The Medicare Advantage Plan is an alternative to the Original Medicare Part A and Part B. The beneficiary may choose to receive coverage based on the Medicare Advantage Plan provided by the contracted private insurance company, rather than benefiting from Medicare through a government-run plan.
To be able to qualify for Medicare C, you must:
- Behaving Medicare Part A and Part B Plans.
- Reside in the service area of the Medicare Advantage Program you are considering.
- There must not be any end-stage kidney disease (with some exceptions).
By law, all Medicare Advantage Plans must provide at least the same level of coverage as the original Medicare Part A and B (except for nursing homes covered by Part A). However, some programs may include other benefits such as prescription drugs, hearing, healthy vision, dental or health plans.
Unlike the original Medicare, if you need a prescription drug benefit (Medicare Part D), please do not register for other Medicare prescription drugs. Instead, you can get this benefit through Medicare Advantage’s prescription drug program. Not all Medicare Advantage programs include prescription drug coverage. Therefore, always check the specific plan you are considering.
WHAT IS THE DIFFERENCE BETWEEN MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENT PLANS?
Since the Original Medicare insurance (Part A and B) cover many healthcare costs, but not everything is taken care of. The beneficiary still takes full responsibility for a couple of copayments and deductibles, even with the coverage healthcare services that don’t add up. Besides, Medicare Part A and B do not offer unique benefits such as daily vision and dentistry, prescription drugs or overseas emergency health insurance. If you only have your Original Medicare insurance, you have to pay these fees at your own expense.
As a result, many people with Medicare participate in two different Plans to fill these gaps in coverage. There are usually two options for replacing or supplementing the Original Medicare. A variant called the Medicare Advantage Plan is another way to acquire the Original Medicare. Another option is the Medicare Supplement (or Medigap) Insurance Plan. It is used as a conjunction with the Original Medicare Plan. These plans have significant differences in cost, benefits and operational methods (how they work). It is vital to understand these exceptions when reviewing Medicare coverage options.
WHAT DOES SUPPLEMENT INSURANCE COVER?
Each company must sell a basic plan, Plan A or “Core Basic Benefit” idea. The standard scheme plans are labelled from A to L. Remember that all of these plans are standardized. In other words, a company’s plan F is the same as another company’s plan F. Choose the supplement policy that meets your needs and then purchase the program from the company that offers the lowest premium price and best customer service.
The main advantage: It should be included in all plans.
- Pays A Part of the hospital’s copayment – $341 per day for 61-90 days, $682 per day for 91-150 days in the years of 2019
- After the end of Medicare benefits, you will be paid for a 365-day for the hospital stay.
- Pays for Part B copayment – usually, 20% of Medicare-approved amount.
You must pay part of the cost of some of the downtime services until you reach the annual out-of-pocket limit. Plan K’s out-of-pocket limit is $5,240 (2018). Plan L has a limit of $2,620 (2018). When the annual limit is reached, the plan will pay 100% of Medicare’s copayments, coinsurance, and deductibles for the rest of the years in the calendar. These amounts vary year by year.
MEDICARE SUPPLEMENT INSURANCE PLAN BENEFITS
Most states offer 10 Medigap insurance plans. Each plan designed with different letters (for example, Plan A). The scope of each plan letter is standardized. It means that any insurance company can take advantage of the critical benefits of Medicare supplements in the same letter category. However, even if the essential benefits are the same for plans with the same letter category, premiums may vary by insurance company and location. If you abide in Massachusetts, Minnesota or Wisconsin, please note that the standardization of the Medigap program in three states differs from the remaining country.
The Medicare Supplement plans 2020 cover out of pocket costs that are not covered by the original health insurance, such as copayment, coinsurance and deductibles. Some Medicare Supplement plans 2020 may help to pay for other benefits not covered by the Original Medicare insurance, such as overseas emergency health insurance or the first 3 pints of blood. The Medicare Supplement plans 2020 does not include the benefits of prescription medication. Medicare Supplement plans for 2020 are affordable. If you have not yet received a reliable prescription coverage (at least equivalent to Part D benefit), consider purchasing a separate Medicare Part D prescription plan to cover the cost of the prescription drug. Also, Medicare Supplementary Insurance plans typically do not provide additional benefits, such as daily dentistry, vision and hearing, beyond what Medicare already covers.