Medicare & Medicare Supplemental Insurance Basics
Medicare is health insurance offered by the Federal government to people who are 65 or older, people under age 65 with certain disabilities, and people of any age with End Stage Renal Disease (ESRD) – permanent kidney failure requiring dialysis or a kidney transplant), who meet the eligibility requirements.
Medicare helps pay for health care, but does not cover all medical expenses. The United States Medicare system is managed by the Centers for Medicare & Medicaid Services.
Read the information below to help determine your eligibility. We also explain the “must know” basics of medicare supplemental insurance coverage.
At Reed & Associates we are “Medicare Specialist”; we are knowledgeable on the various parts of Medicare and the ancillary insurance options that accompany Medicare. Reed & Associates has assisted thousands of Medicare beneficiary’s and has decades of experience, we provide concise and understandable advice on the myriad of options.
There are three main parts to Medicare; Part A, B and D. Part A and B work together, they cover hospital and doctor expenses. Part D covers prescription drugs.
Medicare Part A covers a wide range of hospitalization and inpatient services. Most people get Part A automatically when they turn 65, or if they are disabled for 24 months.
Medicare Part B helps pay for doctor’s services, outpatient services and other medically necessary services that are not covered under Part A. You must pay a monthly premium to Medicare for Part B.
Medicare Part D was added in 2006 and provides prescription drug coverage to Medicare recipients. Unlike Part A and B, you do not have coverage until you enroll with a private company. The cost associated with Part D can be a monthly premium, deductible and co-pays.
Medicare Supplemental / Medigap Coverage Options
Medicare Supplement policies, sometimes called Medigap policies, are sold by private insurance companies and supplement Part’s A and B of Medicare. They pay after Medicare, so your health care bills are paid by Medicare and the Medicare supplement policy. Insurance companies that sell Medicare Supplement insurance can only sell 10 Standardized plans and each of these standardized plans is represented by a letter, for example Plan A, B, C, F, etc. These plans are all standardized as far as the coverage that they provide, however the premiums that companies charge are not – we shop around and find the most competitively priced plans as we represent many companies. Medicare Supplement insurance allows you to choose your physician, specialist or facility. Supplements generally provide the highest level of coverage with minimal cost sharing (co-pays and co-insurance).
Medicare Advantage Plans
Medicare Advantage Plans work differently than Medicare Supplement plans and are also called Part C. Under a Medicare Advantage Plan a private insurance company that is contracted by Medicare administers your Medicare benefits. These plans don’t supplement Medicare they take the place of Medicare as far as paying your medical bills. You are still in the Medicare program if you have a Medicare Advantage and you are still afforded the same rights and protections. There are a few different types of Medicare Advantage Plans; HMO’s, PPO’s and PFFS plans. Plan availability is determined by your county of residence and in certain counties plan availability is very limited. Medicare Advantage Plans sometimes have lower premiums than traditional Medicare Supplement insurance however they generally also have higher cost sharing (co-pays and co-insurance).
Medicare Part D
Medicare Part D is for prescription drug coverage and can be obtained in one of two ways; “stand alone” or integrated into a Medicare Advantage Plan. Part D coverage is purchased from private companies that are contracted by Medicare. We will help you find the Plan that is best for you based upon your current prescription regiment.
Purchasing Medicare Supplemental / Medigap Insurance
Medigap policies are sold by private insurance companies, but are not like Medicare Advantage Plans (like an HMO or PPO). It is sometimes called “Medicare Supplemental Insurance.” A basic Medigap policy works with Original Medicare coverage to help pay some of your out-of-pocket costs like copayments, coinsurance, and the yearly Medicare deductible. They pay for the “gaps” in Medicare coverage.
There are many Medigap/Medicare Supplemental health insurance plans from which to pick. There can be big differences in the costs of various plans for the same basic benefits. Medigap policies must follow the Federal and State laws that are designed to protect you. Insurance companies must clearly identify their policies as “Medicare Supplemental Insurance” on the front of the policy. A Medigap policy can only cover one person. If you are married, both you and your spouse must buy separate policies.
There’s No Need to Be Overwhelmed…
We will save you time, money and headache in searching for the right Medicare supplement coverage. The solutions we provide will be the best you can find and for the lowest cost available.
Serving Oregon, Idaho, Washington, California, Nevada, Arizona, and Texas.