Many of us spend a lot of time trying to understanding the difference between Medicare and Medigap plans. Today, you will clearly get to know the difference between these two. This article will also help you to wisely select your plan.
Basically, Medicare supplement plans are also known as Medigap plans or policies and they can cover some of the costs that original Medicare coverage doesn’t include. Originally, the government provides Part A and Part B of Medicare coverage to all the eligible individuals. However, this Medicare coverage might not fulfill your demands at later stage so you will need to decide at some point whether the traditional coverage is enough for you which is provided by the government or you need some other Medicare supplement plans.
Medicare and Medigap plans are federal healthcare programs which is designed to fulfill the needs and to help senior citizens during their golden years. According to the law, any senior citizen who is 65+ and currently enrolled in Medicare can apply for a Medigap plan. There are about 10 Medigap plans available to choose from. According to the Centers for Medicare and Medicaid Services (CMS), all the Medigap plans have to offer the same coverage plans, regardless of the company which is selling it or where they are located. It means that Plan A and Plan B is exactly the same in all 50 states of America.
In recent years, private Medicare plans have become more popular than the traditional plans. It has been observed that more than 10 million senior citizens has enrolled in the Medicare advantage plans. These plans actually help to combine the physician and hospital services into one package. Before selecting the perfect plan for yourself or your loved one, you need to keep in mind few things.
First of all, if there are no Medicare advantage or supplement plans are available in your region than you will be in traditional Medicare, which is administered by federal government. You can select any doctor who accepts Medicare in the traditional Medicare and you will have to pay deductibles of the cost of care. If you had a Medigap policy, those expenses would have been covered by your Medigap plan. So, a Medigap plan covers a vast variety of treatments which Medicare wouldn’t cover. There are multiple types of Medicare supplement plans.
Most plans such as health maintenance organizations and preferred provider organizations, manage to control costs. Other like HMOs and PPO, which is based on a network of doctors, so you want to make sure that your doctor and the hospital of your choice are involved in the network. You can also ask about the policy for referrals, In case of a PPO, you may want to know how much you have to pay to see doctors who are not on the network. Private plans fee-for-service provides more choice because they are not allowed to have a network of doctors and hospitals.
Sometimes, Medicare supplement plans have extra benefits like eye exams, dental care and hearing coverage. For many people, this coverage doesn’t seem to be enough, and this is where private insurance, such as Medicare Supplement plans come in. These plans may offer coverage of health services not covered for Part A and Part B. To participate in a Medicare Supplement plan a beneficiary must be enrolled in Part A and Part B, live in the state where it is offered, and generally be over 65 years. But you must make sure you understand each and every point of the Medicare advantage plan you will be selecting.
One benefit of Medigap plans is that Medigap policies are renewable, as long as you pay your monthly fees and your insurance company doesn’t go bankrupt, you cannot be dropped from your plan. Medicare has a small network of doctors, but Medigap provides access to an extensive network of doctors. In short, Medicare is designed for those on a tight budget and if your pocket allows you then you have to go Medigap.
According to the latest research, Medigap plans are usually more expensive than Medicare Advantage plans. Medigap offers a variety of supplemental insurance to Medicare, while Medicare coverage and Medicare Advantage are almost identical. Furthermore, you also need to keep in mind that if you travel a lot or migrate yearly as per job requirements or you live in an area where there are lack of medical facilities, then you must go for a Medigap policy. No doubt, there are other ways to supplement your Medicare coverage but Medigap offers the best flexibility.
With Medigap, you are free to receive care from any hospital and any doctor which accepts Medicare. If you have a need for vision or dental benefits, then you will also have to buy Medicare supplement plans for that which will be covered by your Medigap policies. Now that Medicare Part D is also here, so all Medigap plans which used to offer prescription drugs are being phased out.
Last but not the least, if you have signed up for a Medigap plan but you later realized that it wasn’t right for you, there’s no need to worry because as long as you make that discovery within a month of coverage, you can cancel the coverage for a full refund.
For Arizona residents who are confused about which plan to choose, visit www.azmedicare.info for all the details and help on Arizona Medicare Supplement plans.
- July 30, 2016
- Arizona Medicare Advantage plans, azmedicare, health insurance, medicare, Medicare Advantage Plans, Medicare Part A, Medicare Supplemental Insurance, medicare supplements in 2015, medicare supplements in phoenix az, prescription drug plans
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In Arizona, medical beneficiaries who are in need of help for paying Medicare expenses must consider enrolling in a Medicare Supplement Plan known as Medigap Plan. It must be noted that Medigap plans are available through private insurance companies, not only in Arizona but in every state across U.S.
Medigap plans generally help with the expenses which are incurred under original Medicare plans which are Plan A and Plan B. Medigap plans are now almost same across all of the United States in terms of both policies and cost. For those of you who are not sure about the number of Medigap plans, just know that there are 10 standardized Medigap plans available in all of the states. The plans are labelled from A to N where Plan A and Plan B are the most basic plans which every state offers under the rule of federal administration.
If you are already enrolled original Medicare Plan A and B, then you are eligible to sign up for Medigap Plans. Not many people know but the best time to buy a Medicare Supplement plan is during the Medigap Open Enrollment Period. This period starts as soon as you reach the age of 65 and is also enrolled in Medicare Plan B. Individuals can sign up for any Medigap plans during this time according to the plans available in their state. The important thing to keep in mind is that there are no additional enrollment periods besides each of theirs Medigap Open Enrollment Period.
In Arizona and across all of the United States, Medigap plans doesn’t include prescription drug coverage, so you have to enroll in a Part D plan for prescription for separate Medicare to cover the cost of medicines or drugs. Prescription drug plans for Medicare Part D in Arizona are available through private insurance companies.
