Medicare Plans

Medicare Health Plans

The following is an overview of the two main types of Medicare plans- Medicare Supplement plans which are also known and Medigap plans and Medicare Advantage plans. You will need Medicare Parts A and Part B  in order to choose either plan type.

What  Is A Medicare Supplement Plan?

Medicare Supplement (Medigap) insurance works with Original Medicare to fill in coverage gaps – items that are not covered such as co-payments, coinsurance, and deductibles.There are Medigap plans that cover travel outside the U.S. that is not covered by Original Medicare, usually subject to a deductible and a lifetime limit. Medicare will pay its share of the approved amount for covered health care costs.

You leave Original Medicare when enrolling in a Medicare Advantage Plan to get Medicare benefits, while a Medigap policy supplements your Original Medicare benefits.

Important Things to Know About Medicare Supplement Coverage

  • If you are enrolled in a Medicare Advantage Plan, you can apply for a Medigap policy during an appropriate enrollment period, but your Medicare Advantage Plan coverage must end before your Medigap policy begins.
  • Your Medigap policy will have a monthly premium in addition to the monthly Part B premium that you pay to Medicare.
  • A Medigap policy covers one premiums are determined by age, gender and tobacco use.
  • Medigap policies have no network restrictions, you can see any doctor, go to any hospital in any state without a referral. When comparing Medigap policies from different carriers, the benefits are identical for each plan. In other words, an F plan is an F plan; the only difference is the price.
  • Medigap policies are guaranteed renewable. The insurance company can’t cancel your Medigap policy as long as you pay the premium even if you have health problems.

What is a Medicare Advantage Plan?

A Medicare Advantage Plan is a version of  Original Medicare sold by a private company that contracts with Medicare to provide your Part A and Part B benefits.Medicare Advantage Plans include HMOS, PPOs, Private Fee-for-Service Plans,. Special Needs Plans, and Medicare Medical Savings Account Plans. The majority of Medicare Advantage Plans also offer prescription drug coverage.

What do Medicare Advantage Plans cover?

Medicare Advantage Plans are required to cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice if you are enrolled in a Medicare Advantage Plan. you’re always covered for emergency and urgently needed care with all Medicare Advantage plans. Medicare Advantage Plans may offer extra benefits, such as gym memberships, vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).

Coverage For Veterans

If you have VA coverage and are currently enrolled in Medicare Part B, a Medicare Advantage plan will provide coverage for non-VA providers and facilities at no additional premium.It is recommended to contact your plan for a written advance coverage decision to make sure a service is medically necessary and will be covered. If you’re not sure the plan will pay for a particular service, ask for an advance coverage decision to avoid paying all of the costs

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