Medicare Plans Original Medicare/Medicare Supplements
Original Medicare is managed by the federal government. Part A covers inpatient hospital stays, skilled nursing, hospice care, and some home health care. Part B covers certain physician services, outpatient care, medical supplies, and preventive services. Most prescriptions are not covered by Original Medicare, however, there are a few exceptions that are covered under Part B. Drug coverage can be added by enrolling in a Medicare Prescription Drug Plan (Part D). You can expect to pay deductibles, co-pays, and/or coinsurance for Parts A, B, C, and D. With Original Medicare, there is no out of pocket limit for what you pay. You can also go to any provider that accepts Medicare.
Medicare Supplements, sometimes called “Medigap” are policies that help fill the gaps in Original Medicare. Medicare Supplements are sold by private insurance companies. A Medigap policy is designed to help pay deductibles, copayments, and coinsurance that Original Medicare does not cover. Certain Medigap policies may also cover services such as medical care when traveling outside the United States, which is also not covered by Original Medicare. With a Medigap policy, Medicare will pay its share of Medicare-approved amounts for health care costs first, then the Medigap policy pays its share. Most claims will be processed due to the mandatory electronic crossover. You must have Medicare Part A and Part B in order to enroll in a Medigap plan as well as a Medicare Advantage Plan. It is illegal for anyone to sell you both a Medigap and a Medicare Advantage Plan at the same time. Medigap plans generally do not cover dental, hearing aids, eyeglasses, and private-duty nursing or long-term care. Most supplements are guaranteed renewable for life, however, rates can be changed on an annual basis. Medicare Advantage plans are renewed on an annual basis and are not guaranteed renewable. There are also special enrollment periods for Medicare Advantage plans, i.e., Initial, Annual, Open and Special that allow beneficiaries to enroll or make changes. Medicare supplements can be changed year-round but can be subject to approval.