Medicare Gaps

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Phone: 360-787-1048

You can get the most from Medicare by learning what Medicare covers and by taking a look at other insurance plans that may cover the gaps that Medicare won’t cover. 

Medicare consists of four different parts: 
Part A is Hospital insurance which includes (inpatient hospital care, Skilled Nursing Facility, hospice care, and some home health services); When you are hospitalized for 1-60days, Medicare covers Most confinement costs after the required Medicare Deductible of $1316.
Part B is Medical insurance which includes (physician services, outpatient care, durable medical equipment, and many preventive services); You have $183 annual deductible plus 20% co-insurance
Part C is Medicare Advantage which provides all Part A and Part B services and may provide prescription drug coverage and other additional benefits); 
Part D is The Prescription Drug Benefit which provides outpatient prescription drug coverage. 

Most people get their Medicare coverage in one of two ways to help cover additional healthcare costs.

You can have Original Medicare plus Medicare Supplement, also known as Medigap which helps cover deductibles, co-pays and coinsurance that Original Medicare doesn't pay for. This maybe right for you if you want the peace of mind of not worrying about unexpected high medical bills in case of illness or accident BUT it costs much higher monthly premium. You also need to enroll on a drug plan to cover your prescriptions.

Another way is enrolling to Medicare Advantage plans like HMO's, PPO's and PFFS, its also known as Medicare Part C. This option combines your Part A and Part B. Your costs may be lower than in the Original Medicare Plan, and you may get extra benefits such as dental, vision and hearing. Some plans even cover for things like Fitness benefits & Prescription Drugs all in one simple and convenient plan. Medicare advantage plan may require you to pay predictable deductibles, co-pays and coinsurance but usually starts at a low to no premium per month. And Most Part C plans cover prescription drugs.

There are items that are NOT covered by Medicare, Medicare Supplements, or Medicare Advantage.
It includes:
First, Custodial Care which is your Nursing Facility, Assisted Living, Home Care, Adult Day Care. Medicare and most Medicare advantage plans only covers the first 20 days of skilled nursing care. 

Second will be Hospital Co-Pays and Co-insurance if you have original Medicare or Medicare Advantage Plans. For this, you can choose Hospital Indemnity? Because accidents or serious illness can happen at any time, and the high cost of hospitalization and related expenses can be overwhelming. Hospital indemnity can help provide a safe harbor to you. It provides a cash benefit paid directly to you, which can help with your out-of-pocket expenses. It pays regardless of other coverage.

Third is Dental/Vision/Hearing – these are covered by select Medicare Advantage plans only.

Next is Final Expense – this is used to cover the costs of things specifically associated with your death.  This could include medical bills, but it most often concerns the fewneral and berial costs. That includes services, items like caskets and hers, or even cremation if that’s your preferred route.

Another is Cancer, Hearth Attack and Stroke?
And why choose Cancer, Heart Attack, Stroke Coverage? This covers out of Pocket exposure with Medicare Advantage plans and covers expenses incurred besides treatment.

Medicare Gaps

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