Straight talk. Answers to 3 FAQ's about Medicare and Medicare Supplement Insurance. You never must be a Medicare expert or devote hours reading info and researching online to know your Medicare and Medicare Supplement options.
Q: What's the difference between Original Medicare and Medicare Advantage (MA) Plans?
A: There are numerous key differences between Original Medicare and Medicare Advantage Plans. Original Medicare can be your government Medicare. Medicare Advantage is private Medicare that takes the spot of your government Medicare. You may have similar out-of-pocket expenses with an MA plan as you'd with Original Medicare alone.
It is very important to realize that generally speaking an MA plan is exactly the same coverage as Original Medicare. You can find some extra benefits such as for instance dental or eyeglasses, and a number of the plans include drug coverage as well, but the beds base coverage will be the identical to original Medicare.It is not similar as Medicare along with a Medigap or Supplement Plan. You cannot get a supplement intend to cover your out-of-pocket expenses when you're enrolled within an MA plan.
Q: What are my potential out-of-pocket expenses with my Medicare coverage?
A: Medicare itself is very good coverage but there are a few gaps in the coverage that lots of beneficiaries fill with a Medicare Supplement policy.
Medicare Part A covers hospital room and board, short-term skilled nursing care and hospice care.
There is a deductible for Part A. Currently the deductible is $1132.00. This means that you will pay the first $1132.00 before Medicare benefits are paid. This is simply not an annual deductible. It is an advantage period deductible. Good results period starts the day you're admitted to a medical facility and ends 60 days after you're released. It is possible that you might encounter the Part A deductible over and over again in a year. Following the deductible is met Medicare covers 100% semi-private room and board for 60 days. From day 61-90 the is a daily co-insurance of $283 per day. After 90 days Medicare provides coverage for one more 60 lifetime reserve days with you paying an everyday co-pay of $566.
Skilled nursing facility adhering to a hospital stay of at the very least 3 days is covered by Medicare at 100% for the first 20 days. Days 21-100 have a $141.50 co-pay per day.
Your exposure on the A side of Medicare are your deductible, and the many co-insurances mentioned above.In addition, Medicare doesn't cover the initial 3 pints of blood.
Medicare Part B covers medical expenses in or from the hospital such as for instance doctor visits, inpatient and outpatient medical and surgical services and supplies.Diagnostic testing, speech and physical therapy, and durable medical equipment are Part B expenses.
There is a calendar year deductible for Part B. This season the deductible is $162.00. After you have met your deductible medicare covers 80% of approved amounts for covered services.
Your exposure on the B side of Medicare includes the deductible and 20% of approved amounts for covered services and any Part B excess charges. Part B excess charges are charges for covered services that exceed Medicare approved amounts.
Q: Just how can I limit my exposure and cover the gaps within my Medicare coverage.
A: You are able to supplement your Medicare coverage with a Medigap insurance policy.
You can find 10 Medicare supplement policies which are approved by Medicare. All of the supplements have exactly the same basic benefits.
Medicare supplement basic benefits for Medicare Part A cover all your hospital co-insurances and will extend your covered days beyond Medicare coverage for and additional 365 days. The Part A deductible and skilled nursing co-insurance coverage are optional benefits.
Your supplement will automatically adapt to the changes in Medicare deductibles and co-pays from year to year.
Under Medicare Part B, Medicare Supplement basic benefits will cover your 20% co-insurance.
You can choose a supplement plan which includes optional benefits such as for example Part B deductible, Part B excess, and foreign travel emergency coverage.
Seek the guidance of a broker who specializes in Medicare to help you determine which of the 10 Medicare Supplement Plans best suits your needs.