The Alphabet Soup that is Medicare

One of the first things I seek to clarify with people when they ask me about Medicare and Medicare Supplements is to help them understand the alphabet soup that is Medicare as Medicare and Medicare Supplements use letters to label the various parts.  The purpose of this paper is to help one clarify the “soup” of Medicare.

Medicare is the fee for service program offered directly through the federal government. The Medicare programs (sometimes referred to as Original Medicare)  was created in 1965. Original Medicare includes Part A, Part B and Part D.  You become eligible for Medicare when you turn age 65.  Failure to properly apply for Medicare benefits could place your benefits at risk. If you use a Medicare provider that accepts Medicare billed charges you will receive the best in benefits that Medicare can offer.  Medicare will cause you to incur out-of-pocket cost.  You may purchase a Medicare Supplement to offset these cost.

Medicare Part A

is often referred to as the “inpatient/hospital”  insurance portion of Original Medicare.  Part A covers hospital care, skilled nursing facility care, nursing home care and hospital health services. You usually do not pay a premium for Part A coverage if you or your spouse paid Medicare taxes while working. Medicare does not pick up all the cost of Medicare covered benefits.  You will have deductibles and other financial responsibilities that must be met.

Medicare Part B

is often referred to as the “medical insurance” portion of Medicare. Part B covers services such as lab test, surgeries and doctor visits and medical supplies such as wheelchairs and walkers considered medically necessary to treat a disease or condition. There is a monthly cost for Part B coverage. Most Americans will pay the standard amount of $134 (or higher depending upon your income).

Medicare Part D

is referred to as prescription drug coverage. Many insurance carriers and pharmacies affiliate wih Medicare to provide prescription drug coverage.  Each Medicare Prescription Drug Plan will have its own formulary (list of covered drugs).  Medicare provides a prescription drug calendar which will assist you in determining the plan that best meets your needs. Most Medicare Prescription Drug Plans charge a monthly fee that varies by plan. You pay this in addition to your Medicare Part B premium. If your income is above a certain amount you may pay an additional Part D income related monthly adjustment amount.

Medicare Supplement Plans

Supplement F

is the “Mercedes” of the Medicare Supplement world.  In most cases if you use Medicare contracted providers and your medical expense is a Medicare covered expense you will pay nothing.  Supplement F pays what Medicare does not pay.   As an example, you are responsible for Medicare deductibles, daily amounts and 20% of doctor visits. Supplement F pays all these amounts in a seamless manner.   When you visit your provide you would give your provider your Medicare and Supplement cards. Medicare would pay whatever they are scheduled to pay and ship the unpaid amount to your Supplement to pay.  The monthly cost for your Supplement will vary as cost are based on the Supplement you choose, your age, and zip code.  Supplement F will also pay the Medicare excess charges.

Supplement G

is fast becoming the most popular Medicare Supplement.  Supplement G pays all that Supplement F  pays with the exception of the Medicare Part B deductible. The Part B deductible for 2017 is $183.  The growth of Supplement G can be attributed to the significant cost savings one experiences over Supplement F.  One of the key benefits of Supplement G is that it does cover Medicare excess charges.

Supplement N

is an attractive alternative to both Supplement F and Supplement G.  Supplement N requires you to pay the Medicare Part B deductible of $183.  You also will be responsible to pay a $20 copayment for some office visits as well as up to a $50 copayment for emergency room visits. Supplement N does not allow for coverage of Medicare excess charges”.  Supplement N also covers all the Medicare Pat A deductibles and out of pocket cost you would experience with Medicare Part A.

To learn more about Medicare you may go to www.medicare.gov. We invite you to contact our office for assistance in understanding the various parts of Medicare as well as the Medicare Supplement world.  Please check out our website, www.medigappro.com for further information or call us at 1-800-535-8016

Ted Guy – The Medigap Pro