Medicare Supplement Agents:
What is Medicare Supplemental Insurance?
Upon reaching the age of 65, many people have a tenancy to think about the negatives instead of positives. Believe it of not, there are a lot of positives that comes with turning 65. Some of these positives include Medicare benefits. Once you reach the ‘golden age’ of 65, you become eligible for tons of discounts and benefits and most of these discounts and benefits have the power to save you tons of money! And let’s face it, who doesn’t want to save money?
As you become an official ‘senior citizen’, you qualify for all sorts coupons that will save you money. It is the same way for Medicare insurance as well. You see, once you turn 65, you are automatically enrolled with traditional Medicare. Traditional Medicare, also know as Original Medicare, is a combination of Medicare Part A and Medicare Part B (we will get into more detail about the different parts of Medicare Insurance later). In addition to becoming eligible for original Medicare, you also become eligible for another type of coverage. This other type of coverage has a few different names—Senior Health insurance, Medigap Insurance, or Medicare Supplemental Insurance.
But before we get into why Medicare Supplemental Insurance is so important and beneficial, we must cover the basics.
What is Original Medicare?
Original Medicare is a fee-for-service plan, which basically means that you are able to go to any doctor, supplier, hospital or other facility that is currently enrolled in and accepts Medicare,as well as currently accepting new Medicare patients.
Original Medicare includes Part A Medicare Insurance (this is your basic hospital coverage) and Part B Medicare Insurance (this is your basic medical coverage). Part A is responsible for covering most hospital bills and hospice care. Part B is responsible for covering most doctor’s fees, medical equipment, diagnostics, outpatient care, and some rehabilitative therapy.
Generally, upon reaching the age of 65, you are automatically enrolled with original Medicare. Like we mentioned earlier, original Medicare is a combination of Medicare Part A and Medicare Part B. The best part is that for most people, Medicare Insurance Part A is free of charge. This is known as ‘premium free Part A’. In order to qualify for Premium Free Part A, you or your spouse had to pay Medicare taxes while working.
Who is eligible for Original Medicare?
Anyone 65 years old or older who is eligible to receive Social Security
An individual who is permanently disabled and has received Social Security Disability Insurance for 24 months
An individual receiving dialysis or awaiting a transplant for permanent kidney failure
An individual diagnosed with ALS (Lou Gehrig’s Disease)
However the downfall to Original Medicare is the fact that it does not cover custodial or long term care such as assistance with activities of daily living.
In addition to the fact that Original Medicare does not cover custodial or long term care, Original Medicare also does not cover beneficiaries 100 percent. In fact, people who are enrolled with Original, or traditional Medicare, are actually only covered up to 80 percent. This is where Medicare Supplemental Insurance, or Medigap Insurance, comes in.
Even many doctors recommend that senior citizens enroll in Medicare Supplemental Insurance. Why? Because with Medicare Supplemental Insurance, you are guaranteed to be 100 percent covered. This is a big deal for senior citizens. Why? Because as people age, it is a fact that they become more vulnerable to illnesses, diseases, and surgeries. In fact, in a recent study, it was suggest that senior citizens 65 years or older are taking more medications now than ever before. May seniors are taking at least 3 medications a day and this is there bare minimum. That being said, it is important to be 100% covered. Because we age daily, in different ways, it is important to realize that as we age we become more vulnerable and let’s face it, surgeries are not affordable. Sure, 80 percent covered for a surgery is very helpful, but you have to ask yourself…”Is it enough coverage”? For most of us, the answer is “No”. Surgeries cost a small fortune. 80% of a small fortune still leaves you having to be 20%. Many of us don’t have to the luxury to be able to afford 5,000 dollar hospital bills due to surgeries.
So, this is why Medicare Supplemental Insurance, or Medigap Insurance, has been a beneficial choice for many senior citizens. As I mentioned previously, we Medicare Supplemental insurance, you will be 100 percent covered. Thus, you do not have to stress about high hospital bills that you many not be able to afford. With so much stress on you already, there is no need to have to worry about hospital bills. So, with a low monthly payment for Medicare Supplemental Insurance, you can 100 percent covered and you will not longer have to worry about the high costs of surgeries, doctor visits, or even bills.
