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Medicare Part C

Differences Between Medicare and Medigap

One of the benefits of our medicine system is there are tools the elderly can use to take better care of themselves. The main thing which confuses seniors is the difference between Medigap and Medicare and which plan is the best for them.

It is extremely important to realize the fact that Medicare is not sufficient to cover all your medical expenses. This is the reason why Medicare supplements are created to fill the gaps in between the original Medicare coverage. These Medicare supplements are also known as Medigap insurance. Every state can differ in terms of Medigap policies, the Medigap plans in Arizona are regulated by the State of Arizona and the federal government.
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There are basically twelve (12) standardized Medicare Supplement plans naming from (A to L) that is covering the entire United States. These 12 Medicare supplements plans have their own set of basic and extra benefits. All insurance companies are obliged to sell Plan A and B as a rule of law. One thing which is common among the Medigap plans is that you cannot be charged differently from others in a particular state for a Medigap insurance plan. For example, if you pay $200 amount for Plan D in Miami, everyone will be paying the exact same amount everywhere in United States. Your Medicare supplements can only cover your expenses, you will have to buy separate policy even for your spouse.

One thing should be kept in mind is you don’t need to buy Medigap insurance policy if you are covered under a group of health insurance plan. And it is not necessary that all 12 plans may be available in all the areas.

Differences between Medigap and Medicare

Many people confuse themselves with the Medicare and Medigap advantages. Basically, Medigap refers to a bunch of supplemental insurance plans that works with the combination of regular medical benefits. Many medical options such as hospital accommodation or international transport are usually not covered in Medicare plans however they are covered in Medigap plans.

Expensive payments are also often covered in Medigap that are charged to Medicare patients without Medigap. Different insurance companies which sell Medigap plans give the same benefits all over the country. Insurance companies can be different but the policies, terms and conditions and the benefits will be same all across the United States. Another thing to keep in mind is that Medicare advantage plans replaces the original Medicare because these Medicare plans are run by private companies and must be able to provide the same coverage as Medicare A and Medicare B.

Some Medicare advantage plans also offer dental, vision, ENT or prescription coverage. Medicare plans are usually much cheaper than Medigap plans, if you are short on funds or you have planned to settle at one place, than Medicare is the best choice for you.

According to the latest research, Medigap plans are typically more expensive than the Medicare advantage plans. Medigap offers a variety of additional coverage to Medicare whereas the coverage of Medicare and Medicare advantage is almost same. Medicare offers a smaller network of doctors but Medigap allows the access to a larger network of doctors. In short, Medicare is recommended for those who are on a tight budget and if your pocket allows you than you must go for Medigap.

Medigap and Medicare plans have same prices almost across whole of the United States and these prices are set using the below mentioned three methods:

Community-Rated method: This method charges everyone the same premium regardless of their age or sex.

Age-Rated method: This method sets the price based on your age when you purchase the plan.

Attained-Age-Rated method: This method will increase the cost each year as you age.

Before buying any plan for yourself, you should understand the levels of coverage from (A-L). Plan F covers everything that Medicare fails to cover, so you do not have to pay any extra costs for doctor/hospital. Lower levels of coverage involve a corresponding lower premiums but doesn’t fill like the Plan F. Another thing to remember is that only you can determine which is the best plan for you as there several type of “pay now or pay later” plans. For example, Pay Now Medigap plans are the most expensive each month. however they will save you a great portion of money if you need extensive medical treatment or service. If you think that your budget can afford a Medigap plan, than they are the best way to protect your health. Pay Later Medicare will always seem to be less expensive in short run because of their lower monthly premiums. Extra services including hospital accommodation, transport or other prescriptions are much more expensive with Medicare plans than with the Medigap plans.

If you are interested in any of the Medicare or Medigap plans, visit AZ Medicare, the best Medicare insurance for Arizona residents. For senior citizens, Medicare only covers 80% after your deductibles have been paid. Medicare plans usually don’t include Plan D which is the drug plan, but it may be included in your Medigap plans.

Medicare advantage plans further include several types of plans, some of which are:

Health maintenance Organization (HMO) plan: Your choice is restricted for hospitals and doctors in this plan, except for emergencies.

Preferred Provider Organization (PPO) plan: You can choose doctors or hospitals outside the scope but it will cost you more in addition to the medical care within PPO.

Private Fee-for-Service (PFFS) plan: You are free to select your hospital or doctor in any way you want. The plan will determine the sharing of expenses.

Medicare Enrollment: Doing Nothing Can Be Costly!

