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Why You Need A Medicare Supplement


Medicare Supplemental Insurance PlansHaving a Medicare supplement can help fill the gaps in your Part A and B Medicare coverage!

Medicare: it's a wonderful program, and has saved senior and disabled citizens untold billions of dollars for health care. But the fact is that Medicare alone was never designed to pay 100% of health care expenses for the elderly.

Why do You Need a Medicare Supplement?

You need a supplement to Medicare in order to pay all of your medical expenses.

You might incur expenses in several areas that would not be covered by Medicare. For example, your deductible for a hospital stay in 2009 is $1068, and Medicare would not pay this amount. There is also a $135 deductible for Part B of your Medicare coverage.

Generally, you must pay twenty percent of your doctor and other medical expenses out of pocket.

As you can see, if you don't have supplemental insurance, your out-of-pocket costs could amount to almost $52,000 in just one year!

Many private insurance companies have these kinds of insurance policies available to pay what isn't covered by Medicare for your medical expenses.

This kind of insurance is legally standardized into twelve plans: Plan A through Plan L. This means that Plan G from one company must have the same benefits as Plan G from a different company. But although the benefits are required by law to be the same; different insurers may be vary according to cost and coverage.

So, it pays to shop wisely for a Medicare Supplement policy!

Which Medicare Supplement is Best for You?

Which Medicare Supplement is best for you depends on your needs. Again, there are many different insurers to choose from, so just shop around and select the plan that seems best suited to your individual needs. Many people have supplemental insurance coverage included in their retirement package, so take this into consideration before choosing a plan.

Can You See Your Own Doctor?

Most major insurers do allow you to see and choose your own doctor.

When Can You Apply for Medicare Supplement Insurance?

It is best to buy a Medigap, or Medicare Supplement, policy during your open enrollment period. This open enrollment period is the period that begins after you reach age 65, on the first day of the month in which you were born. It lasts for six months. During your open enrollment period, you cannot be denied any Medicare Supplement coverage that an insurance company sells, or made to wait for coverage to start, or be charged more for a supplemental Medicare policy because of poor health.

Do You and Your Spouse Need Separate Medicare Supplements?

Yes, you will each need your own individual Medigap policy, just as you each have your own Medicare coverage.

Can You Switch Medicare Supplements?

Yes. In fact, even if you are happy with your policy, it's a good idea to compare rates and benefits of other plans from time to time. If you find a plan that seems better than what you have, check with the insurer for Medicare Supplement quotes. You might be able to save a considerable amount of money by switching to a different Medicare Supplement!

Get a quote for Medicare Supplemental Insurance.

Medigap (Supplemental Insurance) Policies



A Medigap policy is health insurance sold by private insurance companies to fill the "gaps" in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn't cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of covered health care costs.

Insurance companies can only sell you a "standardized" Medigap policy. These Medigap policies must all have specific benefits so you can compare them easily.

You may be able to choose up to 12 different standardized Medigap policies (Medigap Plans A through L). Medigap policies must follow Federal and State laws. These laws protect you. A Medigap policy must be clearly identified on the cover as "Medicare Supplement Insurance." Each plan, A through L, has a different set of basic and extra benefits.

It's important to compare Medigap policies because costs can vary. The benefits in any Medigap Plan A through L are the same for any insurance company. Each insurance company decides which Medigap policies it wants to sell.

Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company.

You and your spouse must each buy separate Medigap policies. Your Medigap policy won't cover any health care costs for your spouse.

For additional information on Medigap policies, including why you would want to buy a Medigap policy and information about what Medigap policies cover, please read our publication, Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.

The Many Different Types of Medicare Advantage Plans

Medicare Advantage PlansMedicare Part C, also known as the Medicare "Advantage" Plan, is a recent addition to Medicare health insurance. It is full of additional options for those receiving healthcare coverage through Medicare. Because it is "privatized," your insurance company takes over and manages all of your Medicare benefits while following government regulations.

For those receiving Medicare, Part A pays for in-patient care at hospital, hospice care, nursing home care, and in-home medical care. Medicare Part B covers most of a patient's medical expenses, while Medicare Part B covers nearly all of a patient's medical expenses for general care by a doctor. Medicare Advantage plans combine everything that Parts A and B cover while also covering the cost of prescription medicines.

Thanks to all of the benefits Medicare Advantage plans offer, they have become very popular. With these plans, Medicare recipients can stay longer in hospitals, pay lower fees for doctor's visits, and receive prescription drugs at a lower price. Also, recipients no longer need to be referred by a primary physician - you can receive care from the doctor or hospital of your choice without a referral.