What if a doctor does not accept Medicare Insurance?
Over 70 percent of doctors in the United States (not including pediatricians and other specialized physicians) have “accepted assignment” with Medicare. These providers, also known as participating physicians, bill Medicare directly at Medicare’s approved rate.
Providers that don’t accept assignment can charge your loved one up to 15 percent more than the approved amount. For example, if the approved amount for a certain test is $500, a doctor who has not accepted assignment with Medicare may charge up to $575. Your loved is responsible for the extra $75.
That might not sound like a big difference, but it can add up quickly, especially since your loved one is responsible for 20 percent of the approved charges plus any required deductible and coinsurance.
What are the different parts of Medicare?
The different “parts” refer to the different types of payment support and coverage provided by Medicare: Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D.
Medicare Part A: Medicare Part A is your basic hospital insurance. Medicare part A helps cover inpatient care in hospitals, skilled nursing facility, hospice care, and home health care. This includes rehabilitation hospital and psychiatric hospital care.
Note: Keep in mind that with Medicare Part A, you will only be 80 percent covered, leaving you to pay the remaining amount (20 percent).
Medicare Part B: Medicare Part B is your basic Medical coverage. Medicare Part B helps cover doctor visits, outpatient care, durable medical equipment and supplies, home health services, ambulance services, and various other medical services. Part b may helps cover some preventive services in order to help maintain your health. Medicare Part B coverage is not mandatory, it is only optional. However, if you are without coverage and wish to enroll late, you may be charged a penalty fee.
Note: Like Medicare Part A, keep in mind that you are only 80 percent covered.
Medicare Part C: Medicare part C is often referred to as a Medicare Advantage Plan. This plan is offered by private insurance companies that are in contract with Medicare. Usually, Medicare Advantage plans consists of a combination of Medicare Part A, Medicare Part B, Medicare Part D. Medicare Advantage plans have different structures and may be HMOs, PPOs, or private free for service plans. With a Medicare advantage plan, you can also receive extra coverage for extra cost. For example, hearing, dental, vision are available for more money. If you are enrolled with a Medicare Advantage plan, your Medicare services will be covered through that plan and original Medicare will not pay for any of your healthcare services.
Medicare Part D: Medicare part D is also know as prescription drug coverage or a prescription drug plan. Prescription drug coverage is available to all people who are eligible for Medicare. If you are looking g to receive coverage for prescription drug, you must enroll in a private prescription rug plan, or a part D plan. These plans are offered through private insurance companies approved by Medicare. Keep in mind the prescription drug coverage is not mandatory. In fact, prescription drug coverage is only optional However, you may be charged a penalty fee if you are without prescription drug coverage and later want to enroll in a Part D plan.
What is open enrollment?
For a period of several weeks during the last quarter of each year, October through December, those citizens who are eligible for Medicare the following year, can make choices about their Medicare services for that next year. This period is called the Medicare open enrollment period. It can be compared to the open enrollment period used by most private health insurers.
There are several choices to be made during Medicare open enrollment. Similar to private health insurance choices, seniors base their decisions on which doctors they want to choose from, what sort of drug coverage is necessary, how much of a premium they can (or want to) afford and more.
Each year there are changes. At a minimum, the premium amounts change. Often, the types of coverage change. Plans offered one year may be dropped or expanded by the private insurers that offer Medicare Advantage coverage. There are also changes due to healthcare reform each year which are intended to make access easier, some of which are focused on preventive healthcare, too.
Because of these changes, you must do your research ahead of time. Each year Medicare Makes changes. For example, in the year 2013, Medicare will now cover more preventive services like: depression screenings, screenings and counseling for alcohol misuse, screenings and counseling for obesity, behavioral therapy for cardiovascular disease, and even more preventative services. Also in 2013, there is even more help in the prescription rug coverage gap. Changes like these may sway your mind on which Medicare plan you choose. So, if you are getting ready for open enrollment, make sure you have done you research for what is new in the next coming year!
What is Initial Enrollment?
You are eligible to sign up for Medicare Part A and or Medicare Part B during the 7 month period that begins 3 months before the money you turn 65. This includes the month you turn 65 and ends 3 months after the month you turn 65.
