Medicare and Medigap Insurance Plans were created to fill the gap left by Original Medicare when private health insurance was not available to senior citizens. To qualify for Medicare, a person must have a genuine “existing condition.” Although Medicare does not pay all of a person’s medical expenses, Medicare does ensure most of them. Because Medicare does not cover all of a person’s medical expenses, the Government pays for the rest.
Medicare Supplement Insurance is purchased to be an alternate payer to Original Medicare, while Medicare Advantage Plans are selected based on the coverage needs of an individual. Although Medicare does not pay for everything, Medicare does provide coverage for some things that insurance companies usually charge extra for.
Medicare coverage includes nursing home care, certain outpatient hospitalization benefits, blood and platelet donations, foreign travel emergency services, durable medical equipment, and eyeglasses. Medicare does not cover costs associated with dental services, hearing aids, cosmetic surgery, braces or lenses, moving inpatient care, transportation services, and food services.
Many people do not realize that Medicare does not cover all of their annual prescription drugs. For this reason, they may choose to purchase a Medicare Part D, or Medicare Part A, policy instead of a Medicare Supplement Insurance plan. However, Medicare supplement plans does provide coverage for some prescription drugs, which means that a Medigap Insurance Plan is the better choice for individuals who need prescription coverage but do not want to pay full-blown Medicare rates.
Some of the more common medications covered by Medigap plans are acne medication, cholesterol medication, arthritis medication, chemotherapy drugs, diabetes medicine, heart medication, hip or knee pain medication, pain reliever or preventive medicine, radiation therapy, and oral cancer or tumor medication.
The premiums charged by Medigap Insurance Plans and Medicare Supplement Insurance Plans are often quite different. Although they are similar in most respects, there are a few differences in the structure of the premiums, as well as the cost per month of Medicare Part A and Medicare Part B.
The two forms of coverage operate under somewhat different rules. For example, while Medicare Part A premium payments are made every month, Medicare Part B premium payments are made based on the higher of the two figures. Also, when an individual reaches the ages of 65 and above, their Medicare costs increase dramatically, resulting in higher premiums as well.
Another difference between Medicare Supplement Insurance Plans and Medigap Insurance Plans is that Medicare Advantage Plans do not restrict the age of enrollees. In addition, while Medicare Supplement Plans allow you to enroll without requiring a hospitalization, Medicare Advantage Plans do not allow you to enroll without having a pre-existing health condition.
Instead, you must first enroll in a Medicare Advantage Plan with a participating healthcare provider. Enrollment in a Medicare Advantage Plan requires you to first select a participating healthcare provider before being able to enroll in Medicare Parts A and B.
Medicare Supplement Plans are standardized and may be purchased at any participating pharmacy in the United States. Medicare Advantage Plans are not standardized and cannot be purchased anywhere. These plans offer some unique benefits, such as prescription drugs coverage, which is not offered by other plans. While they do cost more than Medicare Parts A and B, Medicare Advantage Plans can be tailored to fit your exact medical needs. Medicare Supplement Insurance Plans and Medicare Advantage Plans can also be tailored to meet your specific health care needs.