Terms to Know for Medicare Insurance and Supplements
Medicare provides a valuable resource for seniors that are unable to pay the bulk of their own health care. However, while medicare and medicaid act as a resource, they do not always cover the entirety of an individual's needs. Many find themselves seeking supplemental insurance to make up for the gap in coverage. For those that are looking into potential supplements or insurance policies, the terms below will help them become more comfortable with the verbiage for the industry.
Medicare - A government funded social program that aims at providing health insurance to seniors over the age of 65, or individuals that have suffered permanent disabilities. This is funded as a part of Social Security, and generally covers about 80 percent of approved costs for patients.
Medicaid - A government and state funded health plan that provides care for low-income families and individuals, or those with qualifying disabilities. Individuals must qualify for this program, based on needs.
Medigap - This term is short for private, supplemental insurance provided to Medicare recipients to make up for the gaps in Medicare health plans. Recipients must be enrolled in plans A or B Medicare to benefit from Medigap plans.
Medicare Advantage - Advantage plans are private health insurance plans that offer Medicare beneficiaries the same advantages through their companies, rather than through the government. These plans may offer benefits not covered under standard A and B plans.
Dual-Eligible - This term refers to Medicare recipients that also qualify for either Medicaid aid, or for the Medicare savings program. Individuals who qualify for this have the gap in their insurance covered by another social program. In these cases, the recipient does not need to apply for a Medigap policy.
Many Americans are enrolled in Medicare. This is a federally funded insurance program that contains four different parts. These four parts deal with different aspects of care.
The first part covers hospitalization, while the second part provides for doctor visits. The third part is known as Medicare Advantage. This alternative is available at an additional cost. Lastly, the fourth part concerns any medication you might be prescribed by a physician.
Another program available is called Medicaid. This is for low-income seniors who are deemed eligible to receive additional assistance with their bills. Medicaid is a federal program that is run in conjunction with individual state governments.
Whatever policy you have, sometimes supplemental health policies are necessary. Medigap, for instance, is available for purchase from private companies. This addition to your current policy will help with expenses that fall outside of your plan. These expenses can really add up. This is especially true for people living on fixed incomes. There are advantages to having supplemental health insurance. Different benefits are offered and varying rates apply. An HMO is a plan where you use a specific, single care provider in a network. A preferred provider organization or PPO, on the other hand, allows for you to chose from a network of providers. Additional policies may also be necessary if you or a dependent are disabled. Unfortunately, many people have to maintain several different policies to simply meet their medical needs. This can be expensive, but initially having medical coverage will save you a lot of money in the long run.