Why Purchase a Medicare Supplemental Insurance Plan (MediGap)?

People under the age of 65 may have difficulty purchasing a medical supplemental insurance plan. The Law states that it is a right duly given to elders age 65 and above only after they have enrolled in Medicare Part A and Medicare Part B.

NOTE TO: All Medicare Advantage Organizations, Prescription Drug Plan Sponsors, and Other Interested Parties

Medicare 2013

SUBJECT: Announcement of Calendar Year (CY) 2013 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter

In accordance with section 1853(b)(1) of the Social Security Act (the Act), we are notifying you of the annual Medicare Advantage (MA) capitation rate for each MA payment area for CY 2013 and the risk and other factors to be used in adjusting such rates. The capitation rate tables for 2013 are posted on the Centers for Medicare & Medicaid Services (CMS) web site at http://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/index.html under Ratebooks and Supporting Data. The statutory component of the regional benchmarks, transitional phase-in periods for the Affordable Care Act rates, qualifying counties, and each county’s applicable percentage are also posted at this website.

Aside from this, they should also pay the monthly premium rate for Medicare Part B on top of what you will need to pay for your Medigap Insurance Policy. Realizing all of these different types of payment, it makes you wonder why many are still interested in purchasing a Medicare Supplemental Insurance Plan. Are the Medicare benefits still not enough to cover the medical expenses of the elders?

How Medicare gov works with other insurance companies

If you have Medicare and other healthinsurance, each type of coverage is called a "payer." If or when there is more than one payer, 'coordination of benefits' rules decide which one pays first. The "primary payer" pays what it owes on your medical services bill first, and then sends the rest to the "secondary payer" to pay. In some cases, there may also be a third payer.

What it means to pay primary/secondary

• The insurance company that pays first pays up to the limits of its coverage.
• The insurance  that pays second only pays if there are costs the primary insurer did not cover.
• The secondary payer (which may or may not be Medicare.gov) may not pay all the uncovered costs.
• If your employer insurance is the secondary payer, you may need to enroll in Medicare Part B before your insurance will pay.

Paying "first" means paying the whole bill up to the limits of the coverage. It doesn't always mean the primary payer pays first in time. If the insurance company doesn't pay the claim promptly (usually within 120 days), your doctor or other provider may bill Medicare. Medicare may make a conditional payment to pay the bill, and then later recover any payments the primary payer should've made.

Latest NEWS about Medicare

Medicare Supplemental Insurance Plans, also called as Medigap or PRIVATE MEDICARE, are individual insurance policies purchased by elders who believe they need more assistance with their medical needs. The Medicare assistance offered by the government is sufficient for majority of the elders in the US, but there are still quite a few individuals who will need more financial assistance on this matter. The only option left for them to grab hold onto is these Medigap Insurance Policies.

Medigap Insurance Policies are classified into 12 distinct categories. This is regulated by law and cannot be altered in any way by the insurance company. The most they can do is to convince you to purchase the plan coverage that will place the company at lesser risk of paying more rather than earning more from you. You should be cautious of these techniques because you may end up tricked by some insurance agents because of their flowery words and convincing speeches.

Choose a Medigap Insurance Policy if and only if you have calculated your potential insurance cost to be more than what the Medicare will be providing you. Otherwise, you will not need any of these supplemental insurance plans because the government will have your medical expenses all covered-up.

Application for Medicaid is accepted at the individual State's Medicaid agency.

Medicare is for individuals:

   * 65 and over

   * of any age who have kidney failure or long term kidney disease

   * who are permanently disabled and cannot work

Medicare is applied for at your local Social Security office (SSO).

Some individuals qualify for both Medicaid and Medicare. Medicaid can sometimes be used to help pay for Medicare premiums. People who qualify for both programs are called 'dual eligible'.

Who Is Eligible For Medicare.gov Coverage?

As a rule, all persons 65 years or older qualify for Medicare coverage. If they have been a resident of the US for at least 5 years. All people with disabilities in the US are also entitled to Medicare.

What is Covered Under Medicare?

Basically, Medicare has four parts. Part A covers hospital stays and expenses. Part B is general medical insurance coverage.  Part D is coverage of prescription drugs. Part C, also called Medicare Advantage Plan - is just another way to receive parts A, B and D.

Medicare Part D offers prescription drug plans (PDP) through private insurance companies. There is 10 national plans offered, including AARP Part D Coverage, and some regional plans. The estimated cost for the premium will vary with the plan but the current estimate for the average PDP is approximately $37 per month. The premium cost is expected to increase annually.

   1.  Humana Insurance

   2.  United Insurance

   3.  Blue Cross/Unicare

   4.  Aetna Medicare

   5.  Coventry AdvantraRx

   6.  CIGNA Medicare Rx

   7.  SilverScript Insurance

   8.  WellCare Coverage

   9.  Sterling Life

   10. EnvisionRx Plus

   11. United American

   12. HealthSpring

   13. Health Net