Medicare Advantage plans are available throughout the United States through private insurance companies. Under government laws, Part A and Part B are always included in Advantage plans. Medicare Advantage plans can be HMO plans, PPO plans, or Private Fee for Service plans. The most popular choice is the HMO Advantage plan because it allows Medicare recipients to pay low or zero monthly premiums, and the lowest out-of-pocket expenses. Keep in mind that HMO Medicare Advantage plans are only available in metropolitan areas where a large number of Medicare recipients reside.

Conversely, a Medicare PFFS or Private Fee for Service Advantage plan permits the Medicare recipient to see the doctor of their choice as well as any hospital of his or her choice in the United States. Naturally, this type of Medicare Advantage plan is extremely popular among Medicare recipients because of the freedom it allows.

In the United States, Medicare Advantage plans are now offered in 98% of counties. Back in 1996, only a meager 15% of American counties offered these plans. According to the 2007 statistics reported on Medicare Advantage plans, the average American pays $736 in monthly premiums, although the actual monthly payments between states can vary from $500 to over $800 per month.

You should be advised that Medicare plan holders, who do not have End Stage Renal Disease (ESRD), or kidney failure, can qualify for a Medicare advantage plan. For anyone that is suffering from kidney failure, there are some counties that offer plans specifically for those that have kidney failure. Your Medicare plan must cover at least what traditional Medicare does, and it may cover more.

As you can see, the Medicare Advantage plan really does include many advantages. Your doctor visit co-pays are cheaper, prescription drugs cost less, and you have more freedom to choose the doctor and hospital that is right for you.

Medicare Advantage Plans
Medicare Supplemental Insurance Quotes

Learning the Enrollment Application Process for Medicare


Medicare Supplemental insuranceIf a facility is to receive payment for procedures covered by Medicare, the facility must enroll in the Medicare program. Medicare was created and is issued by the federal government and it is a form of medical insurance for citizens age 65 or older. In order to receive payments from Medicare, the facility is required to complete a form titled "Medicare Enrollment Application for Institutional Providers" (CMS-855A). There are several ways that the facility can submit their application once they choose to enroll in the Medicare program.

There is information titled the "Provider Enrollment Packet" that the facility can request. This packet provides the step by step instructions needed to complete and submit the CMS-855A application. By logging on to the Centers for Medicare & Medicaid Services (CMS) website, the facility can also electronically submit the application. On the website they can download the application to print, or just electronically submit it.

If the facility is not a Medicare provider yet, and has not yet received Medicare payments directly into a bank account, then an electronic funds transfer (EFT) must be submitted with the CMS-855A application. Information about submitting funds electronically is given in the electronic data interchange (EDI). In order for the application to be processed, this form must be submitted with the CMS-855A application.

In addition to the enrollment application, the CMS-855A is required for any changes. These changes include any changes in billing or telephone information, any additional locations, change of ownership, stock transfer, or reactivation of an old Medicare provider number. This also includes changes of address, business name, financial information; as well as changes in management or facility directors.

Any facility that chooses to accept patients with Medicare insurance will receive a National Provider Identifier (NPI). This is a number that must be submitted on each application so the review process can be as quick and efficient as possible. Before submitting the CMS-855A forms, the NPI number should be requested.  Any forms without the NPI number will not be processed until the NPI is submitted.

Upon submission of all information and applications, the forms are reviewed for approval. To ensure that providers receive prompt payment for services rendered under Medicare, all information on file must be kept up-to-date. The person that reviews the CMS-855A form is an audit intermediary (AI). They also review the Medicare provider's cost reports to decide what the final settlement of the cost report will be. This review helps to provide payment only to facilities that are operating within Medicare's guidelines and costs. To ensure that facilities are only billing for services rendered, and that patients are receiving Medicare-approved services, any payments for services provided under Medicare are closely scrutinized.

The detailed application process for Medicare ensures that facilities who apply for Medicare payments have high standards. So, they are eligible to be a Medicare provider. These standards allow for Medicare recipients to receive the best care possible when a medical situation arises.

Medicare Supplemental Insurance Quotes

How to Choose Medicare Supplemental Health Insurance


medicare supplemental insuranceMany insurance companies offer additional benefits known as Medicare supplemental health insurance plans. All of these plans are to provide coverage for health insurance costs that are not covered by Medical. When Medicare changed the way of coverage and payment that was in place for a number of years, Medicare supplemental health insurance plans were created.

