Medicare Health Plans and Medicare Supplements
Medicare is the federal health insurance program for people age 65 and older, as well as people with certain disabilities. There are four main types of Medicare health plans: Original Medicare, Medicare Advantage Plans, Medicare Supplement Insurance (Medigap), and Medicare Part D Prescription Drug Plans.
Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.
Medicare Advantage Plans (MA Plans) are offered by private insurance companies and are an alternative to Original Medicare. MA Plans provide all of the benefits of Original Medicare, plus additional benefits such as prescription drug coverage, dental and vision coverage, and fitness programs. Medicare Supplement Insurance (Medigap) is an optional insurance policy that can help pay for out-of-pocket costs in Original Medicare, such as deductibles, coinsurance, and copays. Medigap policies are sold by private insurance companies and there are 10 different types of Medigap plans to choose from. Medicare Part D Prescription Drug Plans are offered by private insurance companies and provide coverage for prescription drugs. Part D plans are voluntary, but if you have Medicare and don't have prescription drug coverage, you may have to pay a penalty when you join a Part D plan later.
Choosing a Medicare Health Plan
- What type of coverage do you need? Do you want all of the benefits of Original Medicare, plus additional benefits such as prescription drug coverage? Or are you happy with the basic coverage provided by Original Medicare?
- What is your budget? Medicare Advantage Plans and Medigap policies can vary in price, so it is important to compare plans before you choose one.
- Do you have a preferred doctor or hospital? Original Medicare allows you to see any doctor or hospital that accepts Medicare. Medicare Advantage Plans and Medigap policies may have networks of providers that you must use.
Medicare Supplements
Medicare Supplement Insurance (Medigap) can be a good option for people who want to help pay for out-of-pocket costs in Original Medicare. Medigap policies can be especially helpful for people who have chronic health conditions or who expect to have high medical expenses.
There are 10 different types of Medigap plans to choose from. Each plan covers a different set of benefits. The most comprehensive plans cover all or most of the out-of-pocket costs in Original Medicare. The less comprehensive plans cover fewer out-of-pocket costs, but they are also less expensive.
Medicare Part D Prescription Drug Plans are offered by private insurance companies and provide coverage for prescription drugs. Part D plans are voluntary, but if you have Medicare and don't have prescription drug coverage, you may have to pay a penalty when you join a Part D plan later.
How to Enroll in a Medicare Health Plan
You can enroll in a Medicare health plan during the Medicare Annual Enrollment Period, which runs from October 15 to December 7 each year. You can also enroll in a Medicare Advantage Plan during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31 each year.
If you have questions about Medicare health plans or need help choosing a plan, you can contact Medicare by calling 1-800-MEDICARE (1-800-633-4227).
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Frequently asked questions
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original
Medicare Plan doesn't cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs.
Any physician or facility that accepts Medicare also accepts Medicare Supplement Insurance. So as long as your provider accepts Medicare, your Medigap plan will also be accepted.
A Medicare Supplement Insurance plan may only be used in conjunction with Original Medicare (Part A and Part B). If you are enrolled in a Medicare Advantage plan and enroll in a Medicare Supplement
Insurance plan, you will need to leave your Medicare Advantage plan before your Medigap plan takes effect.
Contact a licensed Harris Insurance agent. Because the prices and availability of plans can differ from one insurance company to another, the best way to shop for a plan is to compare offerings from multiple insurance
companies in your area. The best way to do this is to have an agent provide you with a range of plan options and price quotes once you are age-eligible.