Medicare started out as a social insurance program by the U.S. government at the national level. The benefits of Medicare are classified in four distinct groups, which cater to specific health care needs of patients in the country.
Although highly beneficial, these healthcare plans from the government have a coverage gap popularly known as the Medicare donut hole, in which the beneficiary is himself responsible to bear the cost of the prescription drugs. It can be described as the difference between the initial limit and the catastrophic threshold.
Medicare supplement companies offer insurance policies that can cover this gap. Medicare supplement or Medigap plans are standardized by CMS and administered and sold by private insurance companies. As per regulations, Medicare beneficiaries are not allowed to enroll in both the Medigap policy and Medicare advantage plan.
Eligibility:
A Medicare supplement company considers a person eligible for Medigap plan if he or she is already enrolled in Medicare Part A and B. The open enrollment period starts from sixth month before a person turns sixty-five.
After the open enrollment period the Medicare supplement company may ask for medical screening from the patient. The applicant may also be required to obtain a statement from the attending physician, if necessary. Medigap insurance and other forms of Medicare coverage, like advantage plans, are not compatible with each other.
Under certain circumstances, like patients with kidney failure or recipients of disability insurance, Medicare coverage is given irrespective of the age of the patient, but such people are not eligible to buy Medigap until they turn the age of sixty-five.
Drugs and Products Coverage Available:
Centers for Medicare and Medicaid Services, the governing body for Medigap plans, has classified the benefits into ten different plans starting from A to N. All the products offered by private Medicare Companies fall under these ten categories.
There may be certain variation from one state to another in terms of sales and offerings for Medigap Insurance Policies. The reason behind this is that these plans are not government sponsored and are sold by private Medicare Supplement Company.
Drug coverage is not available to people who are already enrolled in standalone Part D plan. People enrolled in Medicare plan that has drug coverage and filed application for Medicare Part D by May, 2006 have the flexibility to shift to another Medicare plan without drug coverage.
Medicare Plans That Insurance Companies Can Sell:
In most cases a Medicare Supplement company is allowed to sell only standardized policies under Medigap. Since benefits vary with state, a person will have to contact the local insurance companies to know the benefits that are on offer.
Insurance companies are not required to offer every Medigap plan when they sell Medicare Supplement Plans. In certain circumstances, insurance companies must sell these policies even if the person has health problems.
Medicare Supplemental Insurance - How to Choose an Advisor? How To Apply For Medicare Supplemental Insurance And Get The Best Rates Help With Your Medicare Supplement Choices What Is Supplemental Security Insurance?
0 comments:
Post a Comment