What exactly is Medicare?
Medicare is a federal health insurance program for people 65 and older, as well as certain younger people with disabilities and those with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Medicare’s various plans assist in the coverage of specific services:
Hospital Insurance (Part A of Medicare)
Part A of the plan covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
Medical Insurance (Part B of Medicare)
Part B provides coverage for specific doctor’s services, outpatient care, medical supplies, and preventive services.
Medicare Advantage Plans (Part C of Medicare )
A Medicare Advantage Plan is a type of Medicare health plan provided by a private company that has a contract with Medicare to provide all of your Part A and Part B benefits.
Prescription Drug Coverage (Part D of Medicare)
Part D supplemented Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans with prescription drug coverage.
What Are the Benefits of Medicare Advantage Plans?
Except for hospice care, Medicare Advantage Plans must cover all of the services that Original Medicare does. Even if you have a Medicare Advantage Plan, Original Medicare covers hospice care. You are always covered for emergency care under all types of Medicare Advantage Plans. Medicare Advantage Plans may include additional benefits such as vision, hearing, dental, and/or health and wellness programs. The majority of them include Medicare prescription drug coverage (Part D). You usually pay a monthly premium for the Medicare Advantage Plan in addition to your Part B premium. You can also request a written advance coverage decision from the plan to ensure that a service is medically necessary and will be covered. If the plan does not cover a service you believe you require, you will be responsible for the entire cost if you did not request an advance coverage decision.
Medicare Supplement Insurance
Medicare supplement (Medigap) insurance can help pay for healthcare costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Some Medigap policies also provide coverage for services that Original Medicare does not cover, such as medical care while traveling outside the United States. If you have Original Medicare and purchase a Medigap policy, Medicare will pay its share of covered health care costs up to the Medicare-approved amount. The remainder is covered by your Medicare supplement insurance policy. A Medigap policy is not the same as a Medicare Advantage Plan. Those plans are methods of obtaining Medicare benefits, whereas a Medigap policy only supplements your Original Medicare benefits.
A Medigap policy insures only one person. We will work with you to set up two separate policies if you and your partner both want Medigap coverage. Even if you have health issues, Any standardized Medigap policy is guaranteed to renew. This means that as long as you pay your premiums, the insurance company cannot cancel your Medigap policy.
Specific to Veterans
We represent several plans that offer you more benefits, options for care closer to home and affordable costs, including plans with $0 premiums and Medicare Part B givebacks. Our Medicare Advantage (MA) plan doesn’t replace your Veterans Affairs (VA) coverage; it complements it. With a Medicare Advantage plan, you can use healthcare providers and hospitals outside the VA system, which may be closer to home, especially in an emergency. And if you select a plan that includes coverage for Rx drugs, you can get your prescriptions from your local in-network pharmacy.