Medicare is the federal healthcare insurance plan for those who are over the age of 65, as well as those with certain disabilities and illnesses. While Medicare provides for the needs of America's senior citizens, there are still some gaps in the system. Following is a list of the different parts of Medicare, an explanation of the Medicare supplement plan and the importance of Open Enrollment.
A, B, C, D…
Medicare is available in four different parts. Each of these parts provides coverage for a specific service.
Medicare Part A provides coverage for in-patient hospitals stays. Part A also covers for certain home care options such as physical therapy.
Medicare Part B provides coverage for general medical procedures such as doctors' visits, outpatient hospital visits, durable medical equipment (wheelchairs, canes, etc.), blood transfusions, prosthetic devices and chemotherapy. The combination of Parts A and B constitute Original or Basic Medicare and are always sold together.
Medicare Advantage Plans
Medicare Part C plans are provided through a contract between a private insurance company like Senior Care Insurance Services and Medicare. This contract provides you with all the benefits of Medicare Parts A and B and can be customized to meet your unique health needs. Often, Medicare Advantage plans offer additional prescription drug coverage as well.
Prescription Drug Coverage
In 2006, Medicare released its Part D plan: prescription drug coverage. The addition of Part D to the original Medicare plan provided some much-needed relief to those who were paying exorbitant out-of-pocket fees to obtain their prescription drugs.
Standing in the Gap
Although Medicare is a fairly comprehensive insurance plan, it does have some significant gaps. One of the most glaring gaps is the lack of a co-pay ceiling for the policy holder. While basic Medicare will cover 80 percent of all costs once the deductible is reached, the other 20 percent can be a hefty price. Depending on what you're purchasing, that 20 percent could range from $200 to $2,000. That's where MediGap steps in.
MediGap is a Medicare supplement plan that places a cap on the co-payment, as well as other services not covered by Original Medicare. If you are currently holding a Medicare Advantage plan, you will need to cancel that policy in order to benefit from a supplement plan. It is against the law for anyone to attempt to sell you a MediGap plan if you do not currently hold the Original Medicare plan.
Come One, Come All: Open Enrollment
Open enrollment for Medicare 2015 began on October 15 and lasts until December 7. This time period enables those who currently hold Medicare policies to reevaluate their needs and consider making changes to their insurance plans. The open enrollment period is also the only time of year during which prospective policy holders can get gain access to the plan.