Medicare Q & A

Medicare Q & A

1. Why Do I Need a Medicare Supplemental Policy?

Original Medicare Parts A and B leave many gaps in coverage. Part A is hospital insurance, and Part B is medical insurance. A Medicare Supplemental Insurance policy works with Original Medicare so that you do not have to pay deductibles or co–pays, for instance. It also covers services that Original Medicare does not, like healthcare needs while traveling. If you have a Medigap policy, you cannot enroll in Medicare Advantage (Medicare Part C).

2. What is a Medicare Advantage Plan?

Medicare Advantage Plans are administered by private insurance companies and cover the same services as Original Medicare. They may provide more coverage, too, and there are annual out-of-pocket spending limits. Most of them come with self-administered Prescription Drug coverage. Usually, there are restrictions on where you get your health care services, and you have to be referred to see a specialist.

3. What is the difference between Medigap and Medicare Advantage?

Medigap Plans allow you to choose your provider, and you don’t need pre-authorization for treatment or a referral to see a specialist. You need a separate Medicare Prescription Plan. You can choose a Medicare Advantage Plan instead of Original Medicare. While a Medicare Advantage Plan may provide more coverage than a Medigap Plan, there may be restrictions on whom you can see or where you can go for your services. If you have a Medicare Advantage Plan, you cannot get a Prescription Drug (Part D) plan. For a breakdown of the differences, see: http://www.medicarerights.org/fliers/Medicare-Advantage/Differences-Between-OM-and-MA.pdf?nrd=1.