Supplemental Insurance Coverage & Medicare

Medicare is a social program funded and managed by the federal government in the United States. Medicare is primarily meant to help senior citizens receive necessary medical treatments by providing them with health insurance. Medicare Parts A and B, often called traditional or original Medicare, offer benefits for in-patient and out-patient hospital services, home health and hospice. Many seniors need more coverage, however, and add Medicare supplement plans to Parts A and B in order to gain more comprehensive care.

Medicare Part D

• Medicare Part D is an optional Medicare plan for prescription drugs. Part D Medicare is offered through private insurance companies rather than through the government. These insurance companies must be approved by Medicare but can vary in their costs and the kinds of prescription drugs they will pay for. Part D is meant to be added to original Medicare, and is also sometimes provided as part of Medicare Advantage.

Medicare Advantage

• Medicare Advantage, also called Medicare Part C, is a supplement that adds benefits to Medicare Parts A and B. You must already be enrolled in both Part A and Part B in order to join a Medicare Advantage plan. Medicare Advantage is also provided through private companies, so costs and benefits can vary. Medicare Advantage must provide all the benefits of Parts A and B Medicare, with the exception of hospice care. Prescription drug coverage is usually included, and your MA plan may have additional benefits such as vision and dental insurance. Each state has its own set of Medicare Advantage programs, and some may only be offered in certain counties while others are available statewide.

Types of Medicare Advantage Plans

• Medicare Advantage (MA) is offered as several different types of health care insurance. You can usually find MA as an HMO (health maintenance organization) plan, a PPO (preferred provider organization) plan or as a private fee-for-service plan. You can generally also get MA as part of a special needs policy customized for people with specific health conditions. Medicare Advantage is also a supplement to a medical savings account, where Medicare deposits money for benefits straight into your account rather than settling individual claims.

Standard Supplement Plans

• There are twelve standard Medicare supplement plans, lettered A through N. Plans E, H, I and J were offered prior to 2010 but were discontinued as of May 31 of that year. Not all of these supplements are available in all states. These plans are often called Medigap plans, since they fill in the holes Medicare does not cover. They also help members make co-payments, excess charges and co-insurance. Medigap policies may include some of the same benefits as Medicare Advantage plans but they are not part of MA. Plan A is a basic supplement and includes the costs of the first three pints of blood per year, co-insurance for hospital costs up to a full 365 days after traditional Medicare benefits are gone and co-insurance for Part B Medicare. Other plans include more services, such as foreign travel emergencies, preventive care not covered by Medicare and skilled nursing facility co-insurance. Plan F can be purchased with a $2,000 deductible, resulting in lower monthly premiums. Plans K and L also have yearly out-of-pocket costs.