It has been observed through the survey that Arizona is the most famous destination to retire. Surprisingly, above a million residents of Arizona are dependent on the Medicare for their main source of health insurance.While no revolutionary changes in Medicare supplement insurance is scheduled for 2016, there are some things to keep in mind which may affect the safety and availability of certain plans.
Here is the possible increase in premiums and Part B deductible. For example, Plan C, Plan F, and high deductible Plan F covers Part B deductible, so if the increased rates for these popular supplements may also increase. In Arizona, all the Medicare Supplement Plans must conform to the standards set by the Medicare Organization. Supplement standards include names from A to N. Each supplement offers basic benefits like coinsurance and blood donations. The only thing to remember is that every supplement is identical from one or another insurance company. In order to determine rates, you must compare different insurers providing Medigap plans however there should not be a big difference because of the Arizona Medigap Policy. It is important that you familiarize yourself before with the Medigap plan as well as each and every plan before you make any purchase.
Supplement Plan F is the most comprehensive among the 10 other plans, covering almost 100 % of Medicare related costs. But even for Medicare Supplement Plan F recipients in Arizona can still incur some out – of -pocket expenses such as Medicare Part B premium.
As soon as you reach the age of 65, you need only a phone call to buy Medigap policy and get excellent coverage without question. And if you buy a policy in the first six months of enrolling in Medicare, you do not have to answer questions about your health. Do not worry if your doctors are not in the network, because you will be covered if you see any doctor who accepts Medicare.
Many people don’t realize the fact that how much they will be spending if they will be selecting the plan which covers the entire Medigap plans. There are total of 10 Medigap plans and each one has its own benefit. The four most comprehensive plans are C, D, F and G which account for more than 60% of all the Medigap sales according to Kaiser Family Foundation research. Plan F, the most expensive among all of them and covers every Medicare gap represents 40% of all policies sold. If your health is good than you must consider a plan which is not much comprehensive for e.g. Plan N and L are good choices because they will save you around $200 to $400 a year.
Medicare and Medigap benefits are identical in all 50 states, however policies and pricing rules may differ (Massachusetts, Minnesota and Wisconsin have their own standardized plans). If you know the rules in your state, this may save you money. You can choose when to upgrade an existing plan to switch to another insurer or drop your current Medicare plan during the annual open enrollment to change Medigap policies.
Most of the people become eligible for Medicare when they turn 65, although some beneficiaries can get Medicare even before if they have some kind of disability. You will automatically get Medicare as soon as you turn 65 if you are already receiving Social Security benefits. Otherwise, you will have to enroll in Medicare during the enrollment period.
There are also many private Medicare options available if you are a Medicare beneficiary in Arizona. Medicare coverage like drug prescription and supplemental coverage are only available through private insurance companies. Your private Medicare options will depend on where you live and the plans available in your area. We hope you found this article helpful as we shed light on Arizona’s Medigap policies. If you are an Arizona resident, feel free to contact www.azmedicare.info for further details.
- July 27, 2016
- Arizona Medicare Advantage plans, centers for medicare and medicaid services, MA PLANS, medicare, Medicare Advantage, Medicare Advantage Plans, medicare az, Medicare beneficiaries, medicare supplements in phoenix az, Medigap plans, Part D plans, prescription drug plans
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Health is a blessing and its importance is only known to those who lack it. Ill health is resulted due to numerous reasons. Aging is one of the top reasons. Yes, elderly people become prey to most of the diseases and their care and treatment is of utmost importance. Some of the diseases are related to seniors only. Being old and weak, you need the best care so that you can fight against all the diseases. In Arizona, senior health care insurance policies are offered to address these needs. Now you might be thinking that you are old, or what age should be considered as old age for you.
Well, no age can be declared as the old age. People stay fit and healthy even in their 90s. On the other hand, some people in their 40s surrender to the old age. It all depends on your lifestyle. A healthy and balanced life style leads to a better health throughout the life. In the US, a person above the age of 65 is considered to be a senior citizen. This age limit is set on the basis of average calculated from the data of the population. It is also found that some specific diseases are found in the people aging 65 or above. Some of the diseases are as follows:
Prostate: The prostate enlargement is the disease caused primarily due to the old age. In severe cases it may lead to the prostatic cancer. The treatment for prostatic cancer is expensive and the best way to afford its treatment is health insurance.
Dental: Tooth and gum decay is normal for the elderly people. They often see the dental surgeon for dental problems. It is also thought that your mouth is the wallet for a dentist. The expensive dental treatment can only be afforded if you have a balanced health insurance policy.
Vision: The vision starts fading away once you cross the 65 figure. Cataract is a gift of old age which needs to be operated within a certain time period. Nowadays, cataract is operated using laser technology and optical lenses. It is appreciable if you manage to bear the expenses through an insurance policy.
Blood transfusion: The problem of blood transfusion is much expensive. The patient needs at least 3-4 rounds of transfusion. In Arizona, the US state offers some health insurance plans which exclusively covers it.
The list of diseases will go on and on, but the point of attention is solution to all these problems. In Arizona, the US state health department has offered health insurances for both the elderly and disabled persons. The basic health insurance plan is called Medicare plan which is directly administered by the federal government. It is comprised on Part A and Part B. Its extension is called the Medicare Advantage plan which also contains Part C and Part D. The most advance form of health insurance plan in Arizona is Medigap health insurance plans.
Medicare health insurance plans:
As mentioned above, it is federal health insurance program for different categories of people including who are aged 65 or older, includes younger people with disabilities, and people having End-Stage Renal Diseases. Every country has its own Medicare policies while the unfortunate countries don’t even have the basic medical insurance plans. The different parts of Medicare help in Phoenix, Arizona cover specific services that are mentioned as follows:
Part A: it covers the expenses on the hospital insurance. This Medicare policy is capable of covering inpatient hospital care, care in a skilled nursing environment, hospice care, and some health care. The participants are entitled free Part A insurance if the participant is 65 years of age and participant or his/her spouse has paid Medicare taxes for last ten years. A participant is also eligible of free Part A insurance if he receives social security or Railroad benefits. Same is the relaxation for the participants who worked for the government agency that offered Medicare coverage as an employment benefit. The patients who are less than 65 years of age and have either a full social security or kidney disease, are entitled to Part A of Medicare original for free.
