To fully understand how a traditional Medicare Advantage plan works, let's create a simple scenario: Let's say that you have to be hospitalized for a head injury. Upon admission, you hope to get a standard room since the cost of it is fully covered by your HMO plan. Unfortunately, it's a busy week for the health care facility, and the only room left is the suite. Moreover, your doctor suggests that you have to get an MRI scan to determine if you suffer from head trauma because of the accident. Again, your HMO will only cover CT scans, not MRI scans. When you come to think of it, there are actually costs that you will incur, yet there's no resource that you can use to pay for them except your own bank account. Even if your HMO has been useful, you're still not going to enjoy its full benefits and fully appreciate its use. This is where you need to have a Michigan Medicare supplement plan. This is a health plan that aims to cover whatever costs or gaps caused by your coverage. Whatever unpaid expenses are left, your supplement plan will cover for it. How Medicare Advantage and Supplement Plans Differ Just the fact that it's a totally different plan from the usual ones offered by Medicare, you may wonder what these differences are. Let's start with the Medicare Medicare Plan. This one is divided into 4 parts. You have part A to part D. Part A basically covers your hospitalization costs. You can also use this if you are in hospice or home care provided that the services rendered by the facility or a registered private nurse, for example, are related to treating and monitoring your illness. There are times when you don't have to pay any premium for this plan. You don't have to if you are a dependent parent of someone who has worked in a government for a certain period of years and where Medicare taxes are being paid. You also don't have to if you're a government employee, as well as if you're a beneficiary of Social Security and railroad work benefits. Part B, on the other hand, takes care of the outpatient expenses. This is mandatory since you need to have resource for your consultation and diagnostic exams that you have to get. You are also asked to pay premium for this one. Part D is intended for individuals who have to deal with prescription drugs. If you are maintaining a lot of them or if their costs are too high for you, you can use your part D plan to pay for them. However, it's imperative that the drugs are within coverage of part D. Part C is the one called Medicare plans. These are health insurance plans that are being provided by private insurance companies that have been approved by the federal government to offer such plans. There are different sub-plans of part C. You have Health Maintenance Organization (HMO), Medical Savings Account, Pay Per Fee Service (PPFS), and Preferred Provider Organization (PPO). With HMO there will be no deductible to your salary, but you need to choose physicians within the provider network. You also cannot avail of special consultations without referral from your main physician. Businesses that want to give away HMO to their employees should have at least 25 staff. Medical savings account means that the government will put funds into your own account for medical reasons. You just need to pay for a high deductible. Nevertheless, for those costs that would not be shouldered by your original insurance plan, you can depend on this one. PPO and PPFS are somewhat similar since you have more freedom to choose your own doctor and health care facility. The only difference is that you are a co-payee in PPO. Some of these plans offer Part D, though you always have the option not to. Moreover, since there are plenty of packages that you can choose from, you can select which one of them would suit your needs and even preferences. These plans are different from one another, but they share a very similar characteristic: not all medical costs will be covered. Traits of Medicare Supplemental Plan This is how Medicare supplemental plans work and why they are different from the above-mentioned health care policies. For one, supplemental plans don't take effect unless the medical costs have already been deducted by your original health plan. Thus, if all expenses can be shouldered by your HMO or PPFS, for example, there's no need for you to use your supplemental plan. In the same way, you can use this if all costs are not covered by your original Medicare. Keep in mind that the main role of this plan is to fill in the gaps created by your original Medicare Advantage plan. Of course, this means that you cannot avail of the supplement plan unless you have any Medicare plan. The premiums for supplemental plans are also quite high. Here's the explanation: Medicare plans are around to offer the lowest possible medical costs for individuals. That's why insurance companies would really take time to evaluate which of the medical services would be considered necessary for the patient care. They are also limiting the number of doctors in their network to allow them to bargain for professional fees. After all, what doctor could say no to a lot of patients? Now, since the supplemental plan can cover any cost as long as it's not covered by your insurance policy, it would mean that those expensive services would have to be shouldered by the former. To compensate for the cost, you also need to give high premium. The premium will also increase as your age also increases. Nevertheless, you are not limited by your choice of physician and hospital. You also don't have to worry if you need to go through several diagnostic exams or stay in the hospital for weeks because you have the supplemental plan to back you up just in case your original Medicare cannot provide everything you require.
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To fully understand how a traditional Medicare Advantage plan works, let's create a simple scenario: Let's say that you have to be hospitalized for a head injury. Upon admission, you hope to get a standard room since the cost of it is fully covered by your HMO plan. Unfortunately, it's a busy week for the health care facility, and the only room left is the suite.
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