Tuesday, September 18, 2012

The Ins and Outs of Medicare

The world of Medicare is one in which is ever changing and always a bit confusing for those embarking on it for the first time. Below is a quick guide to enrolling in Medicare and Supplemental Insurance Plans.

When it comes to Medicare Part A enrollment is fairly easy as this is something you don’t have to actively participate in.  Once you become sixty five you are automatically enrolled in the program if you have elected to receive Social Security or a railroad retirement disability.  If you are holding off on receiving social security it is super simple to fill out and file an application.  You can call and have one sent or go to the government site which offers information about Medicare.

Medicare Part B is also a plan in which participants are automatically enrolled when participants become eligible. Part B of Medicare is one that is optional and can be declined.  Part B requires a monthly premium be paid for coverage.  Remember you may have to apply for coverage if you are not receiving social security are employed by the government or have kidney disease.

You are only able to enroll without penalty if you enroll during open enrollment.  Three months before participants turn sixty five and three months after is the period in which open enrollment for Plan B takes place.  After that or if you previous declined insurance there is a ten percent plan increase per twelve month period you could have signed up but didn’t.  This changes however if participants are covered under a separate group health plan in which case you have up to eight months after that coverage ends as open enrollment for Medicare Part B.

The Medicare Advantage Plan takes the place of Medicare Part A, Part B and Supplemental Medicare Insurance.  You can take part in this plan or stop taken part of the Medicare Advantage program during the annual coordinated enrollment period which is November 15th through the 31st of December.  While Medicare Part A and B are enrolled through Medicare direct the Medicare Advantage plan requires enrollment through individual companies that offer the plan. 

Next is the step involving supplemental plans.  In order to purchase a Medigap policy you must be enrolled in Medicare coverage.  Enrolling in Medigap begins on the first day of the first full month that you are sixty five or have enrolled in Part B Medicare and ends after six months.  This is the period in which an insurance company must waive all exclusions such as pre-existing conditions and accept all participants.  The must also allow your coverage to begin immediately.  After the six months insurers have the right to deny selling you a particular Medigap Supplemental Plan.

This article contains the basic enrollment information for the general arenas for Medicare.  There are other areas to consider such as prescription drug coverage plans, otherwise known as Medicare Part D.  For more in depth information is a good idea to contact an insurance agent that sells Medicare Supplemental Plans.  They will be able to guide you through the complex maze of Medicare and all that encompasses it. 

The Basics of Medicare and Medigap Insurance

Medicare originally is understood to be Part A, which is hospital insurance and Part B, which is medical insurance.  This original coverage allows for many but not every medical or health related service and supply.  There is insurance available, called Medigap or Medicare Supplemental Insurance that covers expenses that are not covered under the general Medicare Part A and Part B. 

This includes things such as copayments, coinsurances, deductibles and expenses when traveling outside of the United States.  Believe it or not the out of pocket expenses can add up very quickly and before you know it you could have easily paid the monthly premium of a Medicare Supplement Plan.

Many Medicare participants don’t understand exactly how Medicare and Medigap work together.  First it should be understood that when you do choose a Medigap policy, Medicare will still pay their approved share upfront and then the Medigap policy pays its share of the cost.  

It is best to understand that Medigap policies are sold by private insurance companies. The policy itself is the same no matter who sells it however the cost to participants might change. When you buy Medigap Plan G at one insurance company is the exact same coverage you will receive through another insurance company. The difference being the premium you pay them to offer you the insurance. This is one of the reasons it is so important to do research before settling on a Medigap plan and provider. 

Each plan covers a variety of services to their participants. Below is a list of options you should look for when choosing a Medigap policy to suit your diverse needs.

·         Inpatient Hospital Care: This piece will cover the coinsurance for Medicare Part A not the deductible though.
·         Medical Costs: This piece will cover the coinsurance for Medicare Part B and copayments for hospital outpatient services. This can save a lot of money as the coinsurance amount left from Part B is twenty percent of the Medicare approved amount.
·         Blood: Believe it or not without a Medigap policy, blood is not covered.  The right Medigap policy will cover the first three pints of blood you need each year.
Other benefits that are included in Medigap Policies can include a variety of services some of which are in the list below.
·         The annual hospital deductible
·         Coinsurance for skilled nursing facilities
·         The annual deductible for Medicare Part B
·         During travel abroad emergency care coverage
·         Recovery at home
·         Care not covered by Medicare
·         Excess charges from the doctor above and beyond the pre-approved Medicare amount

If you are enrolled in the Medicare Advantage Plan you will not purchase Medigap insurance. It is unnecessary as the items covered by the Medicare Advantage Plan are equivalent to the items covered within MedicareSupplemental Insurance.   If you would like more information on Medicare and Supplemental Insurance a great online resource is run through the government although you are not able to purchase Medigap policies directly through the government. To purchase a policy it is best to research insurance providers in your area that offer Medigap insurance.