Medicare-Eligible Health Insurance

It is easy to get confused between Medicare and Medigap.  Both have the prefix “Medi” and both have different versions that are identified by letters such as Medicare PART B or Medigap PLAN B.  Let’s get it straightened out right here. 

What is Medicare?

Medicare is Federal health insurance for people age 65 or older, or for people of any age that have certain disabilities or end-stage renal.  Medicare covers many health services that are considered medically necessary, but there many health care related services that it does not cover.  We will address how to address these “gaps” in coverage later below.

You have two timeframes to enroll in Medicare 1) Initial Enrollment Period and 2) The Special Enrollment Period. Medicare is divided into 4 sections or “parts” that cover many health care services and supplies.  These parts are explained below.

The 4 Parts of Medicare

Medicare Part A

This is basic hospital insurance.  It helps cover inpatient care in hospitals. It also covers the costs associated with skilled nursing facilities, hospice care, and even some home health care.

Medicare Part B

This is general medical insurance. It helps to cover many doctors’ services and outpatient care. It also helps to cover some costs associated with preventive care and services.

Medicare Part C

This is where you will find Medicare Advantage Plans. Medicare Advantage plans are federally approved private health insurance options that cover include, at a minimum, equivalent benefits to Medicare Part A and B above as well as additional benefits such as prescription drugs.

Medicare Part D

Part D is Medicare’s prescription drug coverage option where private insurance companies cover some or all of the cost of prescription drugs.

Once you understand the above, you will have a pretty good understanding of Medicare.  And it’s important to understand Medicare first so that you can make an informed decision whether Medigap insurance to fill in the gaps left by Medicare is right for you..

What is Medigap Insurance?

Medigap is a nickname for Medicare supplemental insurance plans.  Medigap plans are private health insurance plans that are designed to help cover the “gaps” in coverage in Medicare. Examples of these gaps would be co-insurance, deductibles and certain medical care not covered under Medicare. While Medigap does address many of the shortcomings of Medicare, Medigap plans currently sold do not cover long-term care, dental, vision or private nursing.

It’s also important to understand that Medigap policies are different from the Medicare Advantage Plans mentioned above. Medicare Advantage replaces original Medicare with equiviilanet or better coverage where as Medigap supplements the “gaps” not covered by Medicare. .

Medigap Plans are Standardized by the Federal Government

Even though Medigap plans are run by private companies such as Blue Cross or Humana, every Medigap policy must offered standardized core benefits according to Federal and state laws.  The plans are labeled the different Medigap plans by letters “A” through “L.”  There are multiple Medigap plan G’s plans offered by multiple insurance companies, but each will offer the same core benefits. This makes it easy to compare Medigap G plans between two companies since they are the exact same core benefits but not necessarily the same price.

Next Steps

We get so many visitors researching Medicare, Medigap, Medicare Advantage or Part D drug coverage that we have just launched a new site dedicate to Medicare Insurance. It’s called Senior65.com and it offers clear information and instant quotes without adding any personal information. http://www.senior65.com here.