Medicare health insurance program is an excellent federally run program for the elderly and the disabled. If you are 65 years or older, or a young person with disabilities, or with end-stage renal failure where dialysis or a transplant is your only option, then Medicare can help cover around 80% of the costs. However, some might find the coverage provided inadequate for their needs, luckily plans like Medigap and Medicare advantage can help provide extended support and coverage options. We will look at what Medicare original covers and how people can use Medigap and Medicare Advantage plans to meet their additional needs.
A Brief Description of Medicare Original
The original Medicare consists of two main parts Part A and Part B. Part A covers things like hospitalization costs, nursing care both at a hospice or at home, or any other nursing facility. Part B covers medical insurance-related costs – any clinical research, ambulance services, the cost of specific medical equipment, mental health treatment and a few outpatient prescription medicines.
The Limited Medicare Original Coverage Problem
Medicare original covers at max 80% of the costs and the remaining needs to be borne by the insuree. These payments include copayments and coinsurance on top of the premiums for Part B and Part A, if applicable. Also, the following are not paid for by Medicare:
- International Medical Care
- Cosmetic Surgery
- Feet Problems Preventive Care
- Eye tests and Prescription Glasses
- Any Hearing Test or Hearing Aids.
- Custodial Care
- Nursing care longer than 100 days after a hospital stay
- Homemaker services
- Private duty nursing care
- Dental services like filling, extractions and dentures
- Prescription Drug Coverage
The Medigap or Medicare Supplement Plans
The treatments not covered by Medicare original aside, the copayments and coinsurance payments, as well as the problems of extended treatments, can take their toll. This situation is more critical in the case of retired individuals having to pay the extra amount on top of premiums. To cover these gaps left by Original Medicare, the Medicare Supplement Plans (Medigap) were brought forward. These plans are offered through private health insurance companies authorized by Medicare. It has an additional ten medical plans – A, B, C, D, F*, G, K, L, M and N. and they each offer various benefits that are set by the United States Government.
The 10 Plans offer the following essential benefits:
- Part A Coinsurance and hospitalization charges up to an additional year (365 days) after Medicare benefits finish.
- CoPayment for Part B as well as coinsurance
- Copayment for Hospice Care in Part A as well coinsurance
- First 3 Pints of Blood (Medicare does not pay for the first 3 pints of blood that a patient receives during hospitalization)
Medicare Plan F is no longer available for new Medicare Patients. For more details, you can visit medicare.gov, or if you would like free advice and consultation regarding the best option according to your need and budget, then sites like thebenefitlink.com are the best option.
Medicare Advantage and its Benefits
As the supplement plans by Medicare cover the copayments, coinsurance and extended medical stay, the Medicare Advantage Plans can cover the treatments not covered by Medicare. The Medicare Advantage plan is also provided by private health insurance companies that are authorized by Medicare. These plans are mutually exclusive the cannot be used with original Medicare or Medicare Supplement Plans. Depending on the type you choose, they can cover the things that Medicare doesn’t as well as provide coverage for prescription medication.
Regardless of what type of Medicare, Medigap, or Medicare Advantage option you choose, you should do adequate research. You need to keep in mind your budget and needs. The better option would be to use reliable companies that can offer free advice or consultation when it comes to the many government and private health plans out there.