Part B: It covers specific doctor fees, diagnostic tests, durable medical equipment, ambulance service prosthetic device, medical supplies and preventive services. Every medicare plan has at least Part A and Part B. it is an optional insurance coverage that can help reduce the cost of medical care. Plan B reimburses the reasonable cost up to 80%. In some procedures 100% reasonable cost is reimbursed. The insured party is responsible for the costs that are not covered by the Part B medicare original plan. Unlike Part A, every eligible participant, regardless of age, employment benefits or disability status must pay Medicare Part B health care premiums, if non-hospital health care coverage through Medicare is desired. Medicare Part B premiums can be withdrawn from a participant’s monthly Social Security, Railroad Retirement or Civil Retirement check. If a participant receives none of these payments, Medicare will send a quarterly bill for Part B premium.
These rules are directly state administered and no private insurance company can mold these rules. However, Medicare Advantage and Medigap insurance plans gives some flexibility while choosing them.
Medigap health insurance plans:
The Medigap health insurance plans fill the gaps that remain after the Medicare insurance coverage. Sold by the private insurance companies, the Medigap policies cover some of the health care cost that Medicare doesn’t cover like copayments, coinsurance and deductibles. If you buy a Medigap policy with the original Medicare plan, Medicare pays its share while the Medigap pays its own share. Paying a premium amount for the Medigap plan will result in covering all the medical expenses from hospitalization to the blood transfusion. These plans are also known as Arizona Medicare Supplement Plans. Arizona Medigap policy offers twelve different Medigap plans labeled through A to L. All you need is to select the plan which suits the requirements best.
There is no doubt that everyone needs medical attention at some point in their life. The younger generation has the ability to stay strong and fight small medical issues. Older people don’t have the stamina and persistence and power to fight back. They need proper medical attention and if they don’t insure themselves, then, they may be spending plenty of money on medical bills.
Federal government has already introduced Medicare Plan A and Plan B long time ago, now for people older than 65 there are variety of supplement plans which add to traditional Medicare. Basically Medigap or Medicare supplement insurance plans covers the gap between the traditional Medicare and your medical costs. These Medicare supplement plans are sold by private companies separately. These plans are perfect for senior citizens who have expenses that will not be covered under traditional Medicare Plan A and Plan B. If the original Medicare does not cover your medical needs, you may want to look to supplement that coverage with a Medigap or Medicare Advantage plan. Both of these plans can be further supplemented with Part D drug coverage.
Different insurance companies are allowed to sell the same Medigap plan for different amounts. Therefore, you will have to look around a little to get the best offer. If you are looking for a Medigap than you must already have Medicare Plan A and Plan B. It should be kept in mind that drug coverage is not a part of Medigap insurance plan. You will have to get the Medicare Part D separate to cover you drug prescriptions. Regarding Medicare, you must know that only Medicare Part A (hospital insurance) and Medicare Part C (Medicare Advantage) count as minimum essential coverage. If you have the minimum essential coverage you will not owe a fee for not having health insurance. Medigap itself is nothing, but it provides a lot of benefits when combined with original Medicare Part A and Part B.
In Arizona, there is a wide range of senior health insurance plans readily available. There are many options available which include health insurance plans for people who have certain health conditions, health insurance plans for people who like to travel in the US and abroad, health insurance plans for those who want to seek the best treatment from doctors in the United States accepts Medicare and health insurance plans for people with low incomes.
Arizona is the only state where majority of the people like to retire and it has the best senior citizen health insurance, Medicare, life insurance and retirement planning options. Not many people know that if you are eligible for Social Security retirement benefits, you will be automatically eligible for Part A of the Medicare as soon as you turn 65 years of age. If you receive a pension of social security benefits, you are automatically enrolled in Medicare Part B at the time you became entitled to Medicare Part A. All the Medicare Advantage plans are approved by Medicare but they are all offered through private insurance companies within the state. Sometimes these plans can be more beneficial, but might cost you a little more than the original Medicare plan.
These plans vary widely in costs and benefits from state to state, so go through your options carefully before you plan to choose one.Benefits of Medicare Plan A include hospital stays, skilled nursing and home health care. Medicare advantage plans also cover all Medicare Part B benefits, including doctor visits, outpatient care and preventive services. Many of them are also benefits as a routine hearing and vision care, fitness program, wellness service or helpline.If you plan to enroll Medicare advantage prescription drug plan than you will also get Part A and Part B coverage along with this combine in one plan. This plan is a good choice for many of the prescribers. In order to get fully insured, you may want to supplement your Medicare coverage to Medicare supplemental insurance i.e. Medigap, which generally pays the deductibles and extra payments which are not covered by Medicare Part A or B.
Medicare allows a small network of doctors but Medigap provides access to a broader network of doctors. In short, Medicare is recommended for those on a tight budget and if your pocket allows you to go for Medigap.Medigap policies are sold by private insurance companies to fill gaps in original Medicare plan. Most states have already adopted legislation restricting the sale of Medigap insurance for no more than a standard policy. The main difference between Medicare advantage and Medigap is that Medigap is used to supplement the original Medicare. These advantage plans are used to get more Medicare benefits, while a Medigap policy is only used to supplement the cost of your original Medicare benefits. Choosing the right Medigap plan depends on your medical needs and costs. If the original Medicare does not cover the actual cost of medical expenses and you have plenty of options. In most countries these options indicated by the letters A through N.
