Medicare Supplement

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Medicare is health insurance through the US Federal Government for people over 65, people under 65 with certain disabilities, people of any age with End State Renal (Kidney) Disease.

It is separated into four parts represented by the letters A, B, C, and D.

  • Part A – Hospital Insurance – helps cover inpatient care in hospitals as well as skilled nursing, hospice, and home health care. Part A & B together make up with is termed 'Original Medicare'.
  • Part B – Medical Insurance – helps cover doctor's services, hospital outpatient care, and home health care. Also helps cover many preventive services to maintain health and keep certain illnesses from getting worse. Part A & B together make up with is termed 'Original Medicare'.
  • Part C – Also known as Medicare Advantage, these are health plans run by Medicare approved private insurance companies. They typically encourage the use of certain doctors or hospitals in an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) arrangement.
  • Part D – Prescription Drugs – an option for Medicare Participants to help with prescription drug costs, run by private insurance companies.

So, why would someone need a Medicare Supplement policy?

Medicare A and B 'help' to pay the health care costs for Medicare participants. There are, however, a number of gaps that require a participant to pay out of pocket. In some cases these out of pocket costs can be significant, even many thousands of dollars. Some examples are below.

  • Co-Payment – An amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor's visit or a prescription. A copayment is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor's visit or prescription.
  • Co-Insurance – An amount you may be required to pay as your share of the costs for services after you pay any deductibles. Coinsurance is usually a percentage (for example, 20%).
  • Deductible – The amount you must pay for health care or prescriptions, before Original Medicare, your prescription drug plan, or your other insurance begins to pay.
  • Excess Charges – If you have Original Medicare, and the amount a doctor or other health care provider is legally permitted to charge is higher than the Medicare-approved amount, the difference is called the excess charge.

Medicare Supplement plans exist to 'fill in' these gaps and help protect Medicare Participants from high and at times unexpected medical payments.

To learn more about Medicare and Medicare Supplements, visit our education center's MedSup Library.  You can also call and speak with a licensed representative at 1-800-258-7041 or email myAMBAbenefits@amba.info