Health insurance is insurance against the risk of incurring medical expenses among individuals. It provides you with an affordable way for you and your family to stay healthy and get medical attention when needed. By investing and protecting yourself from the unexpected we provide guidance in choosing the best health insurance coverage that best fits your needs.
What is a Medigap policy? A Medigap policy is a health insurance policy sold by private companies to fill gaps in the Original Medicare Plan coverage. Medigap policies must follow federal and state laws. These laws protect you. The front of a Medigap policy must clearly identify it as "Medicare Supplemental Insurance". You need both Medicare Parts A & B to buy a Medigap Policy. In all States, except Massachusetts, Minnesota, and Wisconsin, a Medigap policy must be one of twelve standardized policies so you can compare them easily. Each policy has a different set of benefits. Two of the standardized policies may have a high deductible option. For a list of Medigap policies in your area and more information about policy benefits, you can call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). These rules can change each year.
Different Types of Medicare Advantage Plans Health Maintenance Organization (HMO) Plans Preferred Provider Organization (PPO) Plans Private Fee-for-Service (PFFS) Plans Special Needs Plans (SNP) There are other less common types of Medicare.