Each standardized Medigap policy must offer the same basic benefits, regardless of the insurance company selling. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies. According to the latest research, Medigap plans are typically more expensive than Medicare Advantage plans. Medigap offers a number of additional coverage for Medicare while Medicare and Medicare Advantage are almost the same. Medicare allows a small network of doctors but Medigap provides access to a broader network of doctors. In short, Medicare is recommended for those on a tight budget and if your budget allows you to go for Medigap.
Medicare is actually the federal health insurance program for different categories of people including who are aged 65 or older. It also includes younger people with disabilities, and people having End-Stage Renal Diseases. Every country has its own Medicare policies while the unfortunate countries don’t even have the basic medical insurance plans. The different parts of Medicare help in Phoenix, Arizona cover specific services, some of them are mentioned below:
Hospital Insurance (Plan A):
This Medicare policy covers inpatient hospital care, care in a skilled nursing environment, hospice care, and some health care.
Medical Insurance (Plan B):
This medical insurance covers some specific doctor’s services, outpatient care, medical supplies and preventive services.
Medicare Advantage Plans (Plan C):
This type of special plan is mostly offered by private companies that contracts with Medicare to provide you with all the hospital and medical insurance benefits. Moreover, Medicare Advantage plan includes health maintenance organizations, preferred health service provider organizations, private fee-for-service plans, special needs plans and Medicare medical savings account plans. If you are enrolled in under such program then they may also offer prescription drug coverage.
Prescription Drug Coverage (Plan D):
This plan adds the prescription drug coverage to the original Medicare Advantage plan. These plans are mostly offered by insurance companies and other private organizations approved by Medicare.
In United States, essentially every 65-year-old person enrolls in Medicare and most of them also receive additional coverage. One medical plan of additional coverage is through supplements to traditional Medicare which includes prescription drug plan to cover some or all of the payments.
Now the question which confuses most people is which Medicare is plan is right for me?
Not every plan is right for everyone. There are numerous Medicare supplement insurance plans which are also sometimes called Medigap plans. What we need to understand is which plan is the best for us. Some of the Medicare supplement plans in Phoenix, AZ are mentioned below:
Full Coverage Plans:
Full coverage plan is the most comprehensive plan. It has the ability to pay for all of your expenses that are already approved but not have been paid by Medicare. This plan includes all your deductibles, co-pays and co-insurances that originally Medicare is not supposed to cover. Full coverage plan is typically the most expensive of all the plans, and is well suited for those who think that they will have medical expenses and/or for those who want the peace of mind knowing that all approved expenses will be covered.
The high deductible Plan is similar to Full Coverage Plan, when you meet the deductible, you pay for all expenses that are approved but not paid by Medicare . In 2015, the deductible amount was $2180. This amount usually changes every year. This plan works probably best for those who are healthy and think that they will require less expenses or those who are willing to take some risk in exchange for a much lower cost rate.
An important point to keep in mind it is that the Original Medicare plan still pays the fair share of medical expenses – for example, Medicare generally pays 80% of your medical/sickness costs and are responsible for 20%. Only 20% of this applies to your deductibles. Think of the high deductible Plan as a plan where you pay the difference to minor expenses, but if you have large expenditures for health, your maximum amount for the year is $2,180, and then your Medicare Supplement high deductible plan picks up all other expenses approved but not paid by Medicare.
Mid Range Plans:
There is a wide variety between 9 full coverage and deductible plans – so if you are not familiar with one of these two options , you have much more to choose from.
Basically, Medigap plans are sold to provide additional coverage for already covered Medicare services. The aim of a good Medicare Supplemental Insurance plan is to reduce some costs for services that are partially covered by traditional Medicare plans.
Medicare insurance plans offer twelve standardized service plans so that consumers can easily compare policies and costs. Medigap plans are labeled A through L, and offer more comprehensive set of covered services. A Medigap policy A example is the most basic Medigap policy. Medigap Policy B will cover all policy Medigap and will offer some improved benefits, however it will not provide as many benefits as Medigap Plan C does. Medigap policy only covers one person at a time, whether a participant is eligible for coverage through her husband or wife. Each participant must have their own Medicare insurance. Just as Medigap insurance plan is optional, participants pay Medigap insurance in addition to Medicare Part B and Part D premiums optionally.
Features of a Medicare Supplement Plan:
- The doctor’s Choice – Individuals can choose their preferred doctors and hospitals (as long as the patients receive Medicare) .
- Access to specialists – Individuals can see specialists without a referral.
- Convenience – Virtually no claim forms to file.
- Freedom – coverage that travels with you anywhere in the US
- Guaranteed changes – Medicare supplement plans are automatically renewed as long as the individual continues to pay their premiums on time, without twisting one or more of the basic facts after the first application registration.
To get a Medicare Supplement plan, you must have Medicare Plan A and B. You must continue to pay the monthly premium of Part B in addition to your monthly Supplement plan premium. You can get this plan during your Medigap open enrollment period, which is a six-month period starting in the first month, you are 65 years or older. During this period, you cannot deny coverage because of past or present medical problems. For more information, visit www.azmedicare.info now!
Health insurance as you age:
Health is an exquisite blessing which we accept wholeheartedly, but we also need to accept ill health in the autumn of our lives. The declining years bring copious physical and mental vicissitudes. The US health insurance system comprehends it and offers a variety of coverage plans. Most of the US citizens who belong to the age group of 65 and above, bank on Medicare to cover the cost of health care to a certain degree. The Medicare does not offer a comprehensive coverage plan, so the Medicare beneficiaries opt for the supplemental Medigap plans to widen the scope of the coverage. These plans are not only for the elderly people, but the people with certain disabilities are also eligible for these plans.
What is Medicare?
