Health Insurance for Medicare Recipients

Medicare recipients have a wealth of insurance options. So many options, in fact, that it can get confusing. There are a few basic types of plans, though. This is by design so that it's easier to compare one plan to another. You have original Medicare, of course, Medicare Supplements (also called Medigap Plans), Medicare Advantage plans, Medicare Part D, Medicaid and other health insurance through a retirement plan or through the Veterans Administration.

Original Medicare

• Original Medicare is made up of two parts: Part A and Part B. Part A covers hospitalization in a semi-private room for up to 90 days per benefit period. A benefit period begins when you're hospitalized and ends when you've been out of the hospital for 60 days. Part A has a deductible of more than $1,000. Part B is the "medical" part of Medicare. You pay a monthly premium, an annual deductible and co-insurance of 20 percent. Part B covers doctor visits and durable medical equipment, among other things. You can opt to just have original Medicare as your health insurance if you choose, although you may want to consider at least adding a Part D plan for your prescription coverage.

Medicare Supplements

• Medicare Supplements, also referred to as Medigap Plans, are regulated by Medicare and are designed to be secondary to Medicare Parts A and B. There are several plans, and what they cover varies. Plans may cover the Part A deductible, Part B deductible, Part B coinsurance, skilled nursing care insurance, Part B excess charges (a percentage above the Medicare-approved amount that providers can charge) and foreign emergency coverage. There is a monthly premium for these plans, and they are available through private companies. Contact your state department of insurance for which companies and what plans are offered in your state.

Medicare Advantage Plans

• Medicare Advantage Plans, or Part C, are plans that take the place of Medicare. You keep all your rights as a Medicare beneficiary; it just means that the MA plan is primary rather than Medicare itself. MA plans usually include your Part D, or prescription, coverage. MA plans can be Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-For-Service Plans or Special Needs Plans. Special Needs Plans are designed for those on both Medicare and Medicaid. There is a monthly premium for all plans except the Special Needs Plans.

Medicare Part D

• Medicare Part D is Medicare's prescription drug benefit. Part D is available through private companies. Most companies offer two or three plans, with varying co-payments and monthly premiums. Each company has its own formulary and classifies prescriptions into tiers. If you have a Medicare Supplement or original Medicare, you may want a Part D plan. There is a penalty if you don't enroll when first eligible and decide to enroll later.

Medicaid

• Some Medicare beneficiaries are also eligible for Medicaid. Medicaid is for low-income individuals and families, and covers the vast majority of medical and prescription costs. If you think you may qualify for Medicaid, it's worth taking the time to apply. Contact your local Department of Aging, Department of Health or Social Services for more information.

Other Health Insurance

• Many Medicare beneficiaries have insurance through jobs, retirement plans or pension plans. Generally, if you're working, the health insurance you have through work is primary, and if you're retired, Medicare is primary. If you have Veterans Administration benefits, generally the VA will pay first, with Medicare helping with co-pays. If it's a service the VA doesn't cover, but Medicare does, Medicare will pay. If you have TRICARE, generally TRICARE will pay first. TRICARE is the health plan provided to current and retired military members and their dependents and survivors.