If you are age 65 or older you are eligible for Medicare. Medicare is most commonly broken into the following "parts." • Part A | Hospital Insurance• Part B | Medical/Doctor Insurance• Part C | Medicare Advantage - Provides Part A, B & D coverage.• Part D | Prescription Drug Plan - Provided through private insurance companies.With Medicare, many times there are gaps between what you need, what you want, and what is covered. Fidelis can help you decide which Medicare Supplements best suit your needs or if you should move to a Medicare Advantage Plan.
A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
Things To Know
• You must have Medicare Part A and Part B.
• If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.
• You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.
• A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
• You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
• Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
• Some Medigap policies sold in the past cover prescription drugs, but Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).
• It's illegal for anyone to sell you a Medigap policy if you have a Medicare Medical Savings Account (MSA) Plan.
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
There are different kinds of Medicare Advantage Plans:
• Health Maintenance Organization (HMO) Plans
• Preferred Provider Organization (PPO) Plans
• Private Fee-for-Service (PFFS) Plans
• Special Needs Plans (SNPs)
There are other less common types of Medicare Advantage Plans that may be available:
• HMP Point of Service (HMOPOS) Plans: An HMO Plan that may allow you to get some services out-of-network for a higher cost.
• A plan that combines a high deductable health plan with a bank account. Medicare deposits money into the account (ususally less the deductible). You can use the money to pay for your healthcare services during the year.
Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to join a Medicare Prescription Drug Plan (Part D) when you're first eligible, and you don't have other creditable prescription drug coverage, or you don't get Extra Help, you'll likely pay a late enrollment penalty.
To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.
Two Options for Medicare Drug Coverage
1.) Medicare Prescription Drug Plan (Part D). These plans (sometimes called "PDPs") add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
2.) Medicare Advantage Plan (Part C) (like an HMO or PPO) or otherMedicare health plan that offers Medicare prescription drug coverage. You get all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan.
Sometimes there are things that Medicare does not cover. That doesn't change that the responsibility of deductibles that falls on you can amount to thousands of dollars.
There's extra coverage you can purchase, including:
• Dental Insurance• Vision Insurance• Cancer Insurance• Accident Plans• Critical Illness Plans• Hospitial Indemnity Plans