August 25, 2016

Medicare Advantage & Supplement

Medicare Advantage/Supplement

What is Medicare Advantage?

Original Medicare (Part A & Part B): Part A helps with Hospital care and Part B helps with office visits and outpatient care. You contribute to Medicare by paying taxes and in general when you reach 65 you are eligible for Medicare. Medicare does not cover everything and you still need to pay monthly premium, deductibles and copays in various services.

Medicare Advantage (also known as Part C) is the program offered by private insurance companies which combines Part A & B with additional benefits, such as vision, dental, etc. Most plans also cover prescription drugs (also known as Part D). Medicare Advantage plans are all offered by private companies that have been approved by Medicare, and they have “service areas.” typically a county, state or region, where they offer coverage. Generally, you must live in a plan’s service area in order to join it. However, all Medicare Advantage plans must offer nationwide coverage for emergency care, urgent care (care provided outside a doctor’s office or emergency room for conditions that require immediate attention) and renal dialysis. If you join a Medicare Advantage plan, you will continue to pay your Part B premium and your Part A premium, if you have one. The plan may also charge its own premium, although some Medicare Advantage plans do not. Premiums for Medicare Advantage plans can vary widely.

Get Started

Are you newly eligible for Medicare? Do you want to know which Medicare Advantage program best fits your healthcare needs? Give Lexim Advisers a call and we are happy to help you pick the right plan.

What is Medicare Supplement Insurance?

Medicare Supplement (also known as Medigap) insurance, which is sold by private insurance companies, can help pay for some expenses that Original Medicare (Part A and Part B) does not cover. Copayments, coinsurance, and deductibles are some basic costs that may not be covered by Original Medicare. If you have Original Medicare and a Medigap policy, Medicare will pay its share of the covered health care costs and your Medigap will pay its share.

Medigap insurance companies in most states can only sell you standardized Medigap policy identified by letters A through N. Each standardized Medigap policy must offer the same benefits no matter which insurance company offers it. Premium is usually the only difference between insurance companies offering the same plan. For example, if you are interested in a plan “F” Medigap policy, you should expect each insurance company selling this plan “F” to have the same benefits even though premium may be different.

What You Must Know About Medicare Supplement Policies

  • You must have Medicare Part A and Part B.
  • If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
  • You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay Medicare.
  • A Medigap policy only covers one person. If you and your spouse both want coverage, you’ll each have to buy separate policies.
  • You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.
  • Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.
  • All Medigap insurance plans sold today do not cover prescriptions. You should consider buying Medicare Part D (Prescription Plans) offered by private insurance companies contracted with Medicare.

Get Started

Do you want to find out if Medicare Supplement policies fit your healthcare needs? Call Lexim Advisers today and we are delighted to discuss with you.