What is the General Enrollment Period?
If you did not sign up for Medicare Part A and or Medicare Part B when you were first eligible, you have the opportunity to sign up again between January 1st and March 31st each year. However, you may have to pay a higher Medicare Part A and or Medicare Part B premium due to the fact that you signed up during the late enrollment period.
What are Your Medicare Coverage choices?
There are two main ways that you are able to get your Medicare coverage. You get can your Medicare coverage through Original Medicare or through a Medicare Advantage Plan, also known as Medicare Part C. Here is how you do it:
Do you want to enroll in Original Medicare or with Medicare Advantage Plan? First you must understand the difference–
Original Medicare: Most people are usually automatically enrolled with original Medicare when they turn 65. Original Medicare is a combination of Medicare Part A and Medicare Part B. As we mentioned earlier on, Medicare Part A is your basic hospital insurance coverage and Medicare Part B is your basic doctor insurance coverage. Together, they original Medicare covers you up to 80 percent. Who is responsible for the remaining 20 percent? You are. That’s right, you must be the 20 percent of all services out of pocket.
Medicare Advantage Plan: Medicare Part C, or a Medicare Advantage plan, is a combination of Medicare Part A, B, and usually D. Medicare advantage plans are offered by private companies approved my a Medicare Plan. They may offer extra coverage for extra costs for: dental,hearing, etc.
If you choose to enroll with Original Medicare, you must next decide if you would like to add a drug coverage plan. A drug coverage plan, also known as Medicare Part D, will help you pay for your prescription drugs.
If you do decide to enroll with a Medicare prescription drug plan, you next must decide if you want to enroll with a Medicare Supplemental insurance plan. A medicare Supplemental insurance plan will allow you to be 100% covered and will give you the freedom to choose any doctor or hospital in the United States. There are many Medicare Supplemental insurance, also known as Medigap, plans out there to choose from. This is why it is so important to do your research so that you can find the best plan for you for the very best price!
If you do not choose original Medicare, and you instead chose to enroll with a Medicare Advantage Plan, or Medicare part C, you must next decide if you want to add a prescription drug coverage plan to your already Medicare Advantage Plan. Now, keep in mind that some plans already offer a prescription drug plan in the Medicare Advantage Plan (refer to earlier as I mentioned some medicare advantage plans were a combination of Medicare Part A, Medicare Part B, and Medicare Part D). IF your medicare advantage plan, or Medicare Part C, already has a prescription drug plan, you do not have to worry about adding a drug coverage plan. However, if your Medicare Advantage plan does not already have a prescription drug plan included, it may be beneficial to enroll with a plan so you are able to afford your prescription drugs.
Regardless of which option to go—Either through original Medicare or through a Medicare advantage plan, it is important to remember that you do have options. In fact, you have sever options. So, do your research. Do your research online, call privat3e insurance companies, speak with doctors, speak with friends, or even speak with family members. By doing your research, you should be able to find the best insurance plan for you for the most affordable price.
Medicare Supplement Plans
There are many things that can influence a Medicare Supplement Plan. So, before looking for Medicare Supplement Plans, you need some basic information and understanding about Medicare Supplement Insurance.
First off, What is the Medicare Supplement definition? The Medicare Supplement definition is:
Private health insurance designed to supplement the coverage provided under governmental programs such as Medicare.
As you may know, Medicare is the government run health program that offers medical coverage for senior citizens 65 years old older or for some people who are disabled. However, like we mentioned previously, Medicare insurance by itself does not provide full health insurance coverage. In fact, there are many ‘gaps’ in the original Medicare plan that could cost you a significant amount of money if you do not have additional coverage. This is why if you are getting Medicare you need to also look into a Medicare Supplement Plan.
As we mentioned earlier, Medicare supplement plans are specially designed to fill in the ‘gaps’ in original Medicare. So, before picking a Medicare supplemental plan, you must look at your current financial situation, your personal health history, and how you use healthcare. Why? Because it is imperative to find a Medicare supplement plan that will fit your current personal situation.
