Original Medicare, Part A and Part B, is a government health insurance program for those who qualify by age or disability. Part A is hospital insurance and Part B is medical insurance. There are some out of pocket costs associated with Original Medicare, such as deductibles, coinsurance, and copayments. To help with those costs, there are two commonly used options used to supplement or replace Original Medicare and both are offered by private insurance companies. These plans have significant differences with regards to costs, benefits, and how they work. It is very important to understand these differences when you review your Medicare coverage options.
Medicare Supplement insurance, also known as Medigap coverage, functions as a secondary coverage to Medicare and may cover costs like deductibles, copayments, coinsurance, and emergency medical care while traveling outside of the United States. There are 10 standardized plan types, each given a letter designation. Plans of the same letter offer the same coverage regardless of the company it is purchased from, but premiums can and will vary greatly. Massachusetts, Minnesota, and Wisconsin offer their own standardized Medicare Supplement plans. Current Medicare Supplement plans do not include prescription drug coverage.
Medicare Advantage plans are an alternative way to receive your Medicare benefits through a private, Medicare approved insurance company. They must include all your Medicare Part A and Part B coverages, but they may offer additional benefits not included in Original Medicare, such as vision, dental, hearing services and prescription drug coverage. Medicare Advantage plan costs and coverages vary greatly, and it is suggested that you shop around to find a plan that will fit your needs as there are many different types of Medicare Advantage plans. To be eligible to enroll in a Medicare Advantage plan, you must be enrolled in Original Medicare, reside in the plan’s service area, and not have end stage renal disease (ESRD).
Medicare Part D is prescription drug coverage and beneficiaries have the option to enroll in Part D if they are enrolled in Medicare Part A and/or Part B and live in the service area of the plan. Medicare Part D is available through private companies that are contracted by Medicare, so costs, coverages, and availability vary between companies, plans, and location. If you do not enroll in Medicare Part D when you’re first eligible and you go without creditable coverage for 63 days or more, you could face a late enrollment penalty if you sign up for Part D later. There are many different Part D plans available and each one has its own formulary (list of covered drugs) so it is extremely important to make sure you enroll in the proper drug plan.
Rachelle Kinsman, a 26-year veteran employee of Gannon Associates, built the Medicare Division at Gannon when she realized the need for dedicated Medicare expertise in this area. With almost 20 years of experience helping Medicare beneficiaries with their confusing insurance coverage decisions, Rachelle has achieved numerous awards for her work, consistently ranking as a top agent across the United States. Rachelle provides FREE consultations to help Medicare beneficiaries find the right coverage and peace of mind! If you’d like to meet with Rachelle she can be reached at 1-866-426-6667.