Medicare and Medicare Supplemental insurance plans constitute a complex web of coverage options and features that collectively can be difficult to understand. With the new health care laws going into effect on January 1, 2014, it is important for all Americans in general, and for Californians in particular, to have at least a foundational understanding of the coverage options that are available.
Understanding Medicare Insurance
Medicare has 4 separate and distinct parts that each cover specific items and instances. Understanding each of these parts is important in order to know what coverage is best for you and your family.
Medicare Doctor & Hospital
Medicare Part A covers expenses that are incurred during hospital visits such as non-elective surgeries, medical tests, and other hospital related procedures. Medicare Part B covers standard health related issues such as checkups and regular doctor visits. Both Medicare parts A and B can be supplemented with prescription drug coverage, and are administered through the Centers for Medicare and Medicaid Services.
Also known as “original Medicare”, Medicare parts A and B do not require outside insurance obtained through a regular health insurance provider as long as the recipient signs up for them through the Centers for Medicare and Medicaid Services.
Medicare Part D Prescription Drug
The Social Services Administration coordinates sign-up, but requires Medicare Part D insurance as well in order to cover the cost of prescription drugs. Medicare Part D Prescription Drug coverage is not mandatory but it can only be purchased during the annual enrollment period and you will be assessed a penalty for each month that you do not have Part D coverage. Additionally, Medicare may not cover all of the associated costs and may require Medigap insurance.
Medicare Part C is the combination of Parts A and B into a single plan and can also include part D as well if prescription drugs are needed. Part C does not, however, include any kind of supplemental insurance, and patients may find gaps in their coverage if they choose this option.
There is also supplemental insurance known as Medigap, mentioned earlier. This is used in order to pay for copays and is administered through outside insurance companies. Medigap is only available as a supplement to Parts A and B, and is not available as a supplement to Part C. Medigap does not cover long term care, vision and dental care, or private in-home care.
Determining your eligibility and what plan is right for you is dependent upon your budget and overall health. Parts A and B are likely the best option for those individuals who are either on a fixed income or who have a tighter budget since it allows for the purchase of Medicare Supplemental insurance.
Medicare Advantage offers four different types of plans that are common for people who are approaching retirement age. The HMO plan allows patients to choose a primary care physician within the network. PPO plans allow for any doctor to be chosen as long as they are part of the nationwide network of doctors. PFFP plans allow patients to choose any doctor provided he or she agrees to the Medicare payment plan. SNP plans are for individuals with specific conditions or diseases.
How do I qualify for Medicare?
Determination of eligibility by the patient is required in order to apply for Medicare. Individuals over the age of 65, or under 65 with a medical condition, should collect their pertinent health information from the previous year, list any medications or prescription drugs that are currently being taken, and disclose how often doctors visits are required for any conditions.
WHERE DO I START?
The answer to that question is easy. Call the professionals at All Types Insurance Agency today and we will help you choose the right coverage for you.
All Types Insurance
805 Twelve Bridges Dr #15,
Lincoln, CA 95648
We are an Insurance agency specializing in Health insurance, including Medicare related products.
With 16 years of experience we will strive to help you choose the right insurance policy.
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