Benefit Priorities, Inc.
9041 Louvaine Dr            Charlotte, NC 28227            (704) 563-1125
Medicare Coverages

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 policies. Your policy won’t cover any health care costs for your spouse.

 

 

Medicare Supplement Plans

 

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 10 different standardized Medicare Supplement policies (Plans A, B, C, D, F, G, K, L, M, N).

 

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, B, C, D, F, G, K, L, M, N), has a different set of basic and extra benefits. It’s important to compare policies because costs can vary.

The benefits in any Medicare Supplement Plan (A, B, C, D, F, G, K, L, M, N) are the same for any insurance company. Each insurance company decides which policies it wants to sell.

 

 

Medicare Advantage Plans (Part C)?

 

A Medicare Advantage Plan is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.

 

If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).

 

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.

However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). These rules can change each year.

 

Different Types of Medicare Advantage Plans

Health Maintenance Organization (HMO) Plans

HMO Point of Service (HMOPOS) Plans— An HMO plan that may allow you to get some services out-of-network for a higher cost.

Preferred Provider Organization (PPO) Plans

Private Fee-for-Service (PFFS) Plans

Special Needs Plans (SNP)

 

For additional information on Medigap policies, including why you would want to buy a Medigap policy and information about what Medigap policies cover, please call us at (704) 563-1125 or click on this link http://benefitpriorities.agentmethods.com.

We will be happy to work with you to help you save money on your coverage. 

 

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