Medigap is Your Best Option

When you go into the world of health insurance you realize that there are many options for you which will always offer you things you may need and maybe not. Some do not give you the benefits you are looking for and others if they hit the spot with everything you need.

Even so, it is very difficult to choose at the beginning with which medical insurance you want to associate after you have retired or when you begin to present a disability. For this reason, people start to look for all the options that are available to them very early so that making the decision does not take them by surprise.

One of the most chosen options by all is Medicare, who with all its parts has slowly won over people and now it is everyone’s favorite health insurance that will always be available to you. And it is not for less since it is a health program proposed by the federal government that is set by many laws which will always protect you as well.

Even so, Medicare, as you may have read, does not only have an original protection plan for retirees, the disabled and people in a terminal state. There are many plans offered such as the original plan, Medicare Advantage and Part D related to medications prescribed by the doctor. From there you choose what is best for you.

After this comes Medigap. As such, it works like a Medicare Supplement Plans 2019 that covers all the bills that are left over once the entire medical procedure is done. You see, when you are hospitalized in the hospital there are certain costs that must be covered and for that Medicare is used, however, when you reach the spending limit of this plan you have need to cover the missing bills and that’s when it comes into play Medigap

Beyond being a Medicare Supplements Plan, Medigap is the salvation of many people who are faced with pressing situations and need something to relieve them with bills. The best thing about all this is that you can purchase this complementary plan at any private institution authorized by Medicare.

Something that has helped people choose Medigap is that you can pay this Medicare Supplements Plans in comfortable installments, this means that you must pay monthly small fees that fit your budget and the services you have requested so these fees they are covering what in the future you are going to need.

On the other hand, Medigap also has excellent coverage for medications. You are free to choose a plan that includes the medications prescribed by the doctor in question. Although some conditions apply, this is one of the most chosen options by the public.

Finally, the Medicare Supplements Plans offer you a high range of options which are reflected in plans from A to N and it is up to you which one you will enjoy.


Occasions where you can use Medicare Insurance

Medicare is a social insurance program created by the federal government that seeks to help alleviate the burden of the person during health emergencies of all its public. However, this is something that everyone already knows and much more information is needed than just that normally provided in the brochures.

When people are deciding whether or not to hire Medicare as their primary insurance, they begin to have many questions about when they will be able to use it. Thousands of questions are present in his head and need someone to attend them so that they can leave them.

The question we will address today is the most common of all. When can Medicare use it? And we say that it is the most frequent since, being an insurance, people assume that there are certain restrictions regarding its use, and that is why we are going to explain it all today.

First of all, you should know that the services underwritten by Medicare Insurance depend on the part of it that is activated, so the first thing to do is to verify which part you manage.

If it is Part A, Medicare Insurance covers home health and hospice care. However, for the latter, your doctor must certify that you are a terminally ill patient and that you have little time left to live. From there, Medicare covers all the necessary items and services, medical equipment, medications, helper for household chores… In addition to this, coverage includes admission to the hospital.

On the other hand, part B covers medical exams that do not fall under Part A coverage. However, certain conditions apply. The services included the range from aneurysm exams, alcohol abuse counseling, ambulance service, ambulatory surgery, mammography, cardiovascular evaluations…

Regarding part C, the coverage is much broader but depends on what is stipulated in the contract signed after the negotiations. However, most of the time it includes part D, which refers to the medication recipes. Here you can get them and save a lot of money that may break your budget later.

Medicare offers many scenarios in which it can be used. The only condition is that they are real emergencies or that the exams you are requesting are really necessary so that they can cover all expenses. Otherwise, you will not be able to use it. For example, if you want to have a cosmetic surgery Medicare will not accompany you because it does not cover this type of things, like dentistry and eye exams for lenses.

Little by little, it has become one of the most sought-after insurances in the whole country and one of the most chosen by all people. Everyone has seen how Medicare has supported them on occasions when they really needed help and that is why they continually renew this insurance in the plan they feel most comfortable with. If you still have doubts about when you can use Medicare we recommend you go to their website, there you will find much more information.

Learn more here

Medicare Advantage Plans Pros and Downsides

Medicare Advantage plans, is referred to as Part C Medicare.  This is one of the beneficiaries received as the benefits of Medicare covered under Part A and B Original Medicare. There is an exception only with hospice care, while it may include benefits such as coverage for vision, dental and prescription drug.


How do these plans function?

Medicare Advantage plans are issued by Medicare approved private insurance companies. Every month, the working system is that the Medicare pays a fixed amount to the private insurance company and that private company covers your costs based on the Medicare set rules.


