Medicare & Medicare Supplement Options
What is the difference between Medicare and Medicaid?
Medicare is a federal health insurance for people age 65 or older, under 65 with certain disabilities and any age with End Stage Renal
Disease ( permanent kidney failure ) requiring dialysis or a kidney transplant. Medicaid is a medical assistance program for
low-income people. It is jointly funded by the federal government and the states, and its benefits vary from state to state. Most health
care costs are covered if you qualify for both Medicare and Medicaid.
What are my Medicare coverage options?
Medicare patients have two options in receiving their Medicare benefits: either through Original Medicare or a Medicare Advantage Plan.
Your out-of-pocket costs vary depending on your plan, coverage and the services you use.
Original Medicare contains what is called Part A ( Hospital ) and Part B ( Medical ) coverage. You can choose to purchase additional
insurance such as a Medicare supplement insurance ( also known as MedSup or Medigap ) and Part D prescription drug coverage.
Medicare supplement insurance and prescription drug coverage each require a monthly premium in addition to your Part B premium.
Medicare Advantage:plans are options approved by Medicare but run by private companies. They are part of the Medicare Program.
With Medicare Advantage plans you generally get all your Medicare-covered health care through that plan. Coverage can include
prescription drug coverage. You may get extra benefits, such as coverage for vision, hearing, dental, and/or health and wellness programs.
You may have to use the plan's doctors and hospitals to get services. you don't need to buy a Medigap policy if you have an Advantage
Plan. These plans may require a monthly premium in addition to your Part B premium.
This fee-for-service plan covers many health care services. You can go to any doctor or supplier that is enrolled and accepts Medicare
and is accepting new Medicare patients, or to any hospital or other facility. You use your red, white, and blue Medicare card when you
get health care.
Medigap policies are health insurance policies sold by private insurance companies to fill " gaps " in Original Medicare coverage.
In general, with a Medigap policy: You get help paying for some of the health care costs that Original Medicare doesn't cover.
In Ohio there are 10 standard plans A-N. Plan A will cover basic benefits while others offer more complete coverage. All plans are
standardized and have the same benefits no matter what insurer offers it, just the cost of the plan's may differ from insurer to insurer.
Part D Prescription Drug Plans:
Prescription drug plans or PDPs offer Medicare prescription drug coverage only and do not include healthcare coverage.
The costs and drug formularies can vary from plan to plan. It's important to carefully consider how your other healthcare needs will
be met if this option is chosen.
Medicare Advantage Plans- MA Only - No drug plan / MAPD comes with a drug plan.
These plans offer all the benefits of Original Medicare plus additional benefits over what Original Medicare alone covers. A MAPD
includes Pard D and must include benefits which are at least as good as the federal government's standard benefit design.
A MA Plan is a Medicare Advantage plan with out the drug card or Pard D benefit included. There are several types of Medicare
Advantage Plans available so choose wisely.