Article by Wiley Long
While all health insurance covers some kind of health care, plans that are designed for Medicare beneficiaries have very different rules.? When you?re eligible for Medicare, you can rely solely on its coverage, or you can augment that.? Before making any decision, take a look at what Medicare provides.??
Part A, which is free for most people, addresses hospital charges.? Unfortunately, Part A only helps after you have met a ,132 deductible per benefit period (2011).? Rather than the annual deductible you?re probably used to seeing on health insurance policies, the Part A deductible only lasts until you have not needed hospital or skilled nursing facility inpatient care for 60 straight days.
If a fractured hip lands you in the hospital, Medicare will pick up the bill for charges in excess of that ,132 deductible up to a 60-day limit.? When you need a longer hospital stay, Medicare downgrades to partial coverage.? Spending enough to meet the Part A deductible does not meet the deductible for the whole year, though.? A deductible period ends when you have not been in the hospital or in a skilled nursing facility for 60 consecutive days.??
If you fall later in the year, get pneumonia, or anything that necessitates hospitalization, you may be into another benefit period, which will trigger another deductible.??
Medicare Supplement Insurance Options Work In Various Ways
You basically have two choices to add to your Medicare coverage.? You can replace the government-funded coverage with one the Medicare Advantage Plans offered by private insurance companies.? You?ll get all the coverage available through Medicare and, usually, some extra bonuses, like help with hearing aids and eyeglasses.
Unlike Medicare, Medicare Advantage Plans operate under individual company rules within Medicare?s guidelines.? The prescriptions covered by these private plans will be different.? The network of providers will probably be more limited, too.
If there are no Medicare Advantage Plans available where you live, you will probably have access to at least some of the Medicare Supplement Plans that are also offered through private insurers.
Known as Medigap Plans, these supplements do not replace Medicare in the manner than Advantage plans do.? Medigap Insurance works with Medicare to pay for services that Medicare doesn?t cover.??
For example, Medicare?s coverage for doctor visits is limited to 80 percent of a standard amount per specific service after you?ve met what?s known as the Part B deductible.? That?s 2 for 2011 and it is an annual deductible, unlike the Part A one.?
After you meet that deductible, if your doctor accepts Medicare payments, you?ll still owe for 20 percent of each bill.? If your doctor charges in excess of Medicare?s payment, you?ll owe for 20 percent of Medicare?s pre-determined rate for that service plus anything above Medicare?s pre-determined amount that your doctor charges.
Medigap Plans can cover all of your out-of-pocket costs under Medicare depending on which form of Medigap Insurance you choose.? While Medicare Advantage Plans operate under separate rules, Medigap Plans are run under only 10 sets of coverage.? These plans are labeled Plan A, Plan B, etc., to specify what benefits are included.? Once you decide which benefits you want, you?re well on your way to finding the plan you want.
Medigap Insurance Pricing Various Tremendously
You?d think that plans with the same coverage would cost relatively the same, or least be in the same ballpark.? That?s not the case with Medigap Plans offered through different insurance companies, though.? The only way to know whether you?re paying more than you need to for a specific plan, like Medigap Plan F, is to check out rates from lots of companies for that plan.
While that may sound like too much trouble, consider that people have been found to be paying literally hundreds of dollars more than others for the very same coverage.? Checking rates from several insurers is really easy if you use the Internet, too.? Find a website that instantly searches for rates available where you live for a specific Medigap Plan, and you can see a side-by-side comparison in less than a minute.?
It may not be worth buying a computer just for that, but libraries and senior centers sometimes provide free Internet access that?s long enough to allow you to search and compare rates.? You can also find extensive Internet resources to help you understand how Medicare, Medicare Advantage Plans and Medigap Insurance work.
By Wiley Long ? President, MedigapAdvisors.com ? The nation?s leading independent agency specializing in Medigap Insurance. Contact our experienced MediGap advisors for help choosing the best Medigap plan for your needs.
By Wiley Long ? President, MedigapAdvisors.com ? The nation?s leading independent agency specializing in Medigap Insurance. Contact our experienced MediGap advisors for help choosing the best Medigap plan for your needs.
Tags: Conventional, differs, from, health, insurance, medicare, supplement
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