Medicare is insurance for most people 65 years and older, disabled people under the age of 65 and those with permanent disabilities, people with irreversible kidney disease, those being treated with dialysis or transplants.
This is a government supported insurance program, administered by the Center for Medicare and Medicaid Services (CMS), and is the largest health insurance program, covering 40 million Americans, citizens of the U.S.
Medicare doesn't cover total health costs and thus health insurance companies provide Medicare supplemental insurance, or Medigap. Some plans are cost-free, while others cover additional services with various fees.
The original Medicare program means that you can go to any provider who accepts Medicare; usually there are costs that you must pay, deductibles, copayments, and coinsurance. Many people buy Medigap insurance to cover the gaps in coverage.
There are two parts to the original Medicare plan:
- Part A which provides hospital insurance
- Part B for which a monthly premium is deducted from your Social Security benefits
This plan provides medical insurance. Prescription drug coverage was added January 1, 2006. Working with Medicare, insurance companies and other private companies offer drug benefits. Depending on the plan selected by an individual, the costs (and the benefits themselves) for such plans vary.
The Medicare Advantage Plan usually means a wider range of services; however, you may have to see certain doctors and hospitals in order to get services.
This plan isn't available in all parts of the country and is a managed care Medicare plan. Medicare pays set amounts of money for your care every month to these private heath facilities; whether or not you use services. (You may not need a Medigap insurance plan if enrolled in the Medicare Advantage plan.)
Medigap policies provide reimbursement for out-of-pocket expenses that aren't covered by Original Medicare. Needless to say, the deductibles, copayments and coinsurance the individual must pay.
In all there are 12 standardized policies, called plans A through L, sold by most private health insurance companies selling Medigap insurance.
We salute you for taking the time to learn about these benefits and for shopping around for coverage since policies offering the same benefits can vary in costs.
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