Medicare insurance is a series of federally funded health insurance plans that allow seniors and other qualified individuals access to affordable and quality health insurance options. As we age, we become more susceptible to disease, illness, and injury. For many seniors on a fixed or limited income, paying for the health care they need can become an overwhelming burden.
Medical insurance can be difficult to understand, and with the many changes being made to the healthcare structure in the United States, some things have changed regarding federal programs like Medicare. Read on to find out more information about Medicare, Medicare Advantage plans, Medicare supplemental insurance plans, and finding the right medical insurance options for you or a loved one.
Original Medicare encompasses Medicare Part A and Medicare Part B. Medicare Part A helps take care of hospital insurance and can cover the costs associated with inpatient care, hospice care, some skilled nursing facility care, and some at-home care.
Medicare Part B is medical insurance and can help cover the costs you might incur while paying for needed medical equipment or supplies, ambulance services, preventative health care services like screenings and check-ups, and outpatient care you may need.
Medicare Advantage plans are bought from a private insurance company, but all are required to offer the basic level of medical insurance coverage as laid out in Original Medicare. What makes the Medicare Advantage plans different from Original Medicare is that they come in a variety of coverage options.
With Medicare Advantage plans, individuals can pick a health insurance policy that offers coverage for what they need most. For instance, some Medicare Advantage plans offer prescription drug coverage, hearing and vision coverage, or dental insurance. This allows qualified individuals the opportunity to get a health insurance policy that meets their health insurance needs at affordable rates and while remaining under the umbrella of Medicare.
Medigap is also known as Medicare Supplemental Insurance. This is a health insurance supplemental policy that is designed to be used by seniors aged 65 years or more. Additionally, individuals who receive Social Security benefits, disability benefits, or Railroad Retirement benefits can qualify, even if they aren’t 65 years old yet.
Individuals suffering from ESRD (end-stage renal disease) or ALS (amyotrophic lateral sclerosis) may also qualify for Medicare and Medigap insurance. Medigap supplemental insurance can help seniors pay for the out of pocket medical costs that Medicare doesn’t cover; most people find that Medicare will cover between 40-80% of their medical costs but having a limited or fixed income can still make that gap insurmountable for some seniors. Medigap supplemental insurance can help fill that financial gap in your Medicare insurance to allow you to decrease some of those out of pocket costs in the future.
The open enrollment period for Medicare and Medigap coverage for 2021 will be between October 15th and December 7th, 2020.
Enrolling in Medigap supplemental insurance 2021 is automatic for people turning 65 years of age. Individuals who want to receive the benefits of Medicare and Medigap can enroll for the program three months before their 65th birthday and four months after or can enroll during an annual open enrollment period.
If you are automatically enrolled in Medicare and Medigap, you don’t have to worry about renewing your coverage every year. This automatic enrollment means that individuals won’t be turned away from an insurance policy or charged more for pre-existing medical conditions that they may have.
Make sure to do your research on Medicare, Medicare Advantage plans, and Medigap supplemental insurance. During the open enrollment period, you do have the chance to switch plans in case you aren’t happy with your current one. This means that you can change from Original Medicare to a Medicare Advantage plan or vice versa. You can test out this new plan, see if it works for you, and if it does, keep it throughout the next year and have it automatically renew.
Some Medigap and Medicare Advantage plans are packaged differently, depending on what insurance company you purchase these policies from and where you live. They should all offer the same coverage if they are a licensed insurance agent. Some Medicare Advantage plans or Medigap plans don’t have prescription drug coverage, dental coverage, or hearing, and vision coverage, so if you need any of those services, be sure to pick a Medicare, Medigap, or Medicare Advantage policy that offers that insurance coverage.
There are a few Medigap plans that people can choose from. Each year some of these options can change. Here are the 2020 Medigap Supplemental Insurance policy plans that are available for seniors and other qualified individuals.
These two plans offer a basic level of health insurance coverage that helps with the costs of medical care involving hospice care, miscellaneous medical expenses, and hospitalization coverage. Licensed, private insurance companies will charge a premium for these two plans, as well as lower deductibles.
This plan has a higher coverage limit than Medigap Plans A and B. Plan C offers the same coverage that A and B do, adding in coverage for skilled nursing care and medical care that might be required while traveling or living abroad. This plan comes with a higher premium rate than Plan A and B.
Plan F and Plan G provide coverage for 100% of the excess charges that can occur from Medicare Part B (medical insurance), charges that can come from skilled nursing care, and emergency medical care you might require when traveling or living abroad. This plan allows policyholders to choose a high-deductible option in order to keep the monthly or annual premium rate lower.
In different states, these three Medigap plans might be combined in different ways. No matter how they are packaged or what they are named, they will offer the same services as Medigap Plans K, L, and N.
These plans offer the highest level of Medigap insurance coverage and can help financially take care of specialized hospital care, the services provided by doctors, skilled nursing care, and all deductibles coming from Medicare Part A. Each plan comes with a maximum out-of-pocket payment, so policyholders know precisely how much they’ll need to pay in case of a medical event or emergency.
All of the following is not covered by a Medicare Supplement plan:
There are many options when it comes to Medicare and Medigap insurance. However, it is always best to do your research and look into your medical needs before choosing a policy. The basic level of coverage offered by Original Medicare can be great for some people, while others require more specific care and medical insurance coverage.
Certain plans will work better for certain people. Look at your Medicare, Medicare Advantage, and Medicare Supplemental Insurance options to see what kind of medical insurance you need, which plan covers you best, and if it fits within your budget. If you need dental, prescription drug coverage, medical insurance for traveling abroad, or other specific care, Medigap insurance can help supplement your Medicare health insurance plan to provide you with another layer of insurance protection.
Medigap can help with medical costs you know you will have as you age, in addition to surprise medical events. Medicare and Medicare supplemental insurance are designed to help seniors afford medical care and know that they are covered for a variety of medical services.
If you would like to cancel your existing Medigap coverage to enroll in another Medicare Supplemental plan or enroll in Medicare Advantage, you need to be careful with your timing. During the Medicare Open Enrollment period each year, you are free to make changes and switch plans easily with regards to Medicare Parts C and D. However, with Medigap plans, you only have a one-time enrollment window when you turn 65. After that initial enrollment period, you are able to change your supplemental coverage only if you’re eligible under a specific circumstance or guaranteed issue rights.