Find a supplemental plan that will fit your budget is just as important as the coverage you supplemental plan will provide. The last thing that you want to be is an insurance poor. What is an ‘insurance poor’? An Insurance poor basically means that you are suffering financially because of the amount of money that you a currently paying for insurance. However, there are tons of Medicare supplement plans out there. Therefore, you should have absolutely no problem finding and Medicare supplemental insurance plan that will fit with your current financial situation.
The premiums of the plans you choose are likely to vary by where you live, which insurance company you choose, your age, your health habits, and other underwriting guidelines. You may also what to consider choosing a Medicare prescription drug plan (Medicare Part D) as well. Because the cost of these Medicare Supplemental insurance plans are likely to go up over time, picking a supplemental plan as soon as you are eligible for Medicare is likely to be the best choice. When you first become eligible for Medicare insurance, you will also be eligible for Medicare Supplemental Insurance. When you first become eligible, (Most people become eligible when you turn 65 years old) there is no requirement for you to go through the underwriting process, the cost will be lower, and you are guaranteed coverage. However, the longer you choose to wait to get Medicare supplemental coverage, the more likely the cost could become excessively high or you may no longer qualify for any additional coverage. So, the sooner you enroll with a Medicare Supplement Plan, the better!
You may be the exclusion, but for most people, as they age they require more healthcare insurance coverage. And if you are like most of us, not having a Medicare supplemental plan in place could leave you with major financial trouble. So, it will be worth the time at the beginning of your Medicare coverage to research the various Medicare supplement plans and to then get one of those Medicare supplement plans set in place. The benefit of a Medicare Supplement plan? Not only will you be 100 percent covered, but your Medicare supplement plan will give you the freedom to choose! You will have the ability to go to whatever hospital or doctor you need or want.
So, when you begin to look at all of the various Medicare Supplement Plans, expect it to be very overwhelming. We can help with the stress by finding the best plan for you that fits all of your insurance needs. All you have to do is call 1-800-MEDIGAP (800-633-4427) and we will get you the information you need to make an informed choice on a Medicare Supplemental Insurance plan.
Medicare Supplement Plan F
What is Medicare Supplement Plan F? Medicare Supplement Plan F is a type of Medigap Insurance that helps medicare beneficiaries fills in the ‘gaps’ that comes with Original, or traditional, Medicare Insurance.
Medicare Supplement Plan F is considered to be the best coverage among the Medicare supplements plans. Why is Medicare Supplement Plan F the best? Because Plan F gives you first-dollar coverage for all Medicare-approved services. So whether you have a hospital stay, a diagnostic exam, or simply a doctor’s visit, you will be 100 percent covered. You just present your Medicare supplement card, and you will owe absolutely no deductibles, co-payments or co-insurance. However, this only happens if Medicare approved the service of treatment you have done. If medicare does approved the service or treatment, Medicare will pay its’ hare and you Medicare Supplement Plan F will pay the remaining amount that Medicare did not cover.
Another benefit is that you will have the freedom to choose any doctor or hospital that accepts Medicare, and your Plan F will also be accepted. It will not matter what insurance company you choose to buy your medicare Supplement Plan F from because it will be accepted anywhere no matter which company you purchase your plan from. However, the prices for Medicare Supplement Plan F will differ depending on who you decide to purchase the supplement plan from.
Medicare supplement Plan F will also cover up to $50,000 in foreign travel emergency benefits. Since this care occurs outside the U.S., Medicare will not cover foreign travel. Plan F will help to pay for emergency health incidents in foreign countries up to the plan limit, although you will pay a small deductible and some cost-sharing for these services.
The only things Plan F does not cover would be those things that Medicare itself also does not cover, such as acupuncture, routine vision exams, routine dental work, etc.
How much does Medicare Supplement Plan F cost?
Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, co payments and coinsurance.
Here is what you can expect to pay with Plan F:
- All hospitalization costs beyond the additional 365 days after the Lifetime Reserve are used
- All costs after 101 days in a skilled nursing facility
- Foreign travel: $250 per calendar year; 20 percent of costs within the first $50,000 all costs thereafter
What is included in Medicare Supplement Plan F?
