Two of the most frequently chosen choices for individual Medicare coverage are Medicare Advantage Plans and Medigap Insurance plans. Medicare Supplement Insurance is purchased on behalf of a primary payer to supplement the coverage of Medicare. Medicare Advantage Plans are designed to offer premium advantages to members of Medicare Part A and B.
In general, Medicare Advantage Plans offer a higher deductible, broader options, and more choices for out-of-pocket expenses than Medicare Parts A and B. It is important to note that Medicare Supplemental Insurance pays at least some of the cost of any out-of-pocket expenses not covered by the primary plan. Medicare Supplement Insurance plans cannot be guaranteed issue and can be discontinued at any time.
Medigap Insurance Plans are standardized contracts between a policyholder and a Medicare Parts A and B provider. Unlike Medicare Advantage or Medicare Part D prescription drug coverage, Medicare Supplement Insurance plans are not required to be part of an individual’s Medicare coverage.
Instead, they are considered additional Medicare coverage and must be purchased from a Medicare provider. Medicare supplement plans are standardized and rarely vary significantly across companies. Although Medigap Insurance generally covers the same diseases and conditions as Medicare Parts A and B, the costs and benefits of these policies are often very different from one company to the next.
Medicare Supplement insurance plans are intended to fill the gap left by traditional Medicare coverage when an individual either loses coverage through their employer, loses coverage through federal accident or health benefits, or for other reasons. Medicare Advantage Plans are available from a variety of sources, including employers, government programs, and extended Medicare programs such as Medicaid and the State Health Department programs.
Medicare Supplement plans can also be purchased directly from a Medicare provider or through brokers and agents. Most Medigap policies are standardized so that they will provide coverage for the same diseases and medical procedures, but there are some exceptions. Medicare Supplement policies can cover additional generic drugs or biological substances not covered under the original Medicare plans.
Some types of Medigap plans are “fee for service” plans, which require enrollees to pay a monthly fee for medical services not covered by their Medicare Advantage or Medicare Part D plans. Some “point of service” plans allow physicians’ services to be optional and non-reimbursable. Most “fee for service” plans have daily or maximum limits for the number of days that a patient can be hospitalized or treated for covered medical services. These limits may be increased or decreased according to each plan.
Some people worry about how to pay for foreign travel insurance when traveling outside the United States. Whether you will be held to ransom during a hospital emergency is another concern. Many US citizens have been evacuated from foreign countries because of natural disasters and emergency medical care. Some companies offer coverage for emergency care overseas even if you are not in the United States. If you are traveling abroad and need urgent medical care, medical insurance plans will help you shoulder the expense.
One disadvantage of medical insurance plans is that they do not provide coverage for pre-existing conditions. This means that if you become ill during the coverage period, you may need to pay out-of-pocket expenses before your coverage kicks in.