• Medicare Supplement (Medigap)

    27 Articles

    All You Need to Know About Medicare Supplement (Medigap)

    Medicare Supplement (Medigap) is an insurance policy provided by private insurance companies to help patients cover medical expenses that are not included in Medicare. These expenses may include charges, like deductibles and co pays. Medicare Supplement Plans act to supplement original Medicare plans. This form of insurance does not include private nursing, long-term care, dental, eyeglasses, vision, and hearing aids.

    What is Medicare Part F?

    Medicare Supplement Part F is popular because a person with this supplement is relieved from paying any gaps in coverage found in Medicare Parts A and B. Basically; Medicare Supplemental Insurance covers the 20% co-pay owed to your doctor together with any deductibles arising from outpatient surgery or hospital stay. When Medicare Part F is your first dollar coverage plan, it pays for the remaining balance from your other Medicare plans. As a result, you do not pay a dime for medical expenses.

    Benefits of Medicare Part F

    • Covers deductibles for both Medicare Part A and B
    • Instead of paying for the 20% of medical costs that are due after Medicare covers 80%, these costs will be taken care of by Medicare Part F
    • Since doctors have the right to charge exorbitantly for Medicare, this 15% increment will be covered by Medicare Part F
    • Since Medicare may deny you costs that they consider unnecessary, Part F will assume these costs
    • Medicare Part A and B do not cover costs incurred abroad. However, Part F can meet expenses incurred abroad provided you begin treatment in the first 60 days of your trip. Part F will cater for part of these costs
    • Medicare Part A and B do not cover expenses for blood. Part F caters for the first 3 quarts of extra blood that may be required during surgery.

    What is the Difference Between Medicare Advantage and Medigap

    Medicare Supplement (Medigap) is a private healthcare policy offered by private companies to cater for out of pocket expenses arising from traditional Medicare policies. On the other hand, Medicare Advantage is a government program provided by private companies to serve as an alternative to traditional Medicare policies.

    Is Medicare Advantage Similar to Medigap?

    Medicare Advantage provides different offers from Medigap. The plans provided included in Part C include PPO and Health Maintenance Organization. You also get MSA, Private Fee-for Service, Special Needs Plan, and HMO-POS. All the plans offered by Medicare Advantage cover the same benefits provided by the traditional Medicare; however, the copayments are lower than those under the original Medicare.

    What are the Main Distinguishing Factors Between Medicare and Medigap?

    • Enrollment Period- The only time you can switch to Medicare Advantage plans is during the "Fall Open Enrollment" period. On the other hand, Medigap accepts applications throughout the year.
    • Hospitals and Doctors- Medicare Supplement (Medigap) Plans are applicable in any institution and can be offered by any doctor who treats Medicare patients without the need for expert referrals. On the other hand, Medicare Advantage utilizes specific hospitals and physicians. You need to be referred to be treated by these specialists.
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  • Original Medicare Parts A & B

    13 Articles

    About Original Medicare Parts A & B

    The Affordable Care Act has expanded the reigns of Medicare, and some recipients are confused as to the type of coverage they have obtained. Here are a few things that you need to know about Original Medicare Parts A & B.

    What is Medicare in its Original Form?

    Original Medicare, also known as Original Medicare Parts A & B, is a federally funded program that provides health insurance to individuals over the age of 65. Recipients of disability insurance who have received compensation for a qualifying ailment more than two years are also eligible for coverage regardless of their age. Medicare Part A pays for costs associated with hospital visits, while Medicare Part B covers doctor's expenses. While parts A and B of Medicare cover various portions of treatment, the plans do not compensate for prescription medications. Patients must seek out a Medicare Part D program for pharmaceutical needs. Many Medicare recipients make the mistake of believing that qualifying for one type of Medicare insurance plan equates to having rights to all programs. Such assumption may be detrimental to one's finances if an emergency arises and there is not enough assurance to pay for all costs.

    More about Medicare Part A

    Part A of the Medicare program is free of charge to individuals who have worked a minimum of ten years for a company that has paid into the Social Security program. Persons eligible for railroad retirement benefits usually qualify for coverage as well as those workers employed by a local or state government. Individuals not meeting these qualifications can obtain Part A insurance by paying a monthly premium of $400 per month or more. It is important to note that this portion of Medicare only covers necessary treatments that extend to hospice care and home health. An insurance company has the right to determine what is essential and a luxury when paying for medical costs associated with hospital visits. Another important point to stress over is Part A's inability to cover every aspect of medical care. Patients are still responsible for deductibles and out-of-pocket costs even if they receive coverage for free.

