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Part One: Unpacking Medicare Supplement


maggie and manhattanlife's medicare supplement part 1

Maggie is on the cusp of celebrating her 65th birthday. Having recently retired from her thirty-year career at an energy company, she is feeling as buoyant as ever. With both her children in graduate school, she is preparing to spend some quality time with her husband and adopt new hobbies. But before blowing out her candles, she has some major decisions to make.

Of course, Maggie wants to enjoy her experiences and not worry about health challenges that could arise. She knows the significance of having comprehensive medical insurance. She knows too that she’ll qualify for Medicare but realizes the limitations it may have.

Maggie is far from alone in her uncertainties about handling such coverage at this point in life.

Let’s join Maggie as she explores various options to find the proper coverage for her.

First, Maggie must learn about Medicare and what it entails.

 Some Quick History: 

In the summer of 1965, President Johnson signed into law the bill that led to Medicare. It was created to provide coverage for an aging population challenged with unaffordable care often when their incomes were declining. Under Medicare, a person is covered regardless of income, medical history, or health status. Over time, this United States government health insurance program has evolved to include more individuals and benefits.

 What is Medicare? 

Today, Medicare is health insurance for people 65 or older, certain people under 65 with disabilities, and people of any age with End-Stage Renal Disease (ESRD), a condition in which permanent kidney failure requires dialysis or a kidney transplant.

 3 - Medicare has 3 distinct parts. They are: 

Part A (Hospital Insurance) – This consists of inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.

Part B (Medical Insurance) – It includes services from doctors and other health care providers. Additionally, it covers outpatient care, home health care, and durable medical equipment like wheelchairs, walkers, hospital beds, and other equipment.

Part D (Drug coverage) – Preventive services like screenings, shots, or vaccines, and yearly “Wellness” visits are covered.

 2Choose between Original Medicare/Medicare Supplement and Medicare Advantage 

 Original Medicare 

Original Medicare comprises Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Though you can add a separate Medicare drug plan to get Medicare drug coverage or Part D. Another feature is that you can use any doctor or hospital that accepts Medicare anywhere in the U.S.

In several ways, this might be beneficial for our protagonist, Maggie. While thumbing through a magazine, she comes across images of ancient architecture, stunningly blue beaches, and trains headed someplace fantastic. This entices her to do some travelling as well. Though to be extra cautious, she’ll want to consider foreign travel emergency coverage.

To obtain that, she’ll need to purchase supplemental coverage called Medicare Supplement Insurance which is also known as Medigap. This coverage also assists in paying out-of-pocket expenses, copayments, coinsurance, and deductibles.

 Medicare Advantage  (also known as Part C)                                                        

This alternative to Original Medicare for your health and drug coverage is a Medicare-approved plan from a private company. These plans are “bundled” and consist of Part A, Part B, and usually Part D.

Typically, you’d have to use doctors that are in the plan’s network.

Plans could have lower out-of-pocket costs than Original Medicare. Medicare Advantage could also offer other services not covered under Original Medicare like vision, hearing, and dental services.

Medicare Advantage has Part A and B, and usually Part D with some extra benefits. Some plans might include lower out-of-pocket-costs as well.

 1 – The Enrollment Period 

When you enroll is key to obtaining the right insurance for you, regardless of how you’re insured.

Generally, unless the individual is still working and prefers to keep the insurance their employer provides or due to other extenuating circumstances, most people can enroll in Medicare beginning 3 months prior to turning 65, plus the month they turn 65, and 3 months after their birthday month. This adds up to a seven-month enrollment period.

Maggie is only two months shy of reaching this age, which means she’s already within her personal enrollment period. It’s recommended that she act right away and enroll.


For info, please visit ManhattanLife Medicare Supplements

Centers for Medicare & Medicaid Services.2021. Medicare History

Centers for Medicare & Medicaid Services. 2022. 2022 Choosing a Medigap

Kaiser Family Foundation. 2019. Medicare Overview

 



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