The Medicare Health Program first came into existence upon President Lyndon Johnson’s approval in 1965. Over the years, the benefits afforded by the law were expanded to include hospice care, physical rehabilitation and an outpatient prescription drug feature. The Medicare Modernization Act (MMA) amended the list of benefits during President Bush’s administration. At present, the healthcare program has four coverage levels- A for hospital care, B for outpatient medical services, C for Medicare Advantage Plans which was excluded from the original Medicare list and D for prescription drug.
This healthcare program comes with limitations though. For instance, non-emergency ambulance costs are covered when the doctor attests the need for medical purposes. However, twenty percent of the amount will become out-of-pocket expense, under Medicare’s approval. Not all expenses are covered by Medicare, hence, needing expenditure backups. The gaps in the healthcare program’s benefits need external support if a comprehensive coverage is to be ensured.
A Medicare supplement plan, also referred to as Medigap plan, provides needed coverage for items barred from the Medicare policy. Supplement plans are usually catered by private health insurance companies and are standardized into twelve categories under Medicare regulations. The regulations specify that all supplemental plans offered by private insurers adhere to the standard categories and are designated by letters: A to D, F, G and K to N.
What costs can be covered under a Medicare supplement plan? Medigap policies include payments for A and B requirements for coinsurance and services related to emergency treatments. Charges in excess of Medicare prescribed rates or fees are also deductibles from Medigap benefits. The twelve categories further present various benefits to compensate for the different gaps under the healthcare law and insurers are obliged to comply under the respective categories.
Standardization of these plans maximizes benefits in as much as insurers are mandated to adhere to the regulation. Although the benefits are uniform under standardization, certain states have additional regulations for add-ons beyond the basic coverage of Medicare. Massachusetts, Minnesota, and Wisconsin are a few of the states having added guidelines for insurers’ compliance.
However, Medigap policies exclude certain items. Long-term care, such as care in a nursing home, vision or dental care, grant of hearing aids and eyeglasses and availment of private-duty nursing are not normally included in the standard policy. What are usually covered are the gaps like copayments, coinsurance and the annual yearly Medicare deductibles.
The need for a Medicare supplement plan can never be overemphasized. Cost-wise and benefit-wise, it encompasses the uncertainty in terms of financial availability and medical urgencies. It also stretches flexibility and the level of preparedness when worse situations come, physical health deteriorates and medical bills become heavier than expected. Or perhaps, even the worst case unimaginable.
As the famous adage goes, prevention is always better than cure. Health consciousness is a trend and as long as people care much for health and its quality over time, supplement plans will never be obsolete. Life is too short to be wasted and the best way to secure health prosperity is to prepare ahead for possibilities. Thus, the need for these supplement plans will always be imminent, no matter the time frame.