As mentioned above, Medicare is a national health insurance program that addresses the needs of people who are above 65 or have certain qualifying disabilities. The Medicare coverage is not much comprehensive. It can only be availed in a couple of ways. The first one is original Medicare consisting of Part A and Part B or Part C. Part A is the hospital insurance while Part B is medical insurance. Part C is a standalone plan which is used as a substitute for original Medicare, Part C is also known as Medicare advantage. It is administered by Medicare-approved private insurance companies like AzMedcare that operates in Phoenix, Arizona. In some cases, the users of original Medicare and Medicare advantage can get prescription drug coverage after purchasing Part D. Besides buying part D, they can also go for the Medicare supplemental insurance or Medigap. The users have to choose among Part D and Medigap as these are mutually exclusive.
What is Medigap?
Medigap coverage plans exist at the portfolio level and support the original Medicare coverage. Medigaps are the private health insurance policies just to supplement the original Medicare plans. Both Medicare original and Medigap plans pay their share and cover the medical costs individually. The Medigap plans cover the costs that are left out by original Medicare. The cost which is not covered in the Medicare plan is known as the coverage gap and as the name depicts, Medigap fills this gap. Similarly, Medicare does not cover the amount exceeding Medicare-Approved amount and the purchase cost for the Medigap policy.
AZMEDICARE; Arizona Medigap policy provider, makes Standardized Medigap policies available for the people of Phoenix. These standardized Medigap policies are aligned with the Arizona Medgap polices. These policies are labeled by letters A, B. C. D. F, G, K, L, M and N. These are called as standardized policies because all the services providers offer the same coverage plans that meet a certain set standard. It should also be noted that all these plans have same benefits but their cost varies from one company to another. Well, the selection of the Medigap plan is entirely based on your needs. You can chose the plan which best suits your requirements. The Medigap policies are renewable and the insurance provider cannot cancel your policy unless you are not willing to pay the premium amount.
Benefits of Medigap policy:
First and the most valuable benefit of Medigap policy is hospitalization. Along with the Part A coinsurance, it gives additional 365 days coverage for hospitalization. Secondly, it bears the medical expenses that are not borne by the Medicare Part B coinsurance. It also covers the copayments for outpatient services. Medigap policies also cover three pints of blood yearly, if the patents needs blood transfusion. Palliation of chronically ill, terminally ill or seriously ill patient’s pain is quite costly, so the Medigap care provides Hospice care coverage as well.
When to buy Medigap policy in Arizona?
It is better to buy the Medigap policy in the open enrolment period. This period automatically starts when you enters the first day of the month when you turn 65. This period is comprised of six months. You must be previously enrolled in Medicare Part B. if you enroll outside the OEP period, the premium rates would be affected. You may also be required to take a physical review of your health information. The price and conditions out of OEP period differ from OEP.
How to choose the best level of Medigap policy?
Living in Arizona, you have the option of choosing among 10 standardized Medigap offers. You have also the option to choose the best insurance provider among 50 companies. These providers don’t sell all the Medigap plans, but their offer must include plan A. In addition to plan A, Plan C or Plan F can be added. Plan F, a highly deductible plan as you have to pay the deductible amount of $2,180 before the policy starts paying you. On the other hand for the Plans K and L Medigap plan pays 100% of the covered services for the rest of the year.Plan N pays 100% of the Part B coinsurance (except up to $20 copay for some doctor visits and up to $50 copay for ER treatments that don’t require inpatient admission).
This might seem a bit complex but you need to thoroughly read ins and outs of each and every plan. You can also check the discounts offered by the company as AZMEDICARE offers discounts for women, non-smokers, or married people, yearly payment discounts, multiple policy discounts etc. Your medical policy should be tightly aligned with medical needs along with your financial abilities. AZMEDICARE provides medicare supplement insurance plans in Arizona and stresses that you should choose a plan, considering the currents needs and the related concerns in the future. For you ease, AZMEDICARE provides 6 types of medicare advantage plans. Health maintenance organization plans, preferred provider organization plans, private fee for services plans, special needs plans, point of services plans and medical savings account are these types. You can choose what suits you the best. ADMEDICARE will also suggest the best option if you seek assistance in any of the stages of Medicare advantage plans.
When one turns 65, having a reliable healthcare plan becomes a top priority. In fact, people start looking for healthcare plans even before that, so they can take advantage of all the benefits of Medicare and Medigap healthcare plans. Normally, people have basic healthcare plans that provide basic Medicare coverage. However, at times, people also opt for additional supplemental plans for senior healthcare Arizona.
Looking at this need, the Arizona Medicare and private medical insurance companies together introduced different supplemental healthcare plans to meet the healthcare needs, particularly for seniors. These plans, that are 10 in number (A, B, C, D, F, K, L, M, and N) focus only on the elderly; and only someone who is aged 65 or above can benefit from any of these plans.
While the charges for these plans vary from one company to another, it is mandatory that all companies provide the same services under a specific plan. For instance, all of the private medicare companies in Arizona would have to provide basic healthcare and hospitalization coverage under Plan A and B. Similarly, all companies in Arizona would provide Medicare Advantage plans in under Plan D. While the packages and monthly premium may differ from company to company, it is not possible that one company provides certain services under plan C, and some other company provides same services under plan D.
Having a reliable senior healthcare Arizona plan also comes in handy when one travels between different states frequently. Arizona has the largest influx of retired people so the choice of senior healthcare company becomes really critical. Moreover, many seniors are attracted to the idea of spending winters in Arizona, and then move to some other state to spend the summers.
Another reason why one must have supplemental plans is because there is no drug coverage in the basic healthcare plans. Therefore, prescription plans for covering he cost of drugs is often paired with basic healthcare plans.
If you are going to opt for medicare supplement plans, you must do so within the six months starting from the month you turned 65. The advantage of doing so is because if you register during this “open-period”, no company would be able to decline your request. However, afterwards, the companies may simply decline you additional senior healthcare Arizona plans, or ask for extra charges. Let us discuss different services that are covered under different senior healthcare Arizona plans apart from the basic Plans A and B.
This is the plan that you should opt for if you want to be “well covered”. This plan offers coverage above the basic benefits and just by adding a little extra to your basic healthcare plans, you can have the security of knowing that you don’t need to worry about additional out of the pocket costs because you have it all covered.
