Medicare Supplements

Medicare Health Insurance is for:

  • People age 65 or older
  • People under 65 with certain disabilities, including End Stage Renal Disease.

You have two Medicare insurance coverage choices

1. Original Medicare

Part A

Hospital Insurance

Medicare Part A helps cover the following:

  1. Inpatient care in hospitals (such as critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals)
  2. Inpatient care in a skilled nursing facility (not custodial or long term care)
  3. Hospice care services
  4. Home health care services

Part B

Medical Insurance

Medicare Part B helps cover some medically necessary services like:

  • Doctors’ services
  • Outpatient care
  • Home health care services
  • Medical services
  • Other medical services

You can find out if you have Medicare Part B by looking at your Medicare card.

You pay the Medicare Part B premium each month. Most people will pay the standard premium amount.

There are two kinds of Medicare Part B-covered services:

  1. Medically-necessary services are services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  2. Preventive services include health care to prevent illness or detect it at an early stage, when treatment is most likely to work best (for example, Pap tests, flu shots, and colorectal cancer screenings).

You usually don’t pay a monthly premium for Medicare Part A coverage if you or your spouse paid Medicare taxes while working.

Part C

2. Medicare Advantage

A Medicare Advantage Plan (like an HMO or PPO) is another health coverage choice you may have as part of Medicare.

Medicare Advantage Plans, sometimes called Medicare Part C or MA Plans, are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. In all plan types, you’re always covered for emergency and urgent care.

Not all Medicare Advantage Plans work the same way. Out-of-pockets can vary, some plans require referrals to see specialists and many have provider networks.

Types of Medicare Advantage Plans include the following:

  • Health Maintenance Organization (HMO) Plans
  • Preferred Provider Organization (PPO) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Medical Savings Account (MSA) Plans
  • Special Needs Plans (SNP)

Part D

Optional Prescription Drug Coverage

Medicare Part D is a prescription drug option run by private insurance companies approved by and under contract with Medicare to help cover the cost of prescription drugs.
It may help lower your prescription drug costs and help protect against higher costs in the future.

You have out-of-pocket costs with Original Medicare

The amount you must pay before any coverage pays.

An amount you may be required to pay as your share of the cost for services after you pay any deductibles.
Coinsurance is usually a percentage (for example, 20%).

An amount you may be required to pay as your share of the cost for a medical service or supply.
A copayment is usually a set amount, for example, you might pay $10 or $20 for a doctor’s visit or prescription drug.

Medicare supplement insurance helps you pay your out-of-pocket costs.

Works with Original Medicare Parts A and B

A Medicare supplement insurance policy, also known as a Medigap policy, helps pay your share (coinsurance, copayments or deductibles) of the costs of Medicare-covered services. Some Medicare supplement policies cover certain costs not covered by Original Medicare Parts A and B.

Companies Offer the Same Basic Benefits

Medicare supplement insurance companies can only sell you a standardized Medicare supplement policy identified by letters A through N. Each standardized Medicare supplement insurance policy must offer the same basic benefits, no matter which insurance company sells it. Cost and customer service are usually the only difference between Medicare supplement policies sold by different insurance companies.

When You can Apply for Medicare Supplement Insurance

You can apply for a Medicare supplement insurance policy just about any time you’re eligible for Medicare and enrolled in Medicare part B, including when:

  • You’re in your open enrollment period
  • You’re past your open enrollment period as long as you don’t have other coverage
  • You want a Medicare supplement plan with a lower premium
  • You leave your Medicare Advantage/Private Fee for Service plan
  • Your employer discontinues its group retiree health coverage