Medicare Supplemental Health Insurance

Medicare supplemental health insurance provides you with additional health insurance benefits that are not available through Medicare Part A or Part B. SomeMedicare supplemental plans, also referred to as Medigap insurance,will provide you with prescription coverage and preventative healthcare. Medicare supplemental health insurance plans can also cover yourMedicare Part A deductible, extra days of hospital care, your Medicareco-payment amounts, skilled nursing and foreign travel emergency care.

Medicare Supplemental Health Insurance Overview

Medicare supplemental health insurance is a plan sold by a private insurance company to those eligible for Medicare as additional coverage for medical needs.These policies can be purchased directly from an insurance provider,which is bound by the federal and state laws governing healthinsurance. Before you sign up for a Medicare plan make sure you get all the Medicare health insurance plan informaiton. You are required to pay a monthly premium directly to theinsurance company, although assistance is available below a certain income level. Medicare supplemental insurance is designed to help cover the "gaps" left by the standard government Medicare plan.

Because Medicare is a compromise between what is needed by the elderlypopulation and what the government can afford to cover, there areobvious gaps in coverage, such as coverage of prescription drugs,extended hospital stays, specialized in-home care, and coverage fortravel abroad.

Before you consider purchasing Medicare supplemental insurance, you should understand the coverage options under Medicare and the rules for joining or switching Medicare policies.You should first maximize your benefits under available Medicareoptions as well as consider the effect of other coverage options suchas group health insurance from your employer or trade union. Analyzing your Medicare costs after accounting for any other health insurance sources may show that you do not need a Medicare supplemental insurance policy.

Thereare 12 standardized policies for Medicare supplemental health insurance andthey are categorized as plans A thru L. This applies to every stateexcept Massachusetts, Minnesota and Wisconsin. Each plan provides adifferent set of benefits. For instance, Plans K and L are new policiesthat will help you limit extensive out of pocket expenses for doctorand hospital service. Plans K and L will have a lower premium than someother Medigap policies, but you will pay a larger amount of Medicare'sdeductibles before the policy pays for any of the medical costs. Withthese new plans you are assuming a greater risk toward your share ofcosts while receiving additional protection over what is provided underoriginal Medicare.

Medicare SELECT policies (Plans F and J)usually cost less but have a high-deductible. You will have to usespecific doctors to get full insurance benefits on these plans. In anemergency you may use any hospital or doctor. The plans are lessexpensive because the physicians that are on the "Select" list agree tosee Medicare patients at a reduced "assignment" fee.

Unlessyou buy a Medicare SELECT policy, you may go to any doctor or hospitalfor treatment. The Medicare supplemental insurance policy pays for itsshare of the expenses and your Medicare policy covers its share. Thelevel of benefits you receive will depend on which plan you choose. Youwill pay for your Medicare supplemental insurance and pay the Medigap insurancecompany on a separate invoice. You will receive a Medicare Summary oncea month by mail and your Medigap insurance company will also send you Medicare health insurance planinformation on what has been paid. A Medicare supplemental health insurance policy doesnot replace your original Medicare coverage. It simply provides additional benefits to help cover themedical expenses that are not paid for by the original Medicare policy.You may also want to join a Medicare Advantage Health Plan that willhelp with drug costs and coinsurance deductibles.

If you haveother insurance, they sometimes pay your bills first and then MedicarePlan pays second. This would mean that your other insurance plan wouldbe the primary payor on your medical expenses. Other insurance that maypay first could be any of the following:

• Employer sponsored group health coverage
• No fault Insurance
• Liability insurance
• Black lung benefits
• Workers compensation

Thesetypes of insurance will pay first in most cases. It is important thatyou let your doctor and hospital know if you have other insurance sothey will know how to handle your billing. Medicare may make aconditional payment is some cases. If your insurance that is supposedto pay first does not, this payment must be repaid to Medicare. That iswhy it is called "conditional." If you currently have other insurancethat pays prescription costs and you enroll in a Medicare prescriptiondrug plan, you must let your Medicare know about your other coverage.You should be familiar with all of your rights as a Mediare recipient and how they effect your Medicare supplemental insurance plan.

On January 1, 2006, new Medicare Prescription Drug Plans were made available to everyone on Medicare. Under these new plans,there is a separate co-payment and deductible associated with the costsof your prescription drugs. You must also go to pharmacies that belongto the Medicare Prescription Drug plan. If you choose to go to apharmacy that isn't part of the plan your drugs will not be covered. Inmost, cases only prescription drugs that show onthe MedicarePrescription Drug Plan lists will be covered.