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Supplementing Medicare Overview
By Denice Merrill

Health Insurance in general can be a confusing experience. As you approach the age of 65, you may be eligible for "Medicare Coverage". This is still health insurance but with different options to consider. The following is a simple overview-

Medicare Coverage includes minimal protection for hospitalization and doctor visits. This is the Medicare Part A & B.

The Health Insurance protection that fills in the gaps in coverage are referred to as "Medigap Plans", as the name implies, it can pick up some or all of the gaps in protection that the Medicare Part A & B do not cover.

This is where it gets tricky, there are 10 standard health plans labeled A through J. Once you buy a Medigap Plan the company cannot change what the policy pays for, and cannot cancel the policy unless you don't pay the premium. The company can however, at their discretion, increase the premium you pay. There are ways to protect against these increases.

Medicare Select plans offer supplemental coverage but require you to receive all your care from the plan's list of providers. If you seek health care outside of the plan's network, you must be prepared to pay most, or all of the costs. Almost all Blue Cross of California plans are Medicare Select.

In Medicare HMOs there are no deductibles and co-insurance charges, however there are usually monthly premiums and co-payments for doctors' visits and other services. You must use only doctors and facilities that contract with the Medicare HMO, and you must obtain your doctor's permission for all specialist and procedures. Unlike Medigap and Medicare Select plans, Medicare HMOs can change their benefits, deductibles, co-payments and premiums annually, or they can decide to leave town or leave your zip code.

Beyond this brief overview, if you have questions, would like to understand your potential options or review your current coverage, please call me.

Denice Merrill
CA Lic#0D99790
Health Care Consultant

(Information gathered from California Health Advocates Association - Health Insurance Counseling and Advocacy Program - HICAP, Rev 2/4/04)

Disclaimer: The above information is presented for educational purposes only. Statements have not been evaluated by the FDA. Products mentioned are not intended or effective for the treatment or prevention of any disease. Consult your physician for all your health needs.

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Article contributed by Denice Merrill Health Care Consultant
(949) 388-7332


 

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