While you have the knowledge that most of your medicare expenses are covered, it is also important to know that the coverage is limited to Medicare-approved charges. This generally results in paying a little extra out of your pocket if you see a doctor who charges a little extra. However, despite this, Plan C may prove to be very useful in unexpected medical conditions.
Under Plan C, while you have all of your basic expenses covered, the additional services that you get include: skilled nursing facility care for yourself, hospitalization deductible for your Plan A, medical and hospital outpatient expenses for your medicare part B, and emergency help in case you have to travel abroad for a medical emergency.
Only a few people know that the basic medicare plans do not cover the prescription charges. It is because of this reason that people often find a plan D paired with original plans A and B for the coverage of their medicare prescription and drugs. At times, there are some drugs that are very costly, and can prove to be a great financial burden because of out of pocket expenses. However, having a Plan D proves to be very useful in such situations.
Some companies have different sub-packages under Plan D. There are plans that have less monthly premium, but have a limited list of drugs you can use. There are also plans where you have to pay a little extra monthly premium but the list of drugs that are covered is comprehensive.
Depending upon your needs and requirements, you may select a senior healthcare Arizona plan best matches your requirements.
Medicare Advantage Plans
These are a series of Healthcare Plans formed by partnership between Medicare and Private Insurance companies to provide cost efficient healthcare services to the elderly.
In Arizona, 5 medicare advantage plans exist:
Health Maintenance Organization (HMO)
Under this plan, you pay a specific sum of money and different doctors and hospitals agree to provide you their services in return.
Preferred Provider Organization (PPO)
Under this plan, you can use doctors and hospitals belonging to a healthcare network. To receive additional service outside the network, you need to pay a little extra. However, you don’t need your physician’s referral to visit a specialist.
Private Fee For Service (PFFS)
This package allows you to visit any hospital and doctor of your choice. The services provider in this case, decides how much you have to pay for your visits. By paying the amount of their choice, you can benefit from additional senior healthcare services as well.
Medicare Savings Account (MSA)
MSA is divided further into 2 parts.
You may have a special savings account for health related expenses. Medicare deposits fixed annual premium into your account that remains there if you do not use it by the end of the year.
Under the second type, you get a fixed deposit into your account from which deductions are made from time to time for your medical expenses. Once the deductions are met, your medicare covered services are covered by your healthcare plan.
Special Needs Plan (SNP)
This plan only provides membership to specific people who reside in certain long-term care facilities, or who have certain chronic or disabling conditions. This plan is generally designed to provide Medicare health care and services to people who require special expertise of the plan’s providers, and focused care management.
Our bodies have a tendency to grow sick more frequently as we grow older. Although there are various health conditions that are not age specific, our body does become vulnerable to various health conditions, diseases and disabilities as we cross the age 60. This is because of a combination of physical and chemical changes in our body, and the weakening tissues and immune system. That is why, it is recommended seniors have reliable medicare plans. The state of Arizona has introduced several medicare supplement insurance plans which have been designed specifically to help the elderly.
The residents of Arizona can choose whether they wish to have a Medigap policy or the Medicare Advantage. Both of these have been designed to help the beneficiaries manage their medical costs by allowing them access to well respected medical health insurance providers. Each of these have their own way of operating, and provide different packages. Some may provide certain medicare facilities without any monthly premium or recurring costs while others may offer additional services such as dental care while charging the same amount as basic medical coverage. That is why, we cannot say that there is one best plan for everyone, because depending upon the needs and condition of an individual, their preferences may vary.
In the state of Arizona, more than 15% of the population is aged 65 or above (the term ‘seniors’ is used for anyone who is aged 65 or above). Many private healthcare and medicare supplement insurance providers in Arizona exist for the sole purpose of providing additional medicare services to this segment of the population. The question that arises here is why would someone need medicare supplement insurance plans in Arizona when they can avail medicare? The answer is, while one cannot find supplements with no monthly premium or charges (medicare supplement insurance plans are never free), they can be combined with the medicare to provide additional benefits to the beneficiaries. This also helps them by reducing their out-of-the pocket costs by covering their additional expenses, and by allowing them to see specialists of their choice. Normally, seeing a specialist requires a referral from a physician. Depending upon your medicare supplement insurance plan, you might not have to worry about network doctors or referrals to the specialists.
In Arizona, there is no difference between the supplemental plans despite the fact that 10 different plans exist. The difference, however, lies in the premium of the private insurance companies. Depending upon the expenses or services of a company, their charges or monthly premium may differ from what someone else is offering. However, one always has a good choice of a medicare supplement or advantage plan depending upon their medical conditions and prescription needs. This is important because sometimes we face expenses we don’t expect.
For instance, not many people are aware that the cost of prescriptions is not covered in the original medicare or medigap plans. For this purpose, people often need to get the medicare Part D plan. To be eligible for this, one simply needs to be a resident of Arizona aged above 65 and is enrolled in both medicare plans A and B. The amount charged for medicare supplement plans also depends upon the place they live, and their medical condition. This is the reason that some consumers find it quite confusing to search for the right medicare supplement insurance plan providers in Arizona.
The very reason we use the term ‘Medigap’ for medicare supplement insurance plans is because it helps an individual pay the gap between the amount paid by their original medicare providers, and what they have to pay from their own pockets.
If we talk about different Medigap coverage options, we notice that there are 10 different choices. These plans are labeled with alphabet, and are in groups A-D, F-G, and K-N. If you are wondering about the missing letters, it is because plans E, H, I and J are no longer available in Arizona.
The period for Medigap enrollment begins on the first day of the month when you turn 65. Afterwards, you would have 6 months to enroll for the supplement plan provided that you have original Medigap policy. You may choose between plan C and plan D depending whether you require Medicare Advantage plans or prescription coverage.
