Medicare, Medicare Advantage, and Medicare Supplement Plans

You have known for a while that once you turn 65

, you will be eligible for Medicare. As the time gets closer, you start paying more attention when people talk about Medicare options. You keep hearing about Medicare, Medicare Advantage Plans and Medicare supplement policies, and now you are confused as to which one you need, and which one you are eligible for, and which one you get for free. These are all good questions.

Traditional Medicare has been around since the 60s. It is a federal government insurance program. American workers who have paid FICA (Federal Insurance Contributions Act) or self-employed taxes have been contributing to the Medicare program already. These persons, once they reach the age of 65 and become Medicare eligible, will be permitted to enroll in what is referred to as traditional Medicare Part A, which are hospital benefits. Part A typically covers 80% of major medical hospital charges, after the deductible has been met. Members will not have to pay premiums for Medicare Part A. However, members will have to meet their deductible, and then be responsible for 20% of the medical hospital charges.

That is when Medicare supplement policies come in. A Medicare supplement policy is designed to fill in the gap in traditional Medicare coverage. There are many different types of Medicare supplement policies. At this time they are identified by the letters A through L, although M through P will be introduced in the coming years. Each of these Medicare supplement policy has a different combination of benefits, included services, premiums, deductibles, etc. Therefore, it is important that consumers shop around carefully to find which Medicare supplement policy will best meet their needs. Many of these Medicare supplement policies will also help cover prescription costs, which is Part D of traditional Medicare.

Different from a Medicare supplement policy is a Medicare Advantage Plan. A Medicare Advantage Plan is a policy that serves just like traditional Medicare Parts A and B, but is purchased from a private health insurance provider, not directly from Medicare. It does not merely cover the gap, like a Medicare supplement policy, but serves the same purpose as a traditional Medicare policy. However, Medicare Advantage Plans will have additional extra benefits to members. Their costs are somewhat higher, between $40 and $75 more per month, which is why they offer additional benefits.

Those individuals who purchase Medicare Advantage Plans are not permitted to also purchase a Medicare supplement policy. This is because the Medicare Advantage Plan already includes extra benefits, and will already be helping members pay things that traditional Medicare does not cover. Therefore, only those older adults who are enrolled in traditional Medicare Parts A and B will need to purchase a Medicare supplement policy to help them pay their medical expenses.

It is recommended that if you have a serious health problem, travel a lot, or split time between two homes, you are better off with traditional Medicare and a Medicare supplement policy. This is because there are no network restrictions with traditional Medicare, and the Medicare supplement policy will help you pay off the deductible and coinsurance. Medicare Advantage Plans do require members to see in-network physicians.

Medicare, Medicare Advantage, and Medicare Supplement Plans

By: Sam Dicosta

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