- 100 percent of Part B excess charges
- Supplemental Medicare coverage for hospitalization (Part A), including semi-private room and board, general nursing and miscellaneous services and supplies
- Supplemental Medicare coverage for medical services (Part B), including in or out of the hospital and outpatient medical services, supplies and treatment, physician services, physical and speech therapy, diagnostic tests and durable medical equipment
- Supplemental Medicare coverage for skilled nursing facility care, hospice care and home healthcare approved services
- 100 percent coverage for the first three pints of blood (this is not covered by Medicare)
- After a $250 cost, this Medicare Supplement insurance plan covers 80 percent to a lifetime maximum of $50,000 for foreign travel emergency care
- Although you can go to a Medicare-eligible hospital of your choice, if you live within a 30-mile radius of a Medicare Select participating hospital and agree to use that hospital for non-emergency elective admissions, you can save on your premiums
- Part B deductible
Medicare Supplement Costs
Upon reaching the age of 65, most senior citizens are eligible for the original Medicare insurance coverage. If you are not 65 years old older, you may be able to access Medicare coverage earlier based on specific medical conditions or disabilities. Keep in mind that if you are eligible for original, or traditional, Medicare, you are also eligible for Medicare Supplemental Insurance as well.
It Is also important to realize that coverage provided by Medicare alone is not enough to pay for the rising prices of medical care and definitely not enough for the rising prices of prescription drugs. Because the original Medicare plan does not cover enough, most seniors are researching the available Medicare supplement insurance costs in order to determine the best way to increase the benefits that they can receive.
Unfortunately, the idea of Medicare Supplement insurance can be confusing for most senior citizens. In fact, it can be confusing for just about anyone. Why? Because it is difficult to find a plan that will provide you with all of the medical coverage that you will need in addition to a plan that you are able to afford. The worst part is the fact that the price of Medicare Supplement plans are subject to change. Because of this very real concern, it is essential to immediately begin researching the benefits of Medicare supplements and comparing the Medicare supplement insurance costs with the advantages in coverage that they provide.
The supplemental insurance is also referred to as ‘Medigap’ because it is used to ‘fill in the gaps’ left by the original Medicare covered. Why are there gaps? Because original, or traditional, Medicare only covers you up to 80 percent. Therefore, you are left to pay the remaining 20 percent out of pocket. Many of us do not have the luxury to be able to afford these high dollar hospital and doctor’s bills. This is why many seniors are enrolling in a Medicare Supplement plan.
How much does Medicare Supplement costs? The Medicare supplement insurance costs are often determined by on what the plan you choose, the coverage it provides, and which company is providing the plan. Many private insurance companies offer the same exact plans, but for all different prices. This is why it is so important to shop around if you are looking to find the best plan for the best price. Other things will impact the costs of your insurance are: age, gender, state of residence, and general health. While there are differences from individual to individual and from state to state, the supplemental plans are federally regulated to ensure that each state and insurance company is providing the same amount of coverage.
Did you know that there are ten regulated Medigap plans that can be offered by private insurance companies? These plans are: A, B, C, D, F, G, K, L, M, and N. The covereage offered by these plans identified by letters of the alphabet must be consistent from state to state. For example, a private insurance company in South Carolina can provide Plan L at a very low price, but it must match the same exact benefits that are provided by another state at a much higher price.
However, Some Medigap plans aren’t available in every state. Therefore depending on the sate you currently reside in can also depend on which supplemental insurance plan you can enroll in. You will be responsible to determine which supplemental plan is the best fit for your individual needs. Therefore it is imperative to do your research. Because, different private insurance companies offer the exact same coverage for very different prices. If you need help comparing the different Medicare Supplement plans, we offer help. All you have to do is contact 1-800-MEDIGAP for for comprehensive help and valuable information.
Medicare Supplement Comparison
You probably understand what Medicare insurance supplement plans do, fill in the gaps where Medicare coverage is lacking. There are tons of Medicare supplement plans out there—Each are different and unique in their own way. For example, some are different in what they cover, who they cover, and how much the coverage plan costs.
If you do not find the right supplement plan for you, you might end up paying a lot more money for the medical care you need . Most seniors are out of work and therefore are on a fixed income. So finding a plan that fits your budget is crucial.
If you are currently looking for the right supplemental health plan for you, you need to do a Medicare Supplement comparison. The comparison can be be a simple, basic comparison of the various plans. It has to be in enough detail that you are certain that you are making the right decision when it comes to spending your own money.
