A Medicare Overview

Medicare and Medicare Supplements, also called Medigap, have a number of parts and they are not always easy to figure out.  In fact, determining how all these parts fit together and what you need for your situation can be totally confusing.  This brief overview will give you information on the basic parts of Medicare and what is covered by them.

Medicare Part A and B make up the original Medicare.  Part A basically covers in-patient services including inpatient rehabilitation and inpatient psychiatric care.
Many of the services are covered completely; others will require a copayment from you.

Part B covers doctor’s services and other outpatient services determined to be “medically necessary” for you.   It also covers certain tests to determine if you have an illness.  There is a deductible, which is $135 for the year 2008, and it also carries some copayments with it.

Medicare Part C is also called Medicare Advantage.  The Medicare Advantage Plans are not part of the actual Medicare system, nor are they run by Medicare.  They are alternatives to Medicare and are run by private companies.  There are a variety of plans that work differently.  Some operate as HMO’s others as Fee for Service plans that allow you to go to any doctor as long as the doctor will accept payment from Medicare as payment in full.  It is essential to research and find out whether the Medicare Advantage Plan you are choosing will actually fit your medical needs.

Part D covers Prescriptions.  These are covered by private insurance companies approved by Medicare.  This coverage is important, and it is urgent to determine what type Part D coverage you need.  You should determine this in advance so that you can enroll immediately when you are eligible.  If not, you will be charged a substantial late fee.  If you enroll in a particular Part D plan and feel it isn’t right for you, every year you will have an opportunity to change between November 15th and December 31st. 
That was the easy part.  Now for the Supplements – the Medigap policies.  There are 12 policies that cover services that are not otherwise covered.  Each supplement is different and covers different things.  In addition, it is possible to purchase these supplements from private insurance companies, get them from you or your spouse’s employer or from various government programs. 

All Medigap Policies are standardized and approved by Medicare.  This means that for policies E on up the alphabet, each lettered plan offers the same coverage no matter what company you purchase it from.  An insurance company can charge you whatever they choose, so compare companies and rates.  Why purchase Part E from a company that charges twice as much as another? 

So, do your research and determine which Medicare Supplemental Insurance is the best for you and find the best price.  If you need information, check the web at www.Medicare.gov.