare Plan coverage. There are ten standardized policies, labeled Plan A through Plan J. Your State decides which of the 10 policies can be sold in your State. Medigap policies only work with the Original Medicare Plan.

Medicare SELECT

A type of Medigap policy that must meet all of the requirements that apply to a standard Medigap policy. You may be required to use doctors and hospitals within its network in order to be eligible for full benefits.

Managed Care Plans

A Managed Care plan involves a group of doctors, hospitals, and other health care providers who have agreed to provide care to Medicare beneficiaries in exchange for a fixed amount of money from Medicare every month. Managed Care plans include Health Maintenance Organizations (HMOs), HMOs with a Point of Service (POS) option, Provider Sponsored Organizations (PSOs), Preferred Provider Organizations (PPOs), and Cost Plans.

• Cost
  You pay a $54.00 Part B premium. Some plans charge an extra monthly premium. You may also pay the plan a copayment per visit or service. You will pay more if you don't follow plan rules. No Supplemental Insurance policy is necessary if you join a Managed Care plan.

Providers

• HMO - You must go to plan doctors and hospitals.
   

• HMOs with POS Option - You may use doctors and hospitals outside of the Managed Care plan at an additional cost.
   
• PSO - You must go to plan doctors and hospitals.
   
• PPO - You may use doctors and hospitals outside of the Managed Care plan at an additional cost.
   
• Cost Plans - You may use doctors and hospitals outside of the Managed Care plan. You will pay the coinsurance, deductible, and extra charges that you would normally pay under the Original Medicare plan.

   

Advantages

There are two main advantages associated with managed care plans. The first is low premiums. The second advantage is many managed care plans offer additional benefits not covered under the Original Medicare plan.

Disadvantages

Managed care plans are not very flexible and the covered person has very little say in treatment options. Managed care plans are not guaranteed renewable and many managed care plans have pulled out of areas forcing people to find new coverage.

Although managed care plans are required to provide benefits similar to Medicare not all plans are the same. Shop around on your own compare rates and benefits from several companies to make sure you get a plan that's right for you. It is also very important to choose a company with a excellent rating. For more information and rates on managed care coverage visit our specialist site below.

Medicare Medical Savings Account

A Medicare health plan option made up of two parts. One part is a Medicare MSA Health Insurance Policy with a high deductible. The other part is a special savings account where Medicare deposits money to help you pay your medical bills.

Religious Fraternal Benefit Society Plans

Health plans offered by a Religious Fraternal Benefit Society for its members. Only members of the society may enroll. The society must meet Internal Revenue Service (IRS) and Medicare requirements for this type of organization.

Private Fee-For-Service Plan

A private insurance plan that accepts Medicare beneficiaries. You may go to any doctor or hospital you want. The insurance plan, rather than the Medicare program, decides how much you pay for the services you receive. You may pay more for Medicare covered benefits. You may have extra benefits the Original Medicare Plan doesn't cover.

Although these are options for some seniors the vast majority of seniors have chosen the Original Medicare plan and supplemental coverage.

Medicare supplement insurance policies being sold today must be approved by the Department of Insurance in your state and there are no bad policies. However, not all companies are the same and there are currently 100's companies marketing policies. To review some of these options and policies visit our

Return to Main Page                     Consult an Expert                 Request a Quote on....