Medicare Supplemental Insurance Plans and Medicare Advantage Plans
Medicare Supplemental Insurance Plans are designed to fill in the coverage gaps that Original Medicare does not cover. These private insurance policies can be purchased from a number of companies who have contracts with Medicare. While they offer similar benefits, each company has its own premiums and services. Medicare beneficiaries may purchase a plan within the six-month period of open enrollment, which begins the month following the month in which they turn 65 and enroll into Part B. Acceptance is not guaranteed. If you don’t buy a Medicare Supplement during this window, you can still apply for one during the annual election period, which begins January 1 and ends March 31.
You can also enroll into a Medicare Advantage plan (Part C). These plans provide all Medicare benefits in one monthly premium. Most of these plans include prescription drug coverage. Plans C and D cover emergency medical care outside of the United States. These plans limit your liability to 80% of what Medicare would have paid for the care. Plans P & N also cover excess charges from doctors, which Medicare would not normally cover. These limits your liability to a maximum of 15% above the Medicare-approved amount for the service.
Medicare Advantage plans include many extra benefits. These include fitness programs (such as gym memberships), vision coverage, hearing coverage, drugs that are not covered under Part D, and health and wellness services. In 2022 most Medicare Advantage plans will offer some of these additional benefits. Nearly all plans cover at least three pints per year. Plans also cover home based palliative or respite care. However, there may be eligibility requirements.
In addition to these plans, some Medicare Advantage organizations have specialty packages for chronically ill enrollees. These packages could include additional benefits not directly related to health, such a transportation to doctor appointments, meals at home, or in-home support.
If you join a Medicare Advantage plan, you will have to choose between the network and out-of-network providers. Most Medicare Plans have preferred networks of doctors or hospitals. If you do not choose a plan with an in-network provider, you might have to pay a higher copayment or coinsurance for your health care.
In 2022, more Medicare Advantage plans included prescription drug coverage than ever before. In addition, a record-high percentage of Medicare Advantage Plans had no Medicare Part D premium for enrollees in the standard MA-PD plan. This was due in part to the availability and affordability of insulin demonstration plans. These plans require a $35 payment for the Part D deductible, as well as the initial coverage phase.
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