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.
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.
What are Medicare Advantage Plans?
A Medicare Advantage Plan is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicareapproved private companies that must follow rules set by Medicare. If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get most of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare.
How do Medicare Advantage Plans work?
When you join a Medicare Advantage Plan, Medicare pays a fixed amount for your coverage each month to the company offering that plan. These companies must follow Medicare’s coverage rules. Medicare Advantage Plans have yearly contracts with Medicare. The plan must notify you about any changes before the start of the next enrollment year. If you join a Medicare Advantage Plan, you’ll have all of the same rights and protections that you would have under Original Medicare.
What’s covered?
Medicare Advantage Plans cover all Part A and Part B services. However, if you’re in a Medicare Advantage Plan, Original Medicare will still cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies. In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care. Some Medicare Advantage Plans offer extra coverage, for things like vision, hearing, dental, and other health and wellness programs. Plans have a yearly limit on what you pay out-of-pocket for Part A and Part B covered services. Once you reach your plan’s limit, you’ll pay nothing for Part A and Part B covered services for the rest of the year.
Prescription drug coverage
Most Medicare Advantage Plans include Medicare prescription drug coverage (Part D). In certain types of plans that don’t include drug coverage (like Medical Savings Account Plans and some Private-Fee-for-Service Plans), you can join a separate Medicare Prescription Drug Plan.