The important thing that everyone must know is that they must get themselves enrolled for the supplement plans within the 6 month period of open Medigap enrollment. If you do so, the companies would not be able to decline medicare supplement insurance plans to you. Generally, what happens is that companies deny medicare supplement insurance plans to certain individuals when they think that they would incur heavy expenses to the company. At times, the insurance companies also make changes to your monthly premium (by increasing it) if a you enroll outside of the specified 6 month period. However, you would not have to worry about that if you get enrolled within the 6 month period, regardless of your medical condition.
If you enroll for the Plan C (medicare advantage plan), you cannot use a Medigap policy and the companies would refuse to sell you one. However, if you turn back to your original Medicare plan within your first year of joining, you may earn a special right to sign up for a Medigap Supplement plan.
Generally, companies determine the premiums on three basis, that are: non-age-rated, entry-age-rated and attained age rated. Depending upon your needs, you may find a company that offers the best medicare supplement insurance plans in Arizona. You must invest in the right place because a good choice can cover a lot of healthcare costs for you.
If you’re using Medicare or planning to join the program, you’re probably wondering if you should get some form of supplemental insurance. Life is unpredictable and an accident or a debilitating illness can result in thousands of dollars spent in treatment costs. If you want additional insurance against life’s unexpected surprises and costs, checking out the different Arizona Medigap plans is a good place to start.
Arizona Medigap plans in the USA
The US healthcare system is multi-leveled and complex. More than half of all coverage is delivered through programs such as Medicare, Medicaid, the Children’s Health Insurance Program and the Veterans Health Administration.
The majority of US citizens under 65 are insured through their employers. Some have private insurance, while the rest are uninsured. Public sector employees are ensured through the government.
Before you decide if Medigap is the right choice for you, familiarize yourself with all your health insurance options. It’s the only way to make an informed decision about your healthcare future.
You can do research on the topic online or consult insurance providers. You can also talk to people already using the choices you are considering.
What is Medicare?
Medicare is the federal health insurance program serving seniors over 65, regardless of their current health, medical history and income.
Individuals under 65 may be eligible for Medicare if diagnosed with end-stage renal disease (ESRD) or a qualifying long-term disability.
Medicare eligibility is linked to a person’s social security benefits. The program is available to people over 65 that have worked for at least 10 years, with social security and Medicare withholding tax deducted from their pay during that time.
Medicare is structured as follows:
Medicare Part A covers inpatient hospital care, limited skilled nursing care and hospice care. It’s premium free for people who have paid into social security for at least 10 years.
Medicare Part B covers non-hospital expenses, like doctor visits, blood tests, X-rays, diabetic screenings and outpatient care. Part B is available for a monthly premium.
Medicare Part C i.e. Medicare Advantage is offered by private companies as an alternative to Original Medicare. It often bundles all the coverage aspects of Medicare into one plan.
Medicare Part D covers the costs of prescription drugs. It’s available as a stand-alone plan through private companies. You can also get your Part D through Medicare Advantage.
Medicare enrollment is mandatory. As long as you have Medicare Part A, you can consider yourself covered. However, if you only have Part B, you may be subjected to a tax penalty for not having essential coverage.
What is Medigap designed to do
Medicare does provide a lot of coverage, but its scope is nonetheless limited. The purpose of Medigap is to help cover some of the costs left out by Original Medicare, like copayments, coinsurance, and deductibles.
This extra coverage allows beneficiaries to better control and predict their annual medical expenses.
Original Medicare and Medigap work together to provide better coverage. First, Medicare pays its share of the Medicare-approved amount for your healthcare services, after which Medigap covers its share.
A few points to remember:
Medigap plans are available as stand-alone policies from private insurance companies, for a monthly premium.
There are 10 standardized Medigap plans available in Arizona, identified by letters (A – D, F – G and K – N). The word standardized means that same-letter plans must offer the same benefits regardless of the insurance provider.
Premiums for same-letter plans vary greatly between providers, so you’ll have to do some research before choosing a plan.
Plan rates can vary depending on your age, place or residence, provider and plan type.
The most comprehensive and popular plan in Arizona is Plan F. This plan covers pretty much all out-of-pocket costs for Parts A and B. The other plans cost less, but allow more gaps to remain open.
Medigap policies are renewable. As long as you pay the monthly fee, your provider cannot terminate your insurance even if you have health problems.
The best time to buy a Medigap policy is when your Medicare coverage begins. If you join Medigap within the first six months of enrolling in Medicare Part B, insurance companies are obligated to sell you a policy regardless of your health status.
After this deadline, you can be denied coverage based on health issues, at the provider’s discretion.
Medigap policies don’t include prescription drug coverage. For this purpose, you will need a Medicare Prescription Drug Plan (Part D).
Reasons to buy a Medigap plan
When contemplating additional insurance, make sure to ask your doctor if Medicare will cover the services and supplies you need. Overall, Original Medicare doesn’t cover many services and items required by many seniors.
According to experts, you should get a Medigap policy if you can afford one, even if you’re currently in good health and don’t need additional insurance.
You won’t need a Medigap plan if you qualify for Medicaid, have an employment-based medical retiree option, if you’re already using a Medicare Advantage plan, and of course, if you are extremely wealthy.
Depending on the plan, Medigap will either pay all or some of the costs not covered by Medicare.
Your Medigap policy is designed to protect you against excessive out-of-pocket costs, especially if you are ill or severely injured, require prolonged hospitalization or require more care as you age.
For instance, if you are hospitalized and you only have Original Medicare, you’ll be required to pay a hospital deductible of $1,216 for each benefit period. For inpatient stays exceeding 60 days, you’ll be responsible for a portion of the daily costs from the 61st day onwards (coinsurance).
These costs will go up the longer you remain hospitalized. Once your lifetime limits are exhausted, you will have to pay the inpatient costs in full.
