Medicare is available to all Americans who meet certain requirements:
- If you’re 65 years or older
- Certain younger people with disabilities
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
Medicare (known as Original Medicare due to the other Medicare program now available) is composed of three parts:
- Medicare Part A (Hospital Insurance). Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
- Medicare Part B (Medical Insurance). Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive care services.
- Medicare Part D (prescription drug coverage). Penned into existence by President Clinton in 2003 and effective in 2006, Part D adds prescription drug coverage.
Part D is available with:
- Original Medicare
- Some Medicare Cost Plans
What’s A Medicare Advantage Plan?
Outside of Original Medicare, the other plans are offered through private insurance companies approved and regulated by Medicare. Known as Medicare Advantage Plans (also known as Part C), these plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.
What Is Medgap?
Medigap, or Medicare supplement insurance, are policies sold by private insurance companies to supplement or fill in the “gaps” in Original Medicare. Medigap helps pay medical costs that Original Medicare does not cover. Thus, once Original Medicare has paid its share of your medical bill, Medigap would cover its portion based on your insurance conditions.
What Do I Need to Know About Medigap?
- All Medigap policies are standardized, so no matter which company sells you the policy or which state you are in, it’s all the same
- All Medigap policies must be labeled “Medicare Supplement Insurance”
- You must have Original Medicare Part A and Part B to purchase Medigap
- You cannot have Medigap and Medicare Advantage Plans
- Massachusetts, Minnesota, and Wisconsin have different labels
On the outside, Medicare can be complicated. With all the stipulations, regulations, conditions, and different plans, it can be hard to know the basics. However, once you familiarize yourself with all the verbiage, Medicare will be demystified and all the benefits will become clear.
If you still need help deciphering Medicare, Medigap, and Medicare Advantage plans, contact the experts at MedicareGov-Directory. We have years of experience of helping people navigate all the laws and different options available. Contact us today!