Medicare Supplemental Insurance Plans

Medicare is a federal program that provides insurance for people 65 and older, people under 65 who have permanent kidney failure or those who have certain disabilities.  The Health Care Financing Administration (HCFA) administers the program with the U.S. Department of Health and Human Services (HHS).  There are two parts to Medicare, Part A (Hospital Insurance) and Part B (Medical Insurance).

The problem with Medicare is that it won't cover all medical services and pays providers 80% of the scheduled allowance making beneficiaries responsible for the remaining expenses.  This "gap" in coverage could be resolved by purchasing Medigap policies offered by private insurance companies.

Both state and federal agencies regulate Medigap policies.  The federal government instituted a standardized set of Medigap policies (Plans A through J) that offer similar types of coverage regardless of where you live.  All private insurance companies that sell Medigap policies must provide at least Plan A, which offers the very basic supplement to Medicare insurance coverage.  Plan J is more comprehensive, but is also more expensive.  The standardized method of identifying plans makes it easy to compare various types of coverage and pricing among private insurance companies.  Plan D for instance will be the same no matter which private insurance company you are looking to purchase supplemental insurance coverage from and regardless of where you reside.  These plans will cover the co-insurance and deductible amounts remaining from the Medicare plan, as well as, offer coverage for prescriptions and preventive care.  Medigap policies do not provide coverage for long term care.   

If you have a Medicare HMO plan, you may not need Medigap insurance, because most services should be covered, including prescriptions, by your policy.  You should verify with your health plan or review your policy booklet for the benefits provided to you before searching for a Medigap plan.

Health Symphony has agents in several states who will provide you with quotes for a Medigap policy.  If you are interested, please click here.