Medicare Supplement Coverage
If you are 65, you are eligible for Medicare. As you approach your 65th
birthday, you should consider applying for Medicare.
There are two types of Medicare: original Medicare and
Original Medicare is divided into two parts: Part A and Part
B. Part A covers you when you’re in the
hospital, a skilled nursing facility, or receiving hospice or home health
services. If you worked and paid
Medicare taxes for at least 10 years, there is no additional charge for Part
A. If not, there is a monthly charge.
Part B covers services from doctors and other health care
providers, outpatient care, durable medical equipment, and preventive
services. You must pay a monthly
premium that varies according to your income for part B.
Original Medicare provides coverage for hospital stays and
for seeing your doctor but does not cover all of these costs. There are deductibles and copayments. Since these amounts not covered by Medicare
can be substantial, you may want to think about buying another health insurance
policy to pay the rest.
This is where Medicare supplement insurance, sometimes
called Medigap, comes in. Medicare
supplement insurance is private insurance that fills in the gaps left by
Medicare. For instance, when you have a
hospital or doctor bill, Medicare pays its approved amount first, then the
supplemental insurance pays other costs, such as deductibles and copays.
There are several different Medicare supplement plans, and each are
identified by a letter. The type and
amount of benefits covered by each plan determines how expensive it is. Here is a chart listing the various benefits
provided by each plan:
All insurance companies must offer the same benefits under a
given plan. In other words, Medicare
Supplement Plan A will have the same benefits regardless of which company sells
it. However, the premium you pay for
that plan may differ from one company to another. It is important to note that most Medicare
supplement plans do not include dental or vision coverage.
An alternative to Original Medicare and Medicare supplement
insurance is Medicare Part C, or Medicare Advantage. These Medicare-approved health plans are run
by private insurance companies and provide benefits for hospital, doctor, and
other health care provider services covered under Original Medicare Parts A and
B as well as supplemental benefits that vary by plan. The insurer receives money from Medicare and
may also charge you a premium in some cases, depending on the benefits covered.
Medicare Advantage might require you to
use certain doctors and hospitals.
Prescription drug coverage is available under Medicare Part
D. Prescription drug benefits are
included in some Medicare Advantage plans but otherwise must be purchased
One other important piece of information to note is that,
unlike many employer or private insurance policies, you and your spouse must
purchase individual policies. Your
policy will not cover your spouse.
Choosing the right Medicare supplement plan can be
complicated. There are a number of
questions to ask. Talking with family
members, friends, and a trusted financial adviser are good ideas before picking
a Medicare supplement plan, but you can get more information on Medicare's website. You can also visit the Pennsylvania Department of Aging's Apprise Program, which is licensed by the federal government to provide insurance counseling services to seniors.
Though we can’t recommend any specific plans, we may be able
to help answer some questions. Contact
our Consumer Services Bureau online
or call our consumer hotline at 1-877-881-6388.