Navigating Medicare Supplement Plans for Individual Wellness

Types Of Medicare Plans & Medicare Supplement Plans

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. While Medicare covers many medical expenses, there are still some out-of-pocket costs that can add up. That's where Medicare Supplement Plans, also known as Medigap, come in.

Medicare Supplement Plans are designed to help pay for the costs that Medicare doesn't cover, such as coinsurance, copayments, and deductibles. There are ten different types of Medicare Supplement Plans, each labeled with a letter from A to N, each offering different levels of coverage.

Here is a breakdown of the different types of Medicare Supplement Plans:

• Medicare Supplement Plan A: This is the most basic Medigap plan and covers the essential benefits, such as Part A coinsurance and hospital costs, Part B coinsurance and copayments, and the first three pints of blood.
• Medicare Supplement Plan B: This plan offers the same coverage as Plan A, with the addition of Part A deductible.
• Medicare Supplement Plan C: This plan provides comprehensive coverage, including all the benefits of Plan A and B, as well as coverage for skilled nursing facility coinsurance, Part B excess charges, and emergency care when traveling abroad.
• Medicare Supplement Plan D: This plan covers everything in Plan A, except for the Part B deductible.
• Medicare Supplement Plan F: This plan is one of the most popular plans and covers everything in Plan C, including Part B deductible.
• Medicare Supplement Plan G: This plan is similar to Plan F, but it does not cover the Part B deductible.
• Medicare Supplement Plan K: This plan covers only 50% of Part A coinsurance, hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and the first three pints of blood.
• Medicare Supplement Plan L: This plan covers 75% of the same benefits as Plan K.
• Medicare Supplement Plan M: This plan covers the same benefits as Plan D, except it only covers 50% of the Part A deductible.
• Medicare Supplement Plan N: This plan covers everything in Plan D, with the addition of Part B coinsurance and copayments.

In addition to Medigap plans, there are also several types of Medicare Advantage Plans, also known as Medicare Part C. Medicare Advantage Plans are offered by private insurance companies and are an alternative to Original Medicare. These plans often include prescription drug coverage and additional benefits, such as dental and vision.

Here are the different types of Medicare Advantage Plans:

• Health Maintenance Organization (HMO): This plan typically requires you to see doctors and other healthcare providers within the plan's network.
• Preferred Provider Organization (PPO): This plan offers more flexibility in choosing healthcare providers but may cost more if you see doctors outside of the plan's network.
• Private Fee-for-Service (PFFS): This plan sets the amount it will pay for healthcare services and allows you to see any healthcare provider who accepts the plan's payment terms.
• Special Needs Plans (SNPs): This plan is designed for people with certain health conditions or who require specialized care.
• Medicare Medical Savings Account (MSA): This plan combines a high-deductible health plan with a medical savings account.

Which Medigap Plan Is The Best Fit For You

Most people purchase a policy with the highest coverage they can afford. Unfortunately, these expensive policies often do not cover everything the policyholder may need. An unexpected hospital visit for an emergency, accident, or surgery can result in outrageous medical bills. An unaware policyholder could be sued for damages if the hospitalization isn't covered by the policy. A careful review of the terms of your policy is the best way to determine exactly what coverage you have and what you may need.

Before shopping for a policy, make sure you understand the specific provisions of the policy. Each company has a slightly different definition of a pre-existing condition and some health conditions are not covered under some companies' policies. Also, keep in mind that each individual health plan is somewhat different from the rest. Know the types of coverage you are looking for before shopping for a policy.

There are different forms of supplemental insurance. HMOs, PPOs, and POSs all offer various kinds of plans to policyholders. Most people opt for a PPO type of plan because it allows a person to choose their doctors and specialists. The monthly cost is usually lower with this type of policy.