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 Want a Medicare Plan? Here's what you need to know!

Medicare is issued to those that qualify (40 quarters of Full-Time work) and is available for those that are 65 years old and above. It will cover all types of procedures including hospital, doctors, x-rays, labs to name a few; and for those facing disability or End Stage Renal Disease.

As the Medicare program states that it has 4 parts, you need to choose the one that best suits your needs. You will automatically qualify for Medicare, if you are already are benefiting under Social Security or Railroad Retirement Board. The same auto enrollment is possible if you have some sort of disability, whether or not you are above 65 years of age.

Still, a normal Medicare plan may not always let you enjoy the full benefits of a health insurance plan. This is when you need a Medicare supplement insurance coverage for adding the missing items, which are not covered under a conventional plan.

This supplemental coverage for Medicare is also known as a MediGap plan, and is generally issued or bought through private health insurance companies.

For a person unfamiliar with a MediGap plan this can be a bit puzzling, as it is involving its own unique set of Plans (namely Plan A, B, C, D, F, G, K, L, M, N, which you have to choose carefully).

MediGap plan or a Medicare Supplement Insurance plans will help you get coverage for the costs, that are not included in the Part A and Part B of your Medicare Plan.

Let's learn about MediGap (Medicare Supplement) in more detail!

When and how can you buy a MediGap policy?

First of all, MediGap policy is purchased from a private health insurance company. However, such private insurance companies must be authorized by the Centers for Medicare And Medicaid Services (CMS).

Next, you must be already covered under both Medicare Part A and B; and must qualify for the criteria of being 65-year-old, or suffering from disability and/or End Stage Renal Disease.

Once you are eligible, you can go ahead and purchase a MediGap plan based on your specifications.

There is also a MediGap Open Enrollment Period that gets started the very day you turn 65, and is valid for 3 months before your birthday and 3 months after. In this time period, you will be getting the best MediGap policy rates without any pre-existing health conditions.

Thus, the key takeaway-point here is that you must be enrolled in Medicare Part A and B, to enroll for a MediGap plan; and policy shopping will be better if the MediGap open enrollment period is still active for you as there will not be any pre-existing conditions.

Is MediGap the same as Medicare Advantage Plan?

MediGap plans and a Medicare Advantage Plans (Medicare Part C) are not the same. Though they are both bought from a private insurance company, they will add significant benefits to your Medicare Plan alone.

A Medicare Advantage Plan will steer you away from your active Part A and Part B Medicare plan, and replace it with a new Part C, this plan combines Part A and B, while providing more add ons. Sometimes, Part D (prescription drug coverage) can also come under the umbrella of the Medicare Advantage plan.

On the other hand, a MediGap plan will give add coverages to your Part A and B Medicare plan more than Medicare alone.

Both the Medicare alternative plans can sound the same, but the basic difference is that with a Part C Medicare Advantage plan it becomes an HMO medical plan, you must see doctors and hospitals that are only in the HMO Network. This does not happen with a MediGap plan with a MediGap plan, you have the freedom to choose any hospital or doctor, accepting Medicare. This gives you a lot of choices, while opting for your preferred treatments.

Again, a Medicare Advantage Plan will only satisfy claims for treatments done inside the insurer's network of doctors and hospitals (HMO Network).

However, a MediGap policy can cost more premium than the Medicare Advantage Plan, also in the Medicare Advantage plan they may include Medicare Part D (Prescriptions), which is not usually covered under the MediGap plan.

Since MediGap and Medicare Part C plans are both an important aspect of coverage, you should always work with a professional health insurance agent to understand these terms thoroughly and make clear decisions.

If you are living in California, searching for a Southern California health agent, then Davidow Financial & Insurance Services is here to help you.

We will help you make the best decisions regarding your health insurance plans.