Medicare is health insurance that is provided by the U.S. government to citizens or individuals who have worked at least 10 years (40 quarters) in a Medicare-sponsored job. This health insurance is broken down into different types of services. In order to be eligible for Medicare an individual also has to be at least age 65 or older. Younger individuals can become eligible for Medicare if they have End-Stage Renal Disease.
Medicare is broken up into four plans: A, B, C, and D. Medicare Part A is considered your hospital insurance. It covers your hospital stay in an inpatient facility, skilled nursing care, hospice, and some home health care services. There is a deductible that needs to be met before your Part A covers your expenses. Similarly, Part B, which covers your medical care outside of a hospital, also has a deductible as well as copayments that you may need to make. Your Part B will cover care such as regular check-ups, lab tests, and outpatient services.
What Is Medicare Advantage?
As mentioned, your Medicare Part A and Part B both have a deductible. They also have copayments that you may be expected to pay when you receive services. Medicare Part C is different from other types of insurance because it doesn’t actually cover specific benefits. Instead, it picks up where Parts A and B don’t cover you. Medicare Part C is private insurance to supplement your primary insurance, which is why they’re also called Medigap plans are referred to as supplemental plans. Medicare Part C was established by the Balanced Budget Act of 1997.
The name Medigap comes from the gap in coverage that your Medicare Advantage Plan will bridge. For example, if you have a very long hospital stay then you may have some expenses that go beyond what your Part A will cover. Your Medicare Advantage Plan, however, will kick in to cover those extra costs. The reason why people like their Medicare Advantage Plan is because they have peace of mind knowing that expensive treatments or surgeries will be covered.
Which Medicare Advantage Plan should I choose?
There are 10 different standardized plans, running from Plan A through Plan N. The best way to know which plan will work for you is to speak to one of our representatives at South Florida Medicare Specialists. You want to ensure that your plan will cover your doctors, medical devices, and other services that you were currently receiving.
Am I eligible for a Medicare Advantage Plan?
Before you choose which plan it’s important to know whether or not you are eligible for Medicare Part C and to consider some unique things about it. Your enrollment period lasts for only six months and begins the day that you enroll in Medicare Part B.
Medicare Advantage Plans are renewable, and you cannot be denied coverage for any health issues that you develop after you have enrolled in the program. No matter what the future holds for your health, you will not be dropped from your Medicare Advantage Plan. You are guaranteed coverage even if you have a pre-existing condition if you enroll during your six month enrollment period. However, if you decide to get a Medicare Advantage Plan after that enrollment period has passed, then you may be denied coverage, and you will have to answer questions about your health. If you have already missed your enrollment period, then give us a call so we can discuss your situation in detail.