One thing that most people know about Medicare is that it is the U.S. government’s taxpayer-supported health insurance program. Therefore, most people assume that they can only qualify for a government-supported plan. This is partly true, but only partly.
Over the years, the Medicare program has expanded and now there are many Medicare options offered by major private insurance companies. They allow you expanded choices to get the health insurance options that you need. While these plans do not replace your Original Medicare, which is the foundation of all coverage, they can supply effective and affordable coverage for qualifying participants. Let’s take a closer look.
Understanding Medicare Options
The government’s standard Medicare program is called Original Medicare. It offers two benefits:
Part A coverage that pays for hospital expenses
Part B coverage that pays for standard medical care services, like physician visits
Nearly all American qualify for Original Medicare around their 65th birthday, though each participant’s cost of coverage might vary.
However, Original Medicare might not supply all the coverage you realistically need. Therefore, the private insurance market has stepped in to help fill this void. Some of the expanded, private coverage options that many Medicare participants need at one time or other include:
- Medicare Advantage Coverage (Part C)
A Medicare Advantage plan takes Original Medicare and then expands upon it. These plans will offer all the benefits of Original Medicare, while also supplying expanded coverage such as dental, vision and prescription drug benefits. You stay an enrollee in Original Medicare even if you choose to upgrade to a Medicare Advantage plan.
- Medicare Prescriptions Drug Coverage (Part D)
Original Medicare does not cover most prescription drugs. Therefore, to cover your regular medication needs, you will need a Part D prescription drug plan. Though plans vary in the drugs they cover and the pharmacy networks they serve, they can all substantially reduce the Medicare policyholder’s cost obligation for their medications. You cannot buy a Part D plan and an Advantage plan at the same time.
- Medicare Supplemental Plans (Medigap Coverage)
Within Original Medicare, you will still have costs like co-payments, deductibles and coinsurance obligations. However, these out-of-pocket costs can still be expensive even with good benefits. If you want added cost aid, then you might be able to apply for a Medicare supplemental plan, also called Medigap coverage. This coverage helps fill in cost gaps where your Original Medicare will not pay. Therefore, your out-of-pocket losses might be lower than otherwise.
The thing to remember about these private Medicare plans is that they must meet standards set by Medicare law, but they can also make substantial decisions on their own. You cannot enroll in these plans indefinitely, and premiums might vary along with the coverage your plan provides. Never hesitate to talk to your Medicare agent about the plan that will best fit into your lifestyle.