Select Medicare and Supplemental Health Insurance

Supplemental Insurance is a kind of health insurance that will pay for some, if not all, of the gaps that Medicare Parts A and B will not

Health insurance can be a tricky topic to discuss with your loved ones. Yet, it is an incredibly important conversation to have. When it comes to caring for loved ones, especially parents or other elderly relatives, having health insurance can make a big difference in the quality of care you are able to afford when health concerns arise. Additionally, health insurance can offer you, and your loved one, integral peace of mind for the present and the future.

Medicare is a viable health insurance option for people with certain diseases or those over the age of 65. As we age, our health concerns grow more frequent and more serious. As a caregiver, you want to make sure that your loved ones are cared for and financially able to keep up with their increased risk of health issues. Medicare can help your loved one with the financial costs of medical care as they age.

What is Medicare?

Medicare is a federal health insurance program geared towards people who are 65 years or older, who are younger with disabilities, or who have End-Stage Renal Disease (ESRD). There are different parts of Medicare that offer a variety of included health care services.

Medicare Part A is also known as hospital insurance. This Medicare part covers hospital stays, skilled nursing facility care, hospice care, and some home health care services.

Medicare Part B is also known as medical insurance. This can cover services from specific doctors, outpatient medical care, medical supplies, and preventative health services.

Medicare Parts A and B are commonly known as Original Medicare.

Medicare Part C, or Medicare Advantage Plans, are a type of health care plan that comes through a private insurance company working with Medicare to offer health insurance coverage. These Advantage Plans provide the services offered in Medicare Parts A and B and offer prescription drug coverage. The Advantage Plans offer the following:

  • Health Maintenance Organizations (HMOs)
  • Preferred Provider Organizations (PPOs)
  • Private Fee-for-Service Plans
  • Special Needs Plans
  • Medicare Medical Savings Account Plans

Medicare Part D offers prescription drug coverage for people who are enrolled in Original Medicare, some Medicare Cost plans, and some Medicare Advantage Plans.

Medicare health plans also include:

  • Medicare cost plans
  • Medical demonstrations and pilot programs
  • PACE programs (programs of all-inclusive care for the elderly)
  • Medication Therapy Management (MTM) programs (medicare.gov)

Cost of Medicare

Medicare Part A can come without a premium, but if you purchase Medicare Part A, the premiums can be between $232-422. Medicare Part B premiums are, on average, $130. The costs for Medicare Parts C and D can vary depending on the plan and the insurance company from which these Medicare parts are being purchased. (medicare.gov)

Supplemental Health Insurance

Supplemental health insurance is optional insurance that can help with specific healthcare needs that you or your loved one are facing. This supplemental health insurance is also known as Medigap. Medigap plans can help qualified individuals obtain additional health insurance coverage beyond their existing Medicare insurance policy.

Medigap is a health insurance policy that is purchased from a private health insurance company. These policies must be advertised and sold as a Medicare Supplemental Insurance policy. These standardized policies are identified by the letters A through N. If an insurance company sells any Medigap policies, they have to offer Plans A, C, and F. They might not offer all the other plans, depending on their individual state laws. All the Medigap policies provide the same basic benefits, but some offer additional benefits that might be of greater use to you or your loved one depending on their healthcare needs. The differences can be complicated so it is usually best to contact a certified Medigap insurance salesperson to learn more about your options.

Medigap can be used to pay for health care costs such as:

  • Co-payments
  • Deductibles
  • Health care outside of the United States. 

Benefits of Medigap Coverage

This kind of coverage can be helpful for those who need financial assistance with their healthcare costs. For instance, if you must purchase a lot of medical supplies that are covered by your Medicare policy, but are still expensive, having a Medigap policy can help cover some or all of the money you are required to pay out of pocket for those supplies.

Medigap can also benefit people who spend time out of the country, whether on vacation or as part of their retirement plan. If you need medical care outside of the United States, some Medigap supplemental insurance policies can help you with the costs that could incur from those doctor or hospital visits. 

Medigap policies are renewable if you continue to pay your premiums on time so that they will renew every year, and you don’t have to worry about re-applying. Additionally, if you enroll in a Medigap policy during the Medicare Open Enrollment Period, you don’t have to worry about being rejected because of pre-existing health issues you might have. 

With most of the Medigap policies, policyholders can visit any doctor within the Medicare network. In most circumstances, people who have a Medigap policy can move around the United States and not have to worry about reapplying for health insurance coverage.

There is also a free period with the supplemental insurance policies that allows policyholders to switch between Medigap plans for 30 days before choosing one to stick with.

What Medigap Doesn’t Cover

There are some aspects of healthcare that a Medigap supplemental insurance policy won’t cover. Medigap doesn’t cover:

  • Long-term medical care
  • Dental
  • Vision
  • Hearing aids
  • Eyeglasses
  • Private nursing services
  • Prescription drugs (in most cases). (medicare.gov)

Medigap policies come in Parts A-N. New subscribers cannot apply for Plans E, H, I, or J. (medicare.gov) If you live in Massachusetts, Minnesota, or Wisconsin, these Medigap policies might be categorized differently. 

Medigap policies can be helpful for people who need blood transfusions, help with skilled nursing facility co-payments, help with Medicare Part A deductibles, foreign travel medical care, and out of pocket payment limits. (cms.gov)

If you or your loved one have ongoing hearing issues, eye problems, or require additional long-term medical care, a Medigap policy might not cover all that you need it to cover. A supplemental insurance policy is designed to help you cover the gaps in your Original Medicare insurance and not be a complete insurance policy in and of itself.

Qualifying for a Medigap Policy

If you or your loved one have already enrolled in Medicare Parts A and B, you are qualified to apply for a Medigap policy. However, if you already have a Medicare Advantage Plan, you cannot receive the services offered by a Medigap policy.

Enrollment in a Medigap plan begins six months after the first day of the month when you turn 65, or within six months of signing up for Medicare Part B if you aren’t already enrolled.

The premiums for each Medigap plan will vary based on the insurance company the policy is purchased from, but the benefits of the plan remain the same.

More Information about Medicare

For more information on how Medicare could help you or your loved one, please visit www.healthcare.gov or www.medicare.gov. Additionally, more information can be obtained by calling (1-800-633-4227). Medicare and Medigap are essential insurance policies that can


Sources:
How To Care for Aging Adults
C
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are.org

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