Some of the differences between the old insurance and the new are the new Medicare insurance does not cover as much of the costs for prescription drugs as the old. It also does not cover many of the preventive health measures required for older Americans. Medicare insurance can be considered a "back up" insurance policy for any item that Medicare will not pay for.

Currently, Medicare has 12 standard Medicare supplemental health coverage plans that are available to senior citizens. Each of these plans must cover the same areas of healthcare for seniors and the plans are strictly regulated by the government. If you are planning to buy a Medicare insurance plan, the best time to purchase is within six months of applying for Medicare.

Oftentimes, insurance companies will tell individuals that their company's Medicare insurance plan is better than all the others and they will attempt to charge a higher price. It is imperative to remember that each one of these plans offer the same services. So, when looking for a Medicare supplemental health insurance plan, it is best to shop around for the lowest price because the services the plan covers stay the same and all of the plans are not different from one another.

Once you qualify for Medicare, many insurance companies have a Medicare supplemental health plan if you have a health policy with your retirement benefits. You generally will not even recognize any changes to your insurance benefits. Unfortunately, many Americans do not have any health coverage. If you are one of these people, then you will need to search for a Medicare supplemental health insurance plan on your own upon qualifying for Medicare benefits. Most of the major health insurance agencies offer a Medicare supplemental health plan. To calculate premiums for Medicare supplemental health insurance, you must consider: Age at the time of issuance; Attained age; and Community rate. And keep in mind that inflation will always increase insurance rates throughout your lifetime.

As you search for the right Medicare supplemental health insurance plan, take into account the fact that the services provided by the plan will not be modified. All plans are government regulated and provide the same healthcare services to everyone. So, if you find a great price that is affordable for you your main focus should be on the cost of the Medicare insurance and what the rate of increase will be during your lifetime. If you find that some plans seem to be more expensive in the beginning, you should remember that there will be a slow or nonexistent increase in the plan's rate over the life of your policy.

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A Medicare and Medicare Supplement Insurance Guide for Beginners


Medicare Supplemental InsuranceTurning the age of 65 or merging onto Medicare can be a very stressful time for the average American. Many of these Americans have a very difficult time sorting through all the different options with Medicare and Medicare insurance. Use these descriptions to avoid all of the confusion and understand the four "parts" of Medicare and what they include.

Part A

Part A is the part of Medicare that everyone receives when they pay into Social Security during their working life, as long as they have met the minimum work requirements. This part is often termed the "hospital" part of Medicare as it primarily covers in-patient hospital care. In addition to hospital care, it covers skilled nursing facility care, hospice facility care, and in-home health care.

Part B

Part B of Medicare is optional. Those who have employer coverage with Medicare coverage do not really need Part B until/unless their employer coverage ends. There is also a monthly cost with Part B that is usually deducted out of the beneficiary's social security check.

Medicare Part B covers certain services that are related to general care by a doctor. This part is often termed the "doctor's office" part of Medicare because it covers diagnostic testing, doctor's services, out-patient care, physical therapy, and some preventive screenings.

Part C

Part C is the newest part of Medicare as it was created just over 10 years ago. It is known as the Medicare Advantage plan, but it has also been termed the "privatized" Medicare. Part C allows for a private insurer, with a government contract, to take over and manage all of your Medicare benefits. All of your benefits are provided to you through an insurance company, and they act as a representative for you by paying your claims for you when you pay premiums directly to that company.

The Part C plan is also optional. If you choose this plan, you still must pay the Part B premium and you will not "lose" Part A and Part B, but the Part C plan will provide your Medicare benefits in lieu of parts A and B.

Part D

Part D is often the most discussed part of the four plans. This part of Medicare covers prescription drugs. Private companies offer Part D and these companies must be certified and accepted by the Centers for Medicare & Medicaid Services annually in order to offer this prescription coverage.

As a receiver of Medicare, you pay certain premiums that go directly to private insurers, and many of these companies allow these premiums to be deducted straight from your Social Security check. Again, this plan is an optional part of Medicare. You do not have to sign up for it when you are qualified for Medicare.

As you can see, making the right choice for your Medicare plan can be much easier once you understand what each part covers. When you know the basics about Medicare and Medicare Insurance, you will have no trouble explaining the options to friends or family members who are new to their Medicare coverage.

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