Medicare Supplement

Posted on 06/17/2013 When jumping into the Medicare landscape, seniors often confuse the “Parts” of Medicare with the various “Plans” offered as Medicare Supplement. Despite the similarities between the words Part and Plan, they have two totally different meanings.  It is important to know the difference between your parts and your plans! There are four Parts of Medicare- Part A, Part B, Part C and Part D.  Medicare Parts & B constitute original Medicare.

•  Part A: Covers hospital care, skilled nursing facility care, hospice and some home health services.
• Part B: Covers doctors’ services and other outpatient care. Additionally, it covers certain physical and occupational therapist services, and some home health care.
• Part C (Medicare Advantage):  These plans are sold through private insurance companies, combining Parts A, B, and sometimes D as well.
• Part D: Offers prescription drug coverage through the purchase of a stand-alone Prescription Drug Plan or combined with Part C coverage through a Medicare Advantage Prescription Drug (MAPD) plan. Each Part D Plan has its own list of covered drugs (called a formulary).

On the other hand, there are Medicare Supplement “Plans.”  There are ten different Medicare Supplement (also know as Medigap) Plans- Plan A, B, C, D, F, G, K, L, M and N. It is important to know that when talking about Part C or Plan C, each phrase means two totally different things.  If someone is speaking about Part C, they are referring to Medicare Advantage coverage, such as Keystone 65, offered through Independence Blue Cross. If someone is referring to Plan C, they are referring to a Medigap Plan.  No one is required to purchase a Medigap Plan.  However, since Original Medicare was never designed to cover all health costs, seniors often enroll in these plans for the additional coverage. Medigap Plans fill the “gaps” in coverage that exists in Original Medicare. We understand that all of this can be very confusing.  MyMedicareAdvisor is here to help. Just call (215) 658-1776

Posted on 06/14/2013 Medicare Advantage Plans such as Keystone 65 are gaining popularity due to strong coverage and very low premium. However, Medicare Supplement Plans (also called Medigap) are still the majority of Medicare Insurance plans being purchased by seniors. Medicare Advantage plans are Part C of Medicare.  These plans are offered through private health care companies, such as Independence Blue Cross. They have contracts and are subsidized by CMS. The reason that Medicare Advantage Plans have been very popular is the very low premium, which can range from $0-$50/month (which includes Rx). The trade-off is that these plans have higher co-pays for your medical care, such as doctor visits, hospital stays, surgery, physical therapy etc.  Lastly, these plans are typically HMO’s- where you must utilize their network of doctors and hospitals and you must get referrals. Medigap Plan F has been the most popular Medicare Supplement Plan. With a Medigap Plan F, a senior received comprehensive health coverage with very little or no out of pocket costs-no co-pays for virtually everything. The only downside to a Medigap Plan F is the cost, which is substantially higher than a Medicare Advantage Plan. In June 2010, the Federal Government introduced a new Medigap Plan- Plan N. This new plan offers seniors the best of both worlds- lower premiums and very low co-pays. No surprise that seniors are flocking to Medigap Plan N. With Plan N, participants must pay the Medicare Part B annual deductible (in 2013- $147), up to a $20 co-pay for doctor/specialist visits, $50 co-pay for emergency room visits and any excess charge over and above the Medicare approved charge (not in Pennsylvania). That’s it! And with all Medigap plans, there are no networks to be concerned about and no referrals required. Are you researching Medicare Plans? Looking for comprehensive coverage at a reasonable cost? Medicare Supplement Plan N might be the plan that works best for you. Call us and let us assist you- MyMedicareAdvisor (215) 658-1776.

Posted on 05/31/2013 Medicare Supplement Plans are also called Medigap plans, since these plans fill in the gaps in coverage of Original Medicare Part A & Part B.  Unlike Medicare Advantage plans (Part C of Medicare), which serve as alternative to traditional Medicare, Medigap plans supplement Medicare. With Medigap plans, Medicare is the primary insurance.  Items such as deductibles and co-pays that Medicare does not pay, your Medigap plan picks up. Unlike Medicare Advantage plans, which have deductibles and co-pays, most Medigap plans have no deductibles, co-pays, or network restrictions. Medigap plans are standardized by Medicare.  There are ten different Medigap plans that are available, such as Plan F, Plan G & Plan N.  Because these plans are standardized, there is no difference whatsoever between one insurance company’s Plan vs another company’s. Well, two differences- the logo on the card and the price they charge. Medicare Supplement Plan F is the richest Medigap Plan available.  With this plan, when you see a Medicare provider or facility, you will never have to pay a single dollar for any treatment.  So if you see a doctor, get diagnostic work, or if you are in a hospital, whether your bill is $100 or $100,000, you will not pay a penny for the Medicare approved charges. Medicare Supplement Plan F: No deductibles No co-pays No referrals No network restrictions As always, we are here to assist you. Any questions, call us at (215) 658-1776.