Definition of Medicare Supplemental Insurance

Medicare is a health insurance program funded by the federal government that provides medical insurance for most people 65 years of age or older. The program also provides coverage for younger people that are disabled or have permanent kidney failure.

What does Basic Medicare Cover?

• Basic Medicare only pays for a portion of an eligible person's medical bills. Most conditions are covered. However, in-home care, assisted living care and nursing home care are not covered by Medicare, nor is treatment for certain chronic disabilities or lengthy illnesses. In addition, prescription coverage is also limited with Medicare. To combat the limitations of basic Medicare coverage, four additional parts have been added to the program, requiring a person to pay monthly enrollment fees, deductibles, and co-insurance amounts.

Medicare Part A Coverage

• Part A Medicare benefits include some inpatient hospital care, hospice care, some nursing facility care, and even some in-home care; it also pays for a semiprivate room, tests, food and doctor's fees. Most Medicare recipients do not have to pay a premium for Part A Medicare coverage.

Medicare Part B Coverage

• Medicare Part B recipients do have to pay a small monthly premium for coverage. These premiums are used to pay for outpatient hospital care, doctors, physical therapy and occupational therapy. Part B also covers flu and pneumonia vaccinations, lab tests, x-rays, blood transfusions, and limited ambulance transportation, as well as medication administered in a doctor's office. Canes, walkers, scooters, wheelchairs,and some artificial limbs are also covered under this plan. Part B is optional and the recipient can choose to purchase the coverage or decline.

Medicare Part C Coverage

• Medicare Part C, also known as "Medicare Choice," covers HMO care, PPO care and coverage from other health care organizations. However, the recipient's choice of doctors and hospitals offered through the health care organizations are limited to providers within the health care organizations network.

Medicare Part D Coverage

• Part D Medicare coverage is for prescription drugs, and a monthly premium and deductible are required for participation. Although Medicare Part D is approved and regulated by the federal government's Medicare program, private health insurance companies actually design and administer the medications covered under the individual company's plan.

Supplemental Medicare Insurance

• Medigap, a supplemental Medicare insurance coverage, is provided by a private insurance company. Although federal law has defined 12 Medigap plans, not all states provide all 12 plans. To determine which Medigap plans are available in each state, click on the link below.