At some point in their lives, everyone needs hospital care. It’s important to know the ins and outs of Medicare so that you understand the hospital coverage and benefits you receive as a Medicare beneficiary.
Not all hospitals accept Medicare, but luckily, the vast majority of hospitals do. Because there are a few exceptions nationwide, you should double-check with the hospital before you go (only if it is safe to do so, of course) or visit Medicare.gov’s Health Care Comparison tool to find Medicare-accepting hospitals in your area.
If you have Original Medicare and your chosen hospital accepts Medicare, you will still have out-of-pocket costs. To mitigate these expenses, Medicare Supplement Insurance or Medicare Advantage are great options.
What is Medigap?
Medigap and Medicare Supplement Insurance are the same thing. It covers things that Original Medicare (Parts A & B) does not. Private insurance companies sell Medigap insurance to help beneficiaries cover extra health care expenses such as:
- Coinsurance costs
- Insurance deductibles
Some Medigap policies give you coverage for services that Original Medicare fails to cover. For instance, there are policies that will pay for medical care when you’re traveling in a foreign country. Original Medicare will cover its portion of the amount approved, and after that, Medigap will step in to cover its approved amount.
To get a Medigap plan, you must be signed up for Medicare Part A and Part B. When you take out a Medigap policy, you’ll be paying a private insurance company once a month. This will be in addition to what you owe each month for Medicare.
You have the option of purchasing Medigap from any insurance company that has the licensing to operate in your state (restrictions apply and rates will vary). You can also renew your Medigap policy whenever you’d like, even if you are suffering from health issues. Once you are enrolled, insurance companies are not permitted to cancel your policy as long as you pay your monthly premium on time.
What is Medicare Advantage?
Medicare Advantage Insurance Plans are offered by private insurance companies and are approved by the Federal Government. They cover the same benefits as Part A (hospital insurance) and Part B (doctor visits). Some also offer other benefits that Original Medicare doesn’t cover like vision, dental and prescription drugs, even fitness benefits and may also offer additional benefits like transportation to and from your doctor’s office. These plans typically use HMO, PPO or PFFS networks.
Medicare Advantage plans are offered by private insurance companies, but they include your Original Medicare coverage. That means you’ll only have one monthly premium for all of your Medicare benefits. This is a great way to simplify your bills without sacrificing helpful coverage.
Getting additional coverage for Medicare
With Part A alone, you will still have out-of-pocket costs when going to the hospital. Medigap or Medicare Advantage plans can help alleviate surprise costs when a serious health situation arises. These options will help give you peace of mind and help ensure that you have health care coverage when you need it.
SmartMatch Insurance Agency can help you decide which plan is right for you. Learn more about Medicare insurance and its many options by calling us at (888) 411-7647 TTY:711. You can also visit our Plan Comparison tool to start the process.