What You Need To Know About Medicare Plans
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There are big differences between Original Medicare, Medicare Advantage Plans and Medicare Supplements Plans (Medigap) First of all, the Federal Government provides the coverage in Original Medicare (Parts A & B). Medicare Advantage (Part C) coverage is provided by private insurance companies, and Medicare supplements (Medigap) coverage is provided by private insurance companies.
The way they are funded is also different, Original Medicare (Parts A & B) is funded by payroll taxes. Medicare Advantage (Part C) receives “a fixed amount per enrollee per month from Medicare” plus the beneficiary’s Part B premium. It is also allowed to charge a premium to the member. In Medicare Supplement Plans (Medigap) the premiums are paid by the policy holder.
It is also VERY IMPORTANT to know that your coverage is GUARANTEED, and can’t be cancelled with Original Medicare through the Federal Government. However, you should know that your policy can be cancelled under Medicare Advantage which is provided by private insurance companies. Medicare Supplement Plans (Medigap) can’t be cancelled unless you don’t pay your premiums on time or you misrepresented something on your application.
It is also important to note that Original Medicare does NOT require pre-certification. But, Medicare Advantage (Part C) generally does require pre-certification. Also, Medicare Supplement Plans (Medigap) does not require pre-certification.
NOTE: Modern Senior Products does not recommend any Medicare plan. This information is only for your information. Be sure to learn about all three kinds, Original Medicare, Medicare Advantage, and Medicare Supplement (Medigap) to see which is best for you. Remember, you can start signing up for Medicare 3 months before your 65th birthday.
Posted on February 13, 2012, in Medicare, Uncategorized and tagged Affordable Care Act, Insurance, Kathleen Sebelius, Medicare, Medicare Advantage, Medicare Supplement Plan, Medigap, Original Medicare, United States Department of Health and Human Services. Bookmark the permalink. 2 Comments.
Thanks for your input, Insurance Barn. I believe it is a case of semantics. I got my information from Medicare.org (Information and Resources for Healthcare, a non-governmental resource).
I also work with Senior products. I only have one, very tiny, objection to what you have said. My objection is purly semantical. You mentioned that Medicare Advantage can be canceled. That is a misnomer. MA cannot be canceled but it can be non-renewed. Essentially, they are the same thing but “cancellation” implies that a beneficiary is out of luck.
Non-renewals generally take place at the first of the year. When a MA is non-renewed, they send beneficiaries an alert. It is then up to the beneficiary to secure a different MA plan or return to original Medicare with a Medigap and Medicare D.
Insurance companies have some problems. However, it is not always the insurance company that is at fault. In many cases people do not take the time to address their insurance needs when they are warned.