What does a Medicare Advantage cover?

A Medicare Advantage, also known as a Medigap policy, is basically an insurance plan secondary to the original Medicare. You must be enrolled in Parts A and B to enroll in a Medicare Advantage Plan.

Original Medicare has four parts. Part A is a hospital insurance with a deductible of $ 1156 for 2012. Part B is a medical insurance with a deductible of $ 140 for 2012. Part C is known as the Medicare Advantage Plan. Medicare benefit plans replace your original Medicare insurance. They include hospital insurance, medical insurance and some plans include prescription drug coverage. Part D is prescription drug coverage. If your Part C plan does not include prescription drug coverage, you can request Part D.

If you choose to keep the original Medicare (Parts A and B), most of your expenses will be covered by having a Medicare Advantage plan. Medicare Advantages of your choice are currently labeled as plans A, B, C, D, F, F (high deduction), G, K, L, M and N. All plans require payment of a premium and some require the payment of additional deductibles before providing any coverage.

Depending on the plan, each benefit below is fully or partially covered:

Medicare Part A hospital and Coinsurance costs for an additional 365 days after the benefits of Medicare run out

  • Medicare Part B coinsurance or copayment
  • Blood (first 3 pints)
  • Part A Coinsurance or copayment in palliative care
  • Specialized Nursing Care Coinsurance
  • Medicare Part A deductible
  • Medicare Part B deductible
  • Medicare Part B surcharges
  • Emergency travel abroad (up to the planned limits)

Detailed plan coverage for each benefit is provided in the official Medicare publication, 2012. How to choose a Medigap policy: a health insurance guide for people with Medicare.

All Medicare Advantage plans must comply with federal & state laws and must be recognized as Medicare Advantage coverage. Insurance firms can only sell standardized policies. In other words, everyone should provide the same basic benefits, but some plans offer additional benefits so you can choose the one that best suits your needs. Usually, the only difference between the policies is the price, so it is worth comparing apples with apples in different insurance companies when buying a specific plan. Current Medicare Advantage plans do not cover your prescription drugs. To receive this coverage, you must enroll in Part D by contacting Medicare at 1-800-633-4227 or through the Medicare website during an open enrollment period. Plans E, H, I and J have been discontinued. If you currently have one of these plans, you can keep it, but if you change the plans, you can no longer get one of them.