Sunday, 28 February 2010

Worried about your medicare read this.

Medicare Supplement Insurance, or Medigap Insurance, is available to cover medical expenses that are not covered by Medicare. However, if you have a Medicare Advantage Plan, Medigap Insurance won't pay co-payments, deductibles, or other cost sharing under your Medicare Health Plan.

Medicare Advantage Plans offer more benefits, and lower co-payments than Medicare Part A and B. With a Medicare Advantage Plan, you're replacing your Medicare Part A and B coverage with coverage through a private insurance company. If you have a Medicare Advantage Plan, typically all of your Medicare-covered health care is provided through the Medicare Advantage Plan, and that may include coverage for prescription drugs.

If you don't have a Medicare Advantage Plan, you may want to take advantage of Medigap Insurance. There is an open enrollment period for Medigap Insurance. During the first six months after you turn age 65, you do not need to qualify, or answer any questions about your prior medical history when enrolling in Medigap Insurance.

How Is Federal Law Changing Medicare and Medigap Insurance?

The federal Medicare Improvements for Patients and Providers Act of 2008 went into effect January 2009. It required states to adopt changes for Medigap Insurance policies.

Currently, twelve Medigap policies (Plans A through L) have different sets of benefits. If you have Plan A, for instance, it has the same benefits regardless of which insurance company offers it. The cost of the plan may be different, though, from different insurance companies. In accordance with the new federal law, some Medigap Plans will be changed or dropped, and new plans will be added.

In June of 2010, four of the Plans A through L will be dropped, and two new plans will be added. Medigap Plans E, H, I, and J will no longer be sold, and Plans M and N will be added. That will leave a total of ten Medigap Plans.

Plan M will pay 50 percent of the Part A deductible, and some of the cost of foreign travel emergencies. It will not cover the Part B deductible. Plan N will pay the full Part A deductible, but it will require a $20 co-payment for Part B office visits, and up to a $50 co-payment for emergency room visits. Plan N will also cover foreign travel emergencies.

According to the new law, Medicare will cover many preventive care benefits, so these benefits will be dropped from Medigap Plans. The Home Recovery benefit will also be dropped from Medigap Plans.

All Medigap Plans will include an additional benefit to cover the out-of pocket costs imposed by the Medicare Hospice Benefit. Medicare will cover any care that is necessary and reasonable for easing the course of a terminal illness. The Medicare Hospice Benefit provides for bereavement services, counseling, drugs for pain relief and symptom management, home health aide and homemaker services, medical appliances and supplies, nursing care, physician services, short-term inpatient and respite care, social work service, spiritual care, and volunteer participation.

The new law also eliminates late enrollment penalties payable by subsidy-eligible individuals with regard to Medicare Part D. That's the Voluntary Prescription Drug Benefit Program. In the past, those who elected not to enroll in Part D, faced penalties if they changed their minds and tried to enroll at a later date.

No Changes for Medigap Plans You May Already Have

Nothing happens to the Medigap Plans that people have already purchased, and a Medigap Plan is guaranteed renewable for as long as you continue to pay the premiums. If you keep your current Medigap policy, your benefits will not change, regardless of the new law.

If your Medigap Plan no longer meets your needs, or the premiums are too high, you may want to look at the new plans. If you're not sure which plan you have, ask the insurance agent or company that issued your policy. Remember that Medicare / Medigap does not have official sales agents, so be wary of sales people who claim to represent Medicare when they try to solicit your business.

Medigap Insurance and Open Enrollment Periods

Insurance companies are now required to issue Medigap policies without health screening, or a new waiting period limitation when an employer stops providing insurance that covers all of the cost for Medicare's 20 percent co-insurance.

If you have Medigap Insurance, you have 30 days of open enrollment following your birthday each year when you can buy a new Medigap policy without a medical screening, or a new waiting period. The new policy must have equal or less benefits than your old policy. To avoid confusion, the new law specifies which of the new Medigap Plans are equal to the old plans. You can find expert advisors online who know these plans, and can answer your questions. The time to ensure you have the right protection for your situation is right now before you need it.

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