Supplemental Insurance Part II

The federal government runs the original Medicare plan. It’s traditional pay-per-visit health plan lets you go to any doctor, hospital, or health care provider who accepts Medicare. You pay the deductible. Medicare pays its share of the Medicare-approved amount and you pay your share. The original Medicare has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).

However, neither the Medicare program nor any managed care were never meant to pay the entire hospital, doctor, or nursing home bill. Nor can it cover all the other expenses that will pile up should a Medicare-user end up in the hospital.

This is where supplement insurance comes in. Supplement insurance is additional coverage that helps pay for expenses that your regular health insurance policy, whether it’s Medicare or not, will not cover. Some forms of supplement insurance are disease or accident specific. This means that you actually have to get cancer, fall ill some other way, or get into an accident to start receiving coverage.

However, it all helps should an accident or illness actually occur.

Supplement insurance can be found from several sources, even from Medicare, but neither Medicare nor Medicare supplement insurance policies cover most long-term care expenses.

Basically, supplement or short term insurance fills in the gaps in whatever current health insurance policy you already have. Sometimes, people refer to supplement insurance as supplemental insurance, but that’s just a matter of semantics. Supplement insurance includes employee or retiree coverage from your employer or union and Medigap insurance from a private company or group.

Medigap has Medicare supplement insurance policies that are sold by private insurance companies to Medicare beneficiaries to fill in any gaps in the original Medicare plan coverage. This includes ten standardized policies, labeled Plan A thorugh Plan J and your state decides on the ten that can be sold in your state. Medigap supplement insurance policies only work with the original Medicare plan.

Medicare SELECT is a type of Medigap policy meeting all the requirements that apply to a standard Medigap policy. However, you may be required to use doctors and hospitals within its network to be eligible for full benefits.

And then there are managed care plans. They involve groups of doctors, hospitals, and other health care providers who have agreed to provide care to Medicare beneficiaries in exchange for a fixed monthly payment from Medicare. Managed care plans include Health Maintenance Organizations (HMOs), HMOs with a Point of Service option, Provider Sponsored Organizations (PSOs), Preferred Provider Organizations (PPOs), and Cost Plans.

Two main advantages that go with managed care plans are that they have low premiums and that they offer additional benefits not covered in the original Medicare plan. However, managed care plans are not very flexible and the cover person has little say in treatments. They’re not guaranteed renewable and many managed care plans have pulled out of area forcing people to find new coverage.

These are mostly supplement insurance options to go along with Medicare. There’s a whole variety and market of them out there so don’t stop looking just at Medicare. You know what your needs are so don’t settle for less.