You've probably heard a lot about Medicare insurance. Maybe someone you love is using it for health care coverage. Maybe it popped up in conversation, or maybe you've heard presidential candidates argue about providing it for all Americans.
Medicare is a federal health insurance program under the U.S. Department of Health for people aged 65 or older, as well as younger people with certain disabilities. There are generally two forms of Medicare coverage: Original Medicare/Medicare Supplement Insurance and Medicare Advantage Insurance, also known as Part C.
What's the difference? A Medicare Advantage plan bundles all of Medicare's benefits, plus additional perks. A Medicare Supplement policy is a supplement to the federal guidelines, also known as Medigap, because it fills in where Medicare does not provide. You can't have both. It is illegal, just FYI.
Medicare comes in three main parts: Part A, Part B, and Part D. Medicare Part A is hospital insurance, covering inpatient care, skilled nursing facilities, hospice care, and home healthcare. Medicare Part B takes care of medical insurance, helping to cover outpatient care, home healthcare, services from doctors and other healthcare providers, durable medical equipment, and many preventive care services. Medicare Part D is prescription drug coverage to help cover the cost of medicine, which Parts A and B do not.
Medicare supplement policies are standardized under federal and state laws and must offer the same core benefits. Medicare.gov does provide greater detail on Medigap plans. However, the following are typically covered:
- Part A coinsurance and hospital costs up to 365 days after Medicare benefits are used up
- Part B coinsurance or copayment
- Payments for blood testing
- Part A hospice care coinsurance or copayment
- Skilled nursing care facility copayment
- Part A deductible
- Part B deductible
- Part B excess change
- Foreign travel exchange (up to plan limits)
Medicare supplement plans become available the month you turn 65, and continues for a six month open enrollment period. During that time, rates are guaranteed to be the same as anyone in as good of health as you. The six-month open enrollment is not mandatory, but signing up for supplement insurance outside the period does not guarantee coverage.
Medicare supplement plans are guaranteed renewable, whether or not your health remains the same. You cannot be dropped. There are exceptions if the case of failing to pay premiums or providing false information on a Medicare supplement application. As mentioned early, you cannot have a Medicare Advantage and Medicare supplement plan simultaneously. You can switch one from the other, but be sure to coordinate on timing as to avoid any lapse in coverage.
The cost of supplement policies does vary based on a few factors:
- What type of plan you buy (the higher the level of benefits, the higher the premium)
- Medical insurance company
- Age at the time of application
- Where you live
Be sure to gather quotes for Medicare supplement policies and review coverage options to find the insurance company right for you. An insurance agent can be beneficial for some extra guidance in reviewing the plans provided by private insurance companies.
It would seem more beneficiaries are enrolling in Medigap plans, seeming a surge in policies in the United States in the past four years. The best way to decide if Medicare supplement insurance is for the best is to explore and compare the options. Consider out-of-pocket costs, what Medicare currently takes care of and if it is enough.
If you have a Medicare Card and have questions about Medigap or Medicare Supplement plans, contact the insurance company that sells the coverage you’re considering or a licensed health insurance agent.