To define it simply, Medicare is a health insurance program of the federal government that is primarily intended to cover part of the healthcare needs of older people at least 65 years of age. Other people under 65 years old may also be eligible due to a qualifying health condition or disability. Medicare supplement insurance can be purchased to defray some healthcare costs not covered by Medicare. It is sometimes referred to as “Medigap” simply because it fills the gaps that exist in the Medicare insurance coverage.
A supplement policy for Medicare is not a necessity for all people. For one, the healthcare coverage gaps can be made up for by some other types of insurance policies. Following are some instances where you do not need to acquire a supplement insurance coverage:
* If you already have Medicare Advantage Plan coverage, a supplemental plan will only be redundant. Remember, the idea is just to make sure that there are no gaps in your health insurance coverage.
* You likewise do not need to get a supplemental Medicare coverage if you are included in your employer’s (or a former employer’s) group health insurance policy that includes military or government retiree plans.
* If your Medicaid premium payments and other related out of pocket expenses are shouldered by the Qualified Medicare Beneficiary Program (QMB) or Medicaid, it is not advisable to get a supplemental plan. The QMB program is one of a number of Medicare savings programs which are intended to help defray costs of Medicare premiums, co-insurance, co-payments, and deductibles.
To avail of the benefits of the traditional or original Medicare insurance, all you have to do is to go to an accredited hospital or doctor. The benefits include hospital, medical, and prescription drug coverage. However, the basic Medicare policy does not cover services such as long-term care; private-duty nursing care; homemaker services; routine eye care, hearing aids, and eyeglasses; routine foot care and cosmetic surgery; and healthcare received while on foreign travel except under some specific circumstances.
Medicare supplement insurance policies, on the other hand, pay only for those services that Medicare considers as “medically necessary” and the payments are normally based on rates approved by Medicare. But there are some supplemental policies that provide benefits not available to Medicare like urgent care required while travelling in a country outside of the United States.
Supplements can be purchased from qualified private insurance providers that are regulated and duly accredited by the TDI. Only the federal government, however, has the power to determine and set the benefits that can be covered by a supplemental plan. It is therefore important to make sure that when buying a supplemental Medicare plan, you only deal with duly licensed private insurance companies.
The supplemental policy automatically renews every year. This means that you do not have to initiate moves or file an application to have it renewed. If you discontinue your policy, it is still possible to put it on active status again. Another option is to purchase a new Medicare supplement policy.