Medicare Supplement Insurance Quote

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Medicare supplements are private health insurance plans approved by Medicare intended to supplement the Original Medicare Plan. The Medicare Supplement plans, also known as Medigap plans, fill the gaps that the Part A and Part B plans fail to cover. These gaps could include medical expenses like fees for some medical services, Medicare Part B excess charges, at-home recovery visits, foreign travel emergency care, deductibles, and even the difference between the actual fees and what Medicare pays, which you normally pay out of your pocket.Medicare supplement policies are standardized policies with twelve plans identified by letters A through L. Though there are different Medigap policies, the same type of policies sold by different insurance companies have the same basic benefits; that is, Plan A of two different companies must offer the same services. The only difference is the change in the cost according to the insurance provider. The Medicare supplement policies also follow Federal and state laws for providing protection to the policy holder.

Supplement policies are not like Medicare Advantage plans that restrict you to certain doctors and providers, and the supplements cannot be replaced by Medicare Advantage. Medigap policies work only with the Original Medicare plan. Each of the twelve plans in the Medicare supplement policies cover a specific medical service and it is essential to understand the range of coverage of each plan before you buy a policy. Medigap policies do not cover everything that the Original Medicare plan has left out.  Including Long-term care from a nursing home, eyeglasses, hearing aids, vision or dental care,  and private nursing.  Prescription drug coverage is not included in the latest supplement policies even though it was covered in previous plans. You will need to add Part D of Medicare to avail this benefit.

The appropriate time for buying a Medicare supplement policy is within six months after your 65th birthday and after you have enrolled in Part B; this is called your open enrollment period. If you apply for a supplement policy after your open enrollment period expires, the chances of an insurance provider selling you a Medigap policy are low. When you buy Medicare supplements, take time to make comparisons of the policies sold by different providers; coverage, service charges and premiums can vary considerably from provider to provider. It is best to hire the services of a professional specializing in Medicare supplements for making the right choice in Medigap policies.

Medicare Part A

Medicare part A is the hospital insurance plan of the Medicare program provided to senior citizens aged 65 and above or to those below 65 with certain disabilities and illnesses. Part A covers the hospital expenses of the policy holder if the patient meets the prescribed criteria for receiving Part A benefits. It is essential to decide which Medicare plan to select before enrolling in a plan. If your requirement is exclusively the coverage of hospital expenses, you may choose Part A of Medicare. Blood transfusions and inpatient care in hospitals, nursing homes, skilled nursing facilities, and critical access hospitals are included in the Medicare Part A benefits. Even hospice or home health care can be a part of Part A provided the patients meet certain criteria. However, long-term custodial or non-skilled care is not included in the Medicare Part A insurance coverage. The cost of room rent, food, and doctor’s fees are covered by the policy. Eligibility criteria for Part A benefits for inpatient hospital stays require the individual to stay at the hospital for at least overnight and stay for three days in the case of brief stays for convalescence in skilled nursing facilities. Part A will cover up to 100 days’ stay in hospitals or nursing homes. Medicare pays hundred percent of the cost for the first 20 days; in the co-payment arrangement for the next 80 days the individual pays a part of the expenses. Part A also covers brief skilled nursing home stays when the patient is convalescing, which is preceded by a stay of three days and three midnights. It is not necessary for the patient himself to pay the premiums for Part A; if the individual or their spouses were employed, they would have contributed to the premium amount in the form of Medicare taxes. In such cases, the payment for the Medicare Part A is already made. If the individual has not paid any Medicare taxes, he can buy the Part A plan. The Medicare enrollment activities are handled by the Social Security Administration (SSA). In order to enroll in a Medicare plan and know your eligibility, you may contact the nearest SSA directly or visit their website www.socialsecurity.gov. If the individual is receiving benefits from Social Security or the Railroad Retirement Board they become eligible for the Medicare program. Application for enrolling in Medicare program can be submitted three months before the 65th birthday; the individuals will get the benefits when they turn 65.

Medicare Part B

Part B of Medicare deals with medical insurance coverage that pays for doctor’s services and other services and products which are not included in the Part A Medicare plan. Part B deals with outpatient care provided to the beneficiaries, such as nursing services, x-rays, lab services, screenings, influenza and pneumonia vaccinations, restricted ambulance services, chemotherapy, hormonal treatments, etc. Preventive services and some home health care services are also covered by this plan. Durable medical equipment like canes, wheelchairs, walkers, mobility scooters, etc., prosthetic devices, one pair of eyeglasses after cataract surgery,  and oxygen equipment for use at home come under Part B services. Some additional services included in the Part B program are hearing and balance exams, mammograms, dialysis, pap test, pelvic exams, mental health care, medical nutrition therapy, occupational therapy, limited prescription drugs, physical therapy, transplant services, chiropractic services, clinical trials, ambulatory surgery center fees, diabetic supplies, bone mass measurement, glaucoma tests, etc. However, routine physical examination is not covered by Part B plan and the patients can get the payment for medication only if it is administered in the doctor’s office. While some medical equipment can be bought under Medicare Part B, some must be rented to get the benefits.