If you are trying to do a Medicare Supplement Comparison, know that you are not alone. There are millions of seniors out there trying to do the same Medicare Supplement Comparison. Most private insurance companies, inducing us, do our own Medicare Supplement Comparison to make it easy for you. In fact, we offer our own Medicare Supplemental Insurance comparison chart. With a Supplemental Insurance comparison chart, you are able to view a chart, and find the different in each plan. It is quick, and easy, and most importantly, we did all the work for you! If you are looking for other Medicare Supplement comparison outside of our company and website, you can find that too! It’s easy because most of the top private insurance companies all provide a Supplemental Insurance comparison chart.
If you are not that trusting in these private insurance companies, you can always make your own Supplemental Insurance comparison chart as well. It’s easy, just compare what all of the different plans have to offer and what they cover. The worst part about doing it yourself is doing the research.
One of the first places to start if you are trying to do a Medicare Supplemental comparison on your own is at the official medicare.gov website. If you are not that computer savvy, don’t sweat it. You can always call in family members or friends to assist you. Once you are on the official Medicare government site, you will have to enter a little bit of information about yourself like: your zip code and other basic information about yourself. Why? Because many insurance plans are state specific and go off of gender and health as well. Once submit that information, the official government site will allow you to look up different Medicare Supplement plans available in your area and then you will be able to compare and contrast.
Using Medicare.gov is not your only option. You can also look up Medicare supplement plans offered in your specific state (For example: Medicare Supplement Plans Maryland). Once you look up Medicare supplement plans in your state, there will be an official website run by your state government that will show you the different options available to you. The advantage to comparing the different Medicare supplement plans this way is the fact that it will already eliminate any plans that are not available because of where you live. This means that there will be must less choices to choose from. Therefore, you will not be as overwhelmed and you can to comparing the different plans easier and quicker. You will also be able to look at your state’s approach to these plans and understand how they are administered. All of this combined will probably give you a head start on understanding what plans will work best for you.
If you take the time to look at both these sites and read through the literature available, you might still have some questions or if you are not computer savvy and calling family members or friends was not an option for you, feel free to give us a call at 1-800-MEDIGAP. We are here to help you with your every insurance need Not to mention, speaking with professional, licensed agents can be very beneficial!
Medicare Supplemental Insurance comparison chart
What is Medicare Tax?
Medicare is a national social insurance program administered by the United States federal government since 1965. Medicare insurance guarantees access to health insurance for Americans ages 65 and older and younger people with disabilities as well as people with end stage renal disease.
Medicare tax is the amount withheld by your employer from your paycheck. This is the amount that is withheld from your paycheck to help cover the cost of running the Medicare program. If you are legally working in the United States, Medicare taxes have been deducted from your wages.
It is part of Federal Insurance Contributions Act, or the FICA, that it is mandatory for your employer to collect and send to the Internal Revenue Service quarterly, who then puts it into a government trust fund. Your total FICA is 7.65 percent. Of that, 1.45 percent represents your contribution to Medicare, with the balance used for the Social Security program. In addition, your employer pays a like amount for Social Security and Medicare.
At the end of the year, your employer will provide you with a W-2 form and on this form you will be able to see the total amount of Medicare taxes that was deducted from your paycheck for the Medicare tax.
Medicaid vs. Medicare
There is a lot of confusion regarding Medicare insurance and Medicare insurance. So, let’s get one thing straight first– Medicaid is not Medicare.
Medicaid insurance differs greatly from Medicare insurance. Many people mistake Medicaid Insurance with Medicare Insurance and vise verse. Because of how similar these two programs are spelled, it is not uncommon for people to get confused. This is exactly why were are taking time out to explain the difference of these two programs in an articled titled ‘Medicaid vs. Medicare’
Most of you readers may be fairly familiar with the Medicare insurance program. Why? Because the majority of us have used Medicare insurance to pay for hospital and doctor visits. If we have used Medicare insurance to pay for hospitals and doctor visits, then I am confident that your parents have. Regardless, most people have seen the Medicare insurance deduction on their paychecks.