The same applies to doctor appointments and medical procedures. Your deductible is $147, after which you’ll have to pay 20% of the Medicare approved amount for doctor services and medical equipment. Depending on the bill, this can be a substantial amount.
Also, keep in mind that:
- Even if you finish this year without needing your Medigap policy, the situation may change next year.
- You should do your homework and check the provider’s reputation, including the claims-paying ability, service and customer care quality.
- If you move to another state after you retire, you may need to change your Medigap plan.
- One Medigap policy covers only one person.
The US health insurance system offers a variety of coverage options, designed to give citizens a peace of mind and reassurance when it comes to their healthcare costs. Medicare is the national health insurance program for seniors, instituted in the mid 1960s. You can get your health coverage through Original Medicare. You can also consider the Arizona Medicare Advantage plans as your coverage choice.
How do Arizona Medicare Advantage Plans and Medicare work?
Medicare addresses the needs of senior citizens aged 65 and above who have worked and paid their social security benefits and taxes. It’s administered by the federal government through around 30 private insurance providers across the country.
Medicare also provides coverage for people under 65 with certain qualifying disabilities and people with permanent kidney failure and amyotrophic lateral sclerosis of any age.
Different parts of Medicare cover different healthcare aspects. Original Medicare has two parts – A and B.
Medicare Part A (hospital insurance) covers inpatient care in hospitals, skilled facilities, hospice and home healthcare.
Medicare Part B (medical insurance) covers the costs of doctor visits, outpatient care, durable medical equipment, certain preventive services and eligible home health services.
Medicare Part C (Medicare Advantage or MA) is designed as a substitute for Original Medicare. It includes all benefits and services covered by Parts A and B. Medicare Prescription Drug Coverage (Part D) is usually bundled into the plan. MA is run by private companies approved by Medicare.
Medicare Part D subsidizes the costs of prescription drugs and drug insurance premiums for Medicare beneficiaries. It’s administered through Medicare-approved private insurance companies.
You can get your Medicare coverage through Original Medicare or you can join a Medicare Advantage Plan.
Types of Medicare Advantage Plans
Health Maintenance Organization (HMO) plans: Your choice in most HMOs is limited to doctors and hospitals within the plan’s network (except in case of emergency). You may need a referral for specialist visits.
Preferred Provider Organization (PPO) plans: Using doctors and hospitals within the plan’s network will cost you less. However, you do have the option to receive medical care outside the network at a higher cost.
Private Fee-for-Service (PFFS) plans: As a plan beneficiary, you can use the services of any healthcare provider or hospital willing to treat you, similar to Original Medicare. The plan sets the costs it will cover for doctor visits and treatments, as well as the amount you will pay for your care.
Special Needs (SNPs) plans: SNPs provide care solely to people with specific conditions and characteristics, so that their needs can be met in the best possible way. This includes people suffering from severe or disabling chronic conditions, nursing home residents, or people eligible for both Medicare and Medicaid.
HMO Point-of-Service (HMOPOS) plans: These plans offer certain services outside the network for a higher copayment or coinsurance.
Medical Savings Account (MSA) plans: These plans combine a high-deductible plan with a bank account. Medicare deposits money to the account and beneficiaries use this amount to pay for healthcare services. Medicare drug coverage is not provided under these plans.
Important facts about Medicare Advantage
If you choose to join a Medicare Advantage plan, you will still be in the Medicare program. The difference is that you’ll be getting your Medicare Part A and B coverage from the Medicare Advantage Plan instead of the Original Medicare.
Medicare Advantage Plans cover all services available under Original Medicare, with the exception of hospice care. For Medicare Advantage beneficiaries, this type of care is covered by Original Medicare.
All Medicare Advantage plans cover emergency care.
In addition to the Part B premium, Medicare Advantage beneficiaries usually pay a monthly premium. Each month, Medicare transfers a fixed amount for your coverage to the Medicare Advantage providers.
Keep in mind that each MA Plan can have different out‑of‑pocket costs and rules regarding its services. These rules can change every year.
Your provider is obligated to notify you of any changes prior to the start of the next enrollment year (Annual Notice of Change).
Providers can join or leave your plan’s network anytime during the year. Also, your plan can change the providers in the network. In such a case, you may need to choose a new provider.
Medicare Advantage Plans can’t charge more than Original Medicare for certain services. This includes chemotherapy, dialysis and skilled nursing facility care.
Once you reach the yearly limit on your out-of-pocket costs for medical services set by the plan, you won’t pay anything for services. This limit may differ between Medicare Advantage plans and may be subject to annual changes, so make sure you do your research on this issue.
You can join or leave a Medicare Advantage Plan at certain times during the year. There are specific windows and rules, for example when you first become eligible for Medicare or if you get Medicare due to a disability. Between October 15 – December 7, anyone with Medicare can join, switch or drop a Medicare Advantage Plan.
Each year, MA Plans can choose to leave Medicare or make changes to their costs and services. If your plan decides to withdraw from Medicare, you’ll have to join another MA Plan or return to Original Medicare.
What are the benefits of Medicare Advantage
- Comprehensive coverage from a single source.
- MA plans have the potential for lower premiums compared to the total sum you would pay for Part D and a Medigap plan combined.
- Some Medicare Advantage plans include benefits not covered by Medicare, such as dental, eye care and wellness.
What are the drawbacks of Medicare Advantage
- Your healthcare choices may be limited to the doctors and hospitals within the plan’s network.
- If you choose to get medical care outside the network, you may be responsible for 100% of the costs.
- There may be a copay required each time you get medical treatment.
When choosing healthcare coverage, check if your area of residence is covered by the MA plan you’re considering.
If you have doctors or specialists whose care you prefer, check to see if they’re in the network.
Also, make sure to consult independent sources, since many sites are sponsored and therefore not objective. It’s best to consult the Medicare websites or those of non-profit organizations supporting the interests of seniors.