If you will become age-eligible for Medicare in 2011, you may be tempted to let your Medicare enrollment slip. Perhaps you’re still employed or you have health care coverage through your spouse. Regardless of the reason, if you don’t enroll in Medicare within three months of your 65th birthday, you could end up paying a premium penalty for the rest of your life, based on when you finally enroll in the plan.

When you become age-eligible for Medicare, you have a “special enrollment period” during which you can enroll in Medicare for the first time. The special enrollment period begins three months before your 65th birthday and ends three months after your birthday.

If you don’t enroll in Medicare during the special enrollment period, you’ll be paying a permanent penalty in the form of increased monthly premiums on Medicare coverage. The penalties can vary, and they apply to all Medicare coverages for which you pay premiums. In other words, the penalty will apply to Medicare Part B, Medicare Part C and Medicare Part D premiums.

This is especially important to understand for Medicare Part D coverage. Medicare Part D coverage is optional. If you opt out for a year or two, even if you enrolled in Medicare Part A and Part B plans, you’ll still pay the premium penalty for your prescription drug coverage when you enroll in a Part D plan.

To avoid the premium penalty, many Medicare-eligible beneficiaries enroll in the lowest cost plans possible when they first become eligible. This strategy may have you spending some additional cash up front, but it will prevent you from paying potentially large non-enrollment penalties later.

One other caveat: your eligibility to enroll in Medicare Supplemental Insurance plans begins when you first become eligible for Medicare. If you choose not to enroll in Medicare at that time, you may forfeit your opportunity to enroll in a supplemental insurance plan later. If you eventually want traditional Medicare Part A and Part B coverage, examine the Medicare Supplemental Insurance plans carefully during your special enrollment period.

Medicare Advantage Plan v. Medicare Supplement: Which One Is Right?

Medicare InsuranceIf you are new to Medicare, or will be joining the ranks of the Medicare-eligible in 2011, you may not know much about Medicare, Medicare Advantage Plans and Medicare Supplemental Insurance, also known as Medigap.  In addition, you’ll probably want to take a crash course in Medicare Part D plans, just to be on the safe side.

Traditional Medicare coverage is designated as Medicare Part A and Medicare Part B.  Part A coverage, which pays for hospitalization, has no additional premium, provided that you are age-eligible for Medicare.  Part B coverage has a premium attached to it. In 2010, the monthly premium was about $111, and is deducted from your monthly Social Security check, Railroad Retirement or Office of Personnel Management payment. If you receive none of these payments, you’ll get a quarterly bill in the mail for your Part B premiums.

You can choose some other Medicare options, including a Medicare Advantage Plan (Medicare Part C), an optional Medicare Part D plan for prescription drug coverage, and a range of Medicare Supplemental Insurance plans, collectively known as Medigap insurance.  Medicare Advantage plans take the place of Medicare Part A and Part B coverage and operate much like an HMO plan does.  Medicare Advantage plans generally offer some additional coverage that traditional Medicare plans do not.

You may also be required to enroll in a Medicare Part D plan if you choose to go with Medicare Advantage coverage.  With Medicare Advantage, you’ll still pay your Medicare Part B and Part D premiums. You may also have to pay additional premiums for a Medicare Advantage plan, depending upon the level of coverage you choose.

You can also choose to enroll in one or more Medicare Supplemental Insurance plans. Medigap plans are designated by letter (e.g., Medigap A, Medigap B, etc.) Each letter plan offers a different level of coverage but all Medigap letter plans are the same, regardless of the insurer that provides them. For example, all Medigap A plans have identical coverage; all Medigap B plans also have identical coverage, etc.) Insurers are not required to offer all Medigap insurance plans, and the premiums among insurers can vary.

Medigap supplemental insurance is designed to provide coverage for certain services that Medicare Part A, Part B and/or Part D don’t pay for, or don’t cover completely.  To take advantage of a Medigap insurance plan, you must be enrolled in both Medicare Part A and Part B. You will pay additional premiums for these services to a private insurance provider, and the additional insurance is strictly optional.  Many Medicare beneficiaries choose not to buy supplemental coverage either because they don’t need it or can’t afford it. Also, each recipient must have his or her own Medigap plan. Your Medigap insurance will not provide benefits to your spouse.

Since each beneficiary’s situation is different, your best strategy is to read all information about Medicare prior to enrolling in a plan. When you become eligible, you will receive a Medicare information booklet in the mail. This document has all of the basic information you’ll need about Medicare. You can also visit the Medicare Web site if you have Internet access to find out more information about Medicare coverage, Medicare Advantage plans and Medicare Supplemental Insurance.

Choose the insurance options that offer the best combination of coverage and cost, based on your income, your current health, and the coverage you’re likely to need in a given year. As you age, you may want to review your coverage and make changes to meet your evolving health needs.

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