Part B is optional which you can add to the Original Medicare Plan (Part A) to cover both hospital and medical insurance. Even though some prescription drugs are included in the Part B program, in order to get the full benefits of prescription medicine plans, the individual has to buy the Part D plan of Medicare and add it to the Original Medicare Plan. Eligibility criteria for enrollment in Part B Medicare plan require the person to be 65 years of age or above though the age limit can be exempted for some particular cases as per the Medicare rules. Part B is a voluntary service and the policy holder has to pay monthly premiums. Part B is very useful for senior citizens and retirees who may require frequent visits to hospitals or physicians. The expenses of these medical needs are made affordable if the individual has added the Part B Medicare to the Part A program which covers only the inpatient services and requires at least three days of stay at the hospital. Part B does not require hospital stay and is an outpatient care service.

Medicare Part C

Part C of the Medicare plan provides the Medicare benefits through health insurance plans offered by private insurance companies approved by Medicare. The Part C plan is a combination of the Original Medicare plan; that is, Part A and Part B. Medicare Part C is sometimes known as the Medicare Advantage plan. Even though Part C covers the services offered by the Original Medicare plan, the coverage of benefits may differ from Part A or B. It has low cost compared to the Original Medicare Plan and even offers some extra benefits. Prescription drug coverage, which is Part D of the Original Medicare Plan and needs to be added to Part A and B as a separate plan, is a part of several Medicare Advantage Plans. Part C plans that include prescription drug coverage are called Medicare Advantage Prescription Drug plan or MA-PD. A benefit of the Part C program is that you can have Part A and Part B coverage of the Original Medicare Plan and still avail the services offered under Part C. There is the dual benefit of the Original Medicare benefits offered by the U.S. government along with the flexibility and options that private health insurance give. Other perks of the Medicare Advantage Plans include fitness and wellness programs for the members and updates on the medicines and treatment procedures.

The coverage and services offered for Part C plans can vary for different insurance providers; the plans also differ considerable based on geographical areas. Usually, the Part C plans have coverage areas and networks, and doctors and hospitals that come under the plan. In order to be covered by the Medicare Advantage Plans, you need to use the facilities in the network. However, emergency or urgent care services can be provided when you are travelling beyond your plan coverage area.

There are different types of Medicare Advantage Plans. The most common ones are Medicare Preferred Provider Organization (PPO) that gives you the option to choose and visit any doctor without a referral, Medicare Health Maintenance Organizations (HMO) that require a referral to visit the doctors in the HMO network, Medicare Private Fee-for-Service (PFFS), Medicare Special Needs for people with specific chronic diseases, and Medicare Medical Savings Account (MSA). You have to decide which type of Medicare Advantage Plan is appropriate for you based on your capacity to pay premiums, your medical needs, and plan area. Those who have already bought a stand-alone Prescription Drug coverage plan can opt for Medicare Advantage plans without the prescription drug coverage.

Medicare Part D

Medicare Part D is a prescription drug plan of the Medicare program. The high cost of prescription medicines can be covered with the Part D plan. This is especially useful for people with a lower income and resources during old age. Those who have already enrolled in Part A or Part B of the Medicare policy are eligible for Part D benefits. Applicants can enroll in a stand-alone Prescription Drug Plan (PDP) and add it to their Original Medicare Plan or they can buy a Medicare Advantage Plan with prescription drug coverage (MA-PD). PDP covers only the cost of the prescription drugs whereas MA-PD covers medical services and prescription drugs. Since, the Original Medicare Plan does not cover prescription drugs, beneficiaries of this plan can opt for a PDP. Those with Medicare Advantage Plan or Part C of Medicare usually have prescription drugs included in the plan (MA-PD) and they may not need an additional Part D coverage.

Private health insurance companies approved by Medicare offer the Part D plans. The plans can differ from company to company and region to region. Subsidies are provided for certain medicines based on geographical areas. Classification of drugs into tiers makes it easier to prescribe lower tier medicines that cost less. Medicare has created Prescription Drug Plan Finder, an online tool that helps to compare drug availability and cost of the different plans of a particular location; you can search medicines, pharmacies, and prices with this tool. It also aids in the calculation of monthly premiums, deductibles, annual cost for the chosen plan, etc. Even though there are monthly premiums to be paid, those with limited income can opt for a low-income subsidy to be added to their prescription account.

The eligible age for enrollment in the Part D plan is 65 though exceptions are made in special cases identified by the Medicare program. A membership card is issued to the individual after he joins the plan which is used to buy prescription medicines from pharmacies participating in the Part D plan. However, not all drugs are covered under the prescription drug plan. Drugs that are not approved by Food and Drug Administration, drugs purchased from outside the Unites States, and drugs covered by the Part A and Part B of the Medicare plan are excluded from Part D plan coverage. All details regarding the Part D plan is available from the U.S. Government website of Medicare, www.medicare.gov. You can also call Medicare or approach private insurance companies approved by Medicare for information on and enrollment in Part D.

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