Do you need an insurance policy to help cut down on
your growing Medicare costs?
Nearly 1 in 4 Medicare beneficiaries think so and have purchased a
Medicare supplement insurance plan.*
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Medicare Supplemental Insurance Plans - Medigap - Medicare Gov
Medicare Supplement Insurance - Compare Medicaid Plans
Medicare supplement insurance covers the gap between what Medicare pays on medical bills and what you have to pay for premium deductibles, coinsurance and co-payments.
Private Medicare supplement insurance policies pay only for services that the U.S. Medicare system indicates medically necessary - and cash payments are generally based on the Medicare approved expense. Some insurance plans offer financial benefits that Medicare do not offer. Such as emergency care abroad.
NOTE TO: All Medicare Advantage Organizations, Prescription Drug Plan Sponsors, and Other Interested Parties
SUBJECT: Announcement of Calendar Year (CY) 2014 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 2014 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.
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.
Medicare.gov - National Health Insurance
Medicare is a social insurance program administered by the US government, providing national health insurance coverage to people 65 and over, or individuals who meet other special criteria.
US Medicare Gov operates similar to a single payer healthcare system. The most important difference is that its coverage only extends to 80% of any given medical cost. The remaining 20% of cost must be paid either via a private company supplemental health insurance, or via the patient's own personal funds. Private health insurance usually require a monthly premium to be paid.
Explain The Difference Between Medicaid and Medicare Gov
Medicaid and Medicare sound similar. They are really two very different government programs. The biggest differences is Medicaid is a state governed program while Medicare is a federal program. Some other differences are:
* Women who are pregnant
* Children under 19 years of age
* Individuals 65 and over
* Individuals are blind
* Individuals who are disabled
* Individuals who need nursing home care
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
13. Health Net
* Source: Kaiser Family Foundation
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Disclosure: “We are not connected with or endorsed by the U.S. Government or the federal Medicare program. Medicare has neither reviewed nor endorsed the information contained on this website. Disclamer: This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.”