Medicare Advantage plans are available in different types, and the benefits vary with each plan. In fact, majority of the plans are inclusive of the coverage for drug prescribed in a type of plan referred to as Medicare Advantage featuring the drug prescribed plan. There are Medicare Advantage plans different forms such as:


  • Health- Maintenance- Organization- (HMO)
  • HMO- Point-Of-Service- (HMOPOS)
  • Preferred-Provider- Organization- (PPO)
  • Medical-Savings- Account- (MSA)
  • Private- Fee-for-Service-(PFFS)
  • Special-Needs- Plans- (SNPs)

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What is Medicare Advantage plans downsides?

The coverage with Medicare Advantage plans is functional through private insurance companies and there is difference in their guidelines and rules leading to restrictions:


  • Medicare Advantage plans of each type are based on the insurance company and thus they need higher costs as out of pocket than Traditional Medicare. In fact, each year, the plan benefits, premiums and copayments change.
  • The insurance company expects to adhere to the strict rules to avail coverage for some health products and services, such as to see specialists there is a need for referral. You may change hospital or doctor within the plans network and receive coverage as per the plan or else you must be ready to pay more cost.
  • There are annual contracts in Medicare Advantage plans and so one can choose to avoid renewing the contract.


Medicare Advantage plans pros

  • Insurance companies provide a premium of $0 for Medicare Advantage plan and the availability is based on the state and county you live.
  • The Advantage plans offer more than Original Medicare as it offer additional cover as benefits such as dental or vision coverage.
  • Each plan features a maximum limit for out-of pocket expenses each year on health costs. On reaching the limit, you need to pay nothing for the services covered.

Medicare Insurance for ESRD

The Medicare insurance is the special type of insurance which has been designed for people who are 65 or older and disable people of any age. The main purpose of this insurance is to provide them the different type of insurances related to health within one package. Usually, there are different healthcare related insurance plans for the different situation but Medicare insurance in America covered most of them in this single insurance plan. So, whether you are looking for the hospital expenses, medical services, and drug coverage, the Medicare insurance will provide coverage on all of them.

The end-stage renal disease people have been usually ignored when we talk about the Medicare insurance. Even if you go to the market and explore different insurance companies who are providing help regarding the Medicare insurance on the basis of commission earning, do not really talked about people who are suffering from the end-stage renal disease. This is the main reason behind the less popularity of Medicare Insurance for the ESRD.

The federal government of United States of America has included the end-stage renal disease people at the very early launch of the Medicare insurance in 1965. But still, it does not make the equal opportunity in the insurance industry due to lack of knowledge and information.

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The end stage renal diseases have many kinds. One example of them is permanent kidney failure. For treatment, the patient needs to bear expenses of transplant, ESRO, and dialysis etc. The Medicare insurance plan covers all of these expenses on the behalf of the patient only if they have purchased the right plan for them.

ESRD Medicare Insurance Eligibility

A person can become eligible for the ESRD Medical Insurance as soon as after the first dialysis treatment. There is not much requirement to claim the coverage but yes, it could be a bit time taking the process or you need to wait up to 3 months for the coverage after the regular dialysis begins.

The Medicare Insurance has been usually famous for the old people but for the ESRD patient, there isn’t any age requirement. As long as the doctor advice for the regular dialysis or kidney transplant, the person becomes eligible for the ESRD Medicare insurance.

When Medicare Coverage End for the ESRD patients?

Like any other health-related insurance, the coverage end when the patient has been recovered completely. Examples of dialysis and transplant patients are:

  • The coverage ends 12 months after the last dialysis treatment for the dialysis patient
  • The coverage ends 36 months after the kidney has been transplanted.

There are multiple insurance plans and even the coverage ratios have been sold by the insurance companies. So, the coverage could have the different ending period in special cases but this is the standard time which most of the ESRD patient got after they claim the insurance coverage.

Once a patient has taken benefit from the Medicare insurance, the 3-month eligibility criteria will be removed from him and the patient can enroll for the Medicare Insurance instantly.

Getting drug coverage with Medicare

As a Medicare user you probably know that Original Medicare Part A and Part B do not cover drug prescriptions and that you will have to pay for the medication your doctor prescribes you. If you would like to save some money, there are two ways in which you can get drug coverage with Medicare through some plans that Medicare offers. In this article you will find information about these and how to enroll on them.

     How to can I drug coverage with Medicare?

There are two ways in which you can get drug coverage with Medicare. The first one is through a Medicare Prescription Drug Plan (Part D), which adds drug coverage Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans, and Medicare Medical Savings Account Plans. You can get one of these through a private insurance company.

The second way in which you can get drug coverage with Medicare is through a Medicare Advantage Plan, like a Health