The Federal Government insurance plan
available nationwide. You are
usually charged a fee for each healthcare
service or supply you receive.
You pay a monthly Part-B
premium of $96.40/mo*
Pay an annual $155 Part-B
deductible
Pay a $1100 Part-A (hospital)
deductible
You may go to any provider
that accepts Medicare
If provider does not accept
assignment, you may have to pay the entire bill a
the time of service. Doctor can charge up to 15%
more than Medicare.
Some services are not covered
and you may have to pay some out-of-pocket costs.
Medigap
Insurance
(Also known as Medicare Supplemental
Insurance)
A supplemental
policy would be in addition to your Original Medicare.
Medicare pays 80% of what it approves, a supplemental
policy helps cover the remaining 20%. You may select one
of the 12 standardized policies (A-L) available through
private insurance companies.
You pay a premium for your
policy.
Each plan (A-L) has a
different set of benefits.* changes in June 2010
All policies, except A, offer
some deductible & coinsurance coverage.
Extra benefits are offered by
some policies not otherwise covered by Medicare
(i.e. at home recovery, foreign travel, preventive
care, etc.).
Policies F and J have a high
deductible option.
Medicare “SELECT” policies
usually cost less because you must use specific
hospitals and doctors.
Medicare
Advantage
Plans
A Medicare approved
network of doctors, hospitals, and other health care
providers who agree to give care in return for a set
monthly payment from Medicare.
Different plans
available:
HMO
(Health Maintenance Organization)
PPO
(Preferred Provider Organization)
PFFS
(Private Fee For Service)
MSA
(Medical Savings Account)
Most managed care plans charge
a monthly premium
A referral may be required to
see a specialist.
Doctors may join or leave the
plan at any time.
Most plans offer benefits that
Medicare does not (i.e. dental care and eye care).
HMO’s require you use their
network of doctors and hospitals.
PPO’s allow more flexibility
to go outside the network for a higher monthly
premium.
PFFS plans allow you to go to
any provider that accepts the plan. The private
company decides (not Medicare) how much it will pay
and what you pay for services received.
