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Individuals who are eligible to receive Medicare benefits may already have individual insurance coverage. It may be beneficial for the individual to retain this private insurance when they elect to take Medicare.
Here are a few helpful facts about Medicare benefits and individual insurance coverage:
• Not all private individual insurance coverage allows the policy holder to be covered under Medicare while retaining the individual insurance. This information should be contained in Evidence of Coverage or Explanation of Benefits.
• Medicare will be the primary insurer if Medicare coverage and individual insurance coverage is allowed. A primary insurer is the insurer that pays a claim first.
• One reason to keep an individual insurance policy is that it may provide better coverage for prescription drugs than Medicare does. If one does not enroll in Medicare Part D, which is the prescription drug coverage under Medicare, there is not a penalty to enroll if one can prove they have an individual policy that is superior to Medicare coverage. If one chooses to terminate the individual policy they must enroll in Part D at least within a 63 day period after the individual prescription policy ends.
• Other reasons to keep individual insurance coverage are if the policy has other benefits greater or more extensive than Medicare.
If individual insurance coverage will allow the policyholder to maintain coverage while receiving Medicare benefits it can be a wise choice to retain the individual policy.
Medicare comparison is sometimes a daunting task, but this article will attempt to summarize this complicated subject. The government has an informative website at https://www.medicare.gov/. The main point to remember about Medicare comparison and Medigap is that it pays to do your homework.
Medicare comparison starts with familiarizing yourself with the different designations of Medicare coverage:
Part A Medicare is hospitalization insurance.
Part B Medicare is medical insurance for everything else but prescriptions.
Medicare provides this coverage; with Part A and Part B you can choose your physician, which hospital you go to and other health providers. You or your supplemental or Medigap insurance pays deductibles and coinsurance. For Part B insurance you will usually pay a monthly premium.
The other Medicare and Medigap policies are:
Part C Medicare is a Medicare plan that is similar to an HMO private policy; with this type plan Medigap insurance is not necessary.
Part D Medicare is for prescriptions; if you have a Part C plan that offers prescription drug insurance you usually have to take it.
Medigap Insurance is supplemental insurance to bridge the gap between what your Medicare Policy covers and the actual cost of medical treatments.
Medicare comparison is made easier by the fact that the government has standardized the coverage between states, and with the recent health reform laws also simplified Medicare choices somewhat. Private companies offer Medigap policies but benefits are standardized through most states by government regulations. Medicaid is another government program that may provide additional assistance with health costs.
|Jennifer Mathes, Ph.D.|