Medicare, briefly, is a type of public health insurance that pays for primary care including doctors visits. Every senior who has paid into the Medicare system during their working years is entitled to enroll with Medicare insurance. However, in order to be considered eligible for Medicare insurance, you must be 65 years or older. Because of this, Medicare is also known as Senior Health Insurance.
There are two “parts” to original Medicare– Medicare Part A and Medicare Part B. As we mentioned previously, Medicare Part “A” is your basic hospital coverage. Part A pays for inpatient care in hospitals, skilled nursing facility, hospice, and home health care. Medicare insurance Part B is your basic medical coverage. Part B pays for doctor visits, outpatient care, durable medical equipment, home health services, and other medically related services. It’s important to also keep in mind that Medicare Part A and B, which is your original/traditional Medicare, will only cover you up to 80 percent. This is why seniors often choose to enroll in additional programs like, Medicare Supplemental Insurance, where they will be 100 percent covered.
On the other hand, For many of us, we have never encountered the Medicaid insurance program. Why? Because Medicaid insurance is a needs based program. What does this mean exactly? Well, because Medicaid insurance is a ‘needs based program’, it’s eligibility requirements are based around people with lower incomes, older people, people with disabilities, and some families and children. Each state operates a Medicaid program that provides health coverage for lower-income people, families and children, the elderly, and people with disabilities.
The eligibility rules for Medicaid are different for each state, but most states offer coverage for adults with children at some income level. In addition, beginning in 2014, most adults under age 65 with individual incomes up to about $15,000 per year will qualify for Medicaid in every state.
- Health Insurance for seniors.
- Need to have contributed to Medicare system to be eligible.
- Pays for primary hospital care and related medically necessary services.
- Generally individual must be over 65 to be eligible.
- May have a co-pay provision depending on the services received.
- Federally controlled, uniform application across the country.
- Needs based health program.
- Pays for long term care.
- Individual must meet income and asset test to be eligible.
- Individual must be over 65, disabled or blind.
- Requires mandatory contribution of ALL recipient’s income.
- Individual state by state differences create a different program in each state. (Generally similar, but may be different in specific application.)
You may be eligible for benefits through Medicaid, but to be sure you may want to check in the current state you are residing in because these Medicaid insurance programs vary by state.
Eligibility: People with disabilities are eligible in every state. However, In some states, people with disabilities qualify automatically if they currently receive Supplemental Security Income (SSI) benefits. In other states you may qualify depending on your income and resources (financial assets).
“Buy Ins”: Some states also have “buy in” programs. These ‘buy in’ programs allow people with disabilities with incomes above regular Medicaid limits to enroll in the Medicaid program. Children with disabilities can also qualify for Medicaid insurance under these disability-related rules, or based on their families current income.
Expansion in 2014: Starting in the year 2014, the Affordable Care Act will expand the Medicaid program to cover people under age 65, including people with disabilities, with income of about $15,000 for a single individual. $15,000 is only for singles. There are other income amounts for couples and families with children.
Help for disabled people: This expansion helps low-income adults who have disabilities but do not meet the disability requirements of the Supplemental Security Income (SSI) program. The expansion also helps those whose income is above their state’s current eligibility levels.
SHOP, SHOP, SHOP
Shop for free Medicare Rates and quotes!
As mentioned previously, I not emphasis enough how important it is to shop around. The best part is that shopping around for health insurance is not nearly as difficult as it used to be. Now, it is so easy to research topics, like health insurance or medicare supplemental insurance, on the internet. You can easy go onto a search engine tool bar and research things like “Medicare Rates New Jersey” or “Free Medicare Supplement Quotes”. It’s time that you take advantage of how many tools are out there for you! With these tools and a little bit of time you will be able to find yourself the best Medicare insurance plan for the most affordable price. If you are a senior and not computer savvy, you always have the options of calling in for reinforcements. Get help from a neighbor, a family friend, or even a family member. If that is not an option, then we at 1-800-MEDIGAP will be here for you. If you have questions, if you need Medicare Rates, if you are looking for free quotes, we have it! We are here to help you with your every need! So, give us a call today at 1-800-MEDIGAP. Together, we can find you the best Medicare plan for the very best price!
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