Medigap: Replacement for your Original Medicare?

 As you get older, healthcare becomes more important than ever. We all know that as we age, we need to start worrying about these things, but it’s not a fun topic to think about.

If you or a loved one is getting up there in age, now is the time to begin thinking about what you’ll do when the time comes. You’ve probably heard of Medicare insurance (see  our guide to understanding Medicare/Medigap), but do you really know a lot about it? Many people don’t know the ins and outs, and don’t start looking until they need it. By then you don’t have a lot of time to research your decisions, you just have to make them.

If you’re looking for more information on Medicare and Medigap (it’s not too early to prepare for 2013), you have to learn sometime and then why not now? Read on for everything you need to know (Medigap is explained a bit farther down).

What is Medicare?

This is the most basic of questions, but many people aren’t exactly sure what it entails.

The simplest definition of Medicare for 2012 (and now 2013) is that it is healthcare coverage for those who are 65 or older (that doesn’t cover everything), or those who are under 65 with certain disabilities. It is also available to people of any age with End Stage Renal Disease (See our page on Medicare for more info or just keep reading).

there is no need to look into an insurers claims-paying history


Different Parts of Medicare

Of course, it’s not that simple. There are different parts of Medicare, and it helps to understand them all in order to make sure your needs are met.

Part A – This is hospital insurance. This covers hospital costs, including inpatient care. It will also cover costs associated with a staying in a skilled nursing facility, hospice care or home health care. Hospital care can be one of the most expensive parts of care, so it’s important that these costs are covered.

Part B which is for Medical care This is the part that covers doctor’s services, hospital outpatient care, home health care and  durable Medicare equipment (like wheel chairs and Prosthetic devices). It will also cover most preventive services so that you can go to the doctor and manage your health. Only 80 percent of approved services will be covered once your annual deductible ($140 in 2012) is met (certain Medicare supplements will handle the rest). Medication administration can be covered if it’s done during an office visit.

Part D.  This part of your Medicare will help to cover the cost of prescription drugs. It is run by Medicare approved private insurance companies and can also help lower your prescription costs to help keep your future costs down.

Medicare Advantage Plans Explained

These are health plans that are run by Medicare approved private insurance companies. Your HMO or PPO are considered Advantage Plans. These are also sometimes called “Medicare Part C”, and will include parts A and B, and Part D for an extra cost.

So you have two choices when it comes to Medicare, Original Medicare or a Medicare Advantage Plan. To decide which one is best for you, you need to first figure out if you need prescription drugs. If so, you may be best suited for Original Medicare since Part D is not always included in a Medicare Advantage Plan.

If you go for a Medicare Advantage Plan, you can add prescription drug coverage, but you can’t add a Medigap policy.

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