The Federal Government features a health insurance program under Medicare for people who are 65 years or older and are suffering from any disability or end-stage renal disease (ESRD). Medicare is one of the most popular options for comprehensive health insurance.
The Original Medicare mainly includes two parts, Part A and Part B, which provide insurance coverage for hospital costs and medical costs. There is an additional insurance cover available from third-party private insurance companies that provide for Medicare Advantage Plans (Part C). One must also note that the Original Medicare and Medicare Part C do not cover medication expenses, which is why Part D Prescription Drug Plan under the Medicare system pays for medical costs.
The Original Medicare does not cover premiums for copayments, coinsurance, and deductibles, which is why one must also purchase the Medicare Supplement Plans that provide for these expenses. Medicare Supplement Plans mainly feature 10 policies under the federal health insurance scheme. Plan A to Plan F feature different benefits under the scheme, wherein Plan F is one of the most popular ones.
There are many insurance plans that can be mistaken for Medicare Supplement Plans or Medigap policies. The health maintenance organization (HMO) plan, the Prefered Provider Organization (PPO) plan, the private fee-for-service plans, Medicare Prescription Drug Plans, Medicaid, Federal Employees Union Health Plans, TRICARE, Veterans Benefits, and other long-term insurance policies do not form part of comprehensive Medicare coverage.
Points to consider when buying Medicare Supplement Plans (Medigap)
- The applicant must already have the Original Medicare before he/she can compare and purchase different Medicare Supplement Plans.
- Plan F is one of the most popular supplement plans for Medicare as it offers comprehensive coverage for health insurance.
- In comparison to other Medigap policies, Plan F provides better coverage for copayment, coinsurance, and deductibles, which ensure that the out-of-pocket hospital and medical expenses are paid for by the insurance.
- There is a major difference between Medicare Advantage Plans and Medicare Supplement Plans.
- A Medigap policy only supplements the additional costs that are not covered by Medicare, which is why the private party insurance is a great alternative to pay for most expenses.
- Eligible applicants must pay an additional premium for Medigap policies and the benefits of the plans will vary accordingly.
- A single Medigap policy will provide cover for only one applicant. If there are additional members in the family who need insurance coverage, each member must apply for Medigap separately.
- Medigap policies can be bought only from those insurance companies that have a license to sell these insurance plans in the state. Not all insurance companies can sell Medigap plans.
- Buying Medigap policies reduces the cost incurred for providing comprehensive health insurance coverage for oneself and the family members.
The ten different Medigap policies more or less offer similar benefits across most of the states in the country. However, the terms and conditions for Medigap policies in the states of Minnesota, Massachusetts, and Wisconsin differ when it comes to copayments, coinsurance, and deductibles applicable.
Before one can understand the terms and conditions applicable to the state of Wisconsin, it is important to know what copayment and coinsurance mean. Coinsurance is a fixed percentage of the expenses and costs paid by third-party insurance companies to supplement Medicare. Whereas, a copayment is a fixed payment amount.
Here is a brief overview of the Medigap policies in Minnesota, Massachusetts, and Wisconsin
Medigap in the state of Minnesota
Third-party insurance providers feature Medicare Supplement Plans that include Part A coinsurance cover for hospital costs, Part B fixed percentage cover for medical costs, and 3 pints of blood per policy each year. The plan also provides cover for hospice care, home health services, and necessary medical supplies on a cost-sharing basis. The basic plan and extended basic plan provide coverage options for foreign travel for a medical emergency, outpatient mental health preventative care, physical therapy, and other state-mandated medical benefits. Policy terms may vary depending on the type of Medigap taken.
Medigap in the state of Massachusetts
The basic coverage for Medicare Supplement Plans in the state of Massachusetts include Part A hospital cover, 20% of approved amount for Part B medical costs, 3 pints of blood each year per plan, and Part A hospice coinsurance and copayment. Medigap plans also offer state-mandated benefits that include cover for inpatient hospital deductibles, skilled nursing facility, foreign travel for a medical emergency, and cost of services in a mental health facility. There are two plans that provide supplemental insurance including the Medigap Core Plan and Supplement 1 Plan. The aforementioned benefits vary depending on the plan.
Medigap in the state of Wisconsin
Medicare Supplement Plans in the state of Wisconsin provide only the basic benefits when it comes to supplemental insurance. The policy primarily includes coinsurance for Part A inpatient hospital care, coinsurance for Part B medical costs, 3 pints of blood each year, and Part A hospice payment. Medicare Supplement Plans in the state of Wisconsin also feature cost-sharing plans that cover deductibles, home health care, excess charges, and expenses incurred owing to foreign travel in time of a medical emergency.