    More about Medicare B

    Part B of Medicare pays for doctor and outpatient services. This plan is completely optional and, as such, typically requires a monthly premium payment of some sort. The amount that patients pay towards insurance is based on their annual income for the past two years.
    A person who earned $20,000 annually over the past two years would not be expected to contribute as much to his healthcare plan as the individuals who grossed $100,000 in 24 months. Part B centrally covers hospital outpatient services, preventative care, lab tests, x-rays, and some ambulance fees. Patients should be prepared to pay a deductible and other out-of-pocket expenses before obtaining the full benefits of insurance. Knowing the advantages of Medicare long before you need to use the service is the best way to ensure protection.
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  • Medicare Prescription Drug (Part D)

    7 Articles

    An Overview Of Medicare Prescription Drug (Part D)

    Medicare Prescription Drug (Part D) provides health insurance to tens of millions of seniors, and it is divided into several sections. Medicare Part D covers prescription drugs. While Medicare Part D covers a lot of the cost of prescription drugs, there typically are out of pocket costs. Here are several things that you need to know about Medicare Part D:

    How Do You Sign Up For Medicare Part D?

    There are a number of different ways that you can sign up for Medicare Part D. If you have any questions about the process, you can call us for assistance. You also can contact your Medicare supplement insurance company to ask for information about signing up for Medicare Part D. Unfortunately, many insurance companies don't provide you with information on which Medicare Part D plan is likely to be best for you. 

    What Medications Are Covered By Medicare Part D?

    You can get coverage for a wide range of medications from Medicare Part D. However, the specific medications that are covered varies between different Medicare Part D plans. We can assist you in choosing the best plan for your needs.

    Do All Insurance Companies Provide Medicare Part D Insurance?

    Unfortunately, many companies cannot help you get Medicare Part D coverage. The specific companies that will be able to help you varies on a state by state basis. Therefore, you will have to check to see that the company you're going through offers Medicare Part D coverage. A list is available of companies that can help you to find Medicare Part D plans, and you can see which insurance companies in your state can assist you. You also can give us a call for assistance.

    What Will I Have To Pay Out Of Pocket With Medicare Part D?

    It can be difficult to determine your out of pocket costs, but there are several main categories of expenses. The main categories of expenses are your premium, deductible, co-pays, fees for Medicare's extra help program, and any expenses resulting from a coverage gap. Luckily, Medicare supplement insurance can cover these costs.

    What Happens If You Enroll After The Annual Enrollment Period?

    Unfortunately, this can result in a late fee. Whether or not you'll have to pay this fee depends upon your income. Therefore, it is important to enroll in Medicare Prescription Drug (Part D) plans before the deadline.

    Can You Be Enrolled In Medicare Part D Along With Medicare Advantage Plans?

    In many cases, when you enroll in Medicare Prescription Drug (Part D), you will automatically be enrolled in Medicare Part A and B instead. If you are enrolled in a Medicare Advantage Plan, you may or may not need to enroll in Medicare Part D. However, co-pays are usually lower through Medicare Part D than they are through a Medicare Advantage Plan. However, this varies on a case by case basis.
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  • Medicare Advantage Plans (Part C)

    11 Articles

    Medicare Advantage Plans

    Medicare Advantage Plans are medical insurance policies provided by private companies by way of the government-funded Medicare program. The benefits are similar to Part A and Part B of Medicare with additional perks such as pharmaceutical needs being fulfilled by Advantage plans. Here is a brief breakdown of the various programs offered under Medicare's Advantage arrangement.
    Health Maintenance Organization (HMO) Plan
    An HMO plan only allows you to receive care from doctors within a specified network. While you are always free to receive medical attention from doctors outside of the group, the insurance provider will not pay for expenses associated with the service unless your primary care physician approves the visit beforehand. Costs related to emergency care are paid by HMO providers regardless of whether an out-of-network doctor gave such services.

    Preferred Provider Organization (PPO) Plan

    Preferred Provider Organization programs are one of several Medicare Part C Plans. While you pay less when receiving care from doctors within the network selected by the insurance provider, you are responsible for substantially more when you opt for a physician outside of the group. One key benefit of a PPO Plan is that there is no need to choose a primary care physician. You can essentially receive care from multiple doctors within the network of physicians at your leisure.

    Private Fee-for-Service (PFFS) Plan

    Another one of the few Medicare Part C Plans available, PFFS is a program that lets providers determine how much they want to pay for hospital and physician care. You are responsible for the expenses not covered by Medicare. As with PPO plans, PFFS coverage comes with the option of paying less by receiving care within the network of physicians. Of course, there is always the option of receiving care from out-of-network specialists at greater cost.

    Medicare Special Needs Plans (SNP)

    The Medicare Special Needs program is unlike other Medicare Advantage Plans. Enrollment in this option is limited to individuals who have specific diseases because benefits are tailor-made for such illnesses.
    HMO Point of Service (HMOPOS) Plan
    An HMOPOS plan lets you receive services from out-of-network physicians at a higher cost. This program is ideal for individuals who are willing to pay more for preventative care.
    Medical Savings Account (MSA) Plan
    The MSA plan is a sort of depository program in which Medicare places money into your bank account that may be used to pay for health services. Many view the MSA plan as an insurance policy with high deductibles. Such program is ideal for individuals willing to contribute more for medical care but not the best plan for recipients who cannot afford to pay enormous amounts for health care.
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