Medicare is a federal health insurance program designed for individuals who are 65 or above, or those under 65 with a disability or another special condition as specified by the program. Medicare has been helping millions of American senior residents and disabled individuals get coverage for their health care expenses.
Medicare also offers various options that include:
- Original Medicare (Part A & B)
- Medicare Supplement Insurance
- Medicare Advantage Plans (Part C)
- Medicare Drug Coverage Plans (Part D)
These different Medicare choices help cover the expenses for different services.
It is important to note that Medicare is not a part of the Affordable Care Act (ACA) or ObamaCare Health Insurance Marketplace. Regardless of which Medicare plan you choose, you can still access the same benefits and protection you have now.
Medicare Supplement Insurance, also referred to as Medigap, is a private health insurance for seniors and other individuals eligible for Medicare benefits. It helps them pay about 20% of the Part B medical costs that Original Medicare does not cover. These are offered by private insurance companies, but are standardized and regulated by the State Department of Insurance. Hence, all these plans feature the same basic benefits regardless of which insurance provider you choose.
These plans do not have to cover dental, vision, hearing aids or long-term care. However, you must have Original Medicare benefits before you can purchase a senior supplement health coverage plan (there are rare exceptions to this rule). Some plans may also include additional coverage. For instance, Medicare Supplement F is the most comprehensive standardized type of Medigap plan, which carries the following supplementary benefits:
- Medicare Part A and Part B deductibles
- Part B excess charges and preventive care co-insurance
- Foreign travel emergency care (almost 80% of Medicare-approved expenses, up to the plan limits)
- Skilled Nursing Facility (SNF) care co-insurance
Therefore, many companies offer Medicare Supplement F because of its popularity. Medicare Supplement G offers all the benefits of Medicare Supplement F, with the exception of the Part B deductibles. Hence, you will need to pay the standard annual Medicare Part B deductibles out-of-pocket if you choose Medicare Supplement G instead of Medicare Supplement F.
Medicare Advantage plans are health insurance options and an alternative to Original Medicare. Part A (Hospital Coverage) and Part B (Medical Coverage) insurance is offered and administered by Medicare approved private insurance organizations. This implies that Medicare Advantage health plans like HMOs and SNPs are legally bound to offer no less than the same benefits as Original Medicare. They also include additional coverage in the form of routine dental or vision benefits, prescription drugs or health and wellness programs.
These plans offer Medicare beneficiaries comprehensive private health care options with access to innovative programs which are similar to those purchased by millions of Americans. They provide disease and care management services, reducing hospitalization charges and improving care. Another benefit of these plans is that you can receive your Medicare Part D (prescription drug benefits) included under the same plan, rather than having to enroll for a separate Medicare Prescription Drug Plan. This is why these plans are also known as Medicare Advantage Prescription Drug plans, as they can provide you the ease of having your Medicare coverage for Part A, Part B and Part D within a single plan.
Government authorities provide insurers generous subsidies to enable them to offer these plans at low costs. In fact, Medicare pays a fixed monthly amount for your care to the organizations offering Medicare Advantage Plans. However, each of these plans can mean different out-of-pocket expenses, which are usually copayments but can also be deductibles and coinsurance. In addition, the costs and coverage details of the plans can vary depending on the county that you reside in and your insurance provider.
All Medicare beneficiaries across America (with either Medicare Part A or Part B) are entitled to Medicare Part D coverage, also referred to as Medicare Prescription Drug plans, regardless of their income. The drug coverage does not require any physical exams and lab tests. In fact, you cannot be denied on the grounds of health reasons such as taking prescription drugs.
IMPORTANCE OF MEDICARE PART D
Original Medicare, or Medicare Part A and Part B, cover medication administered during doctor or hospital visits, but not the drugs you have been prescribed. Therefore, many people who qualify for Original Medicare choose to supplement the coverage with a Medicare Prescription Drug plan.
WHAT MEDICARE PART D COVERS
Medicare Prescription Drug plans offer coverage for generic as well as brand name prescription drugs. However, variation from plan to plan is expected for prescription drugs. Therefore, always verify that your plan covers your prescriptions.
GETTING DRUG COVERAGE IN TWO WAYS
We are one of the leading private insurance providers operating nationwide. Sunsure Insurance has been approved by Medicare to provide you Medicare Part D. Regardless of your location; you can obtain drug coverage in one of the two ways:
- Through separate stand-alon plans (PDPs) offering only drug coverage;
- Through Medicare Advantage Plans (MA-PDs) covering medical services as well as prescription drugs
Find Affordable Medicare Advantage Plans
Marketplace Quotes can get you the best Medicare Prescription Drug Coverage plans at flexible terms that meet your individual needs and budget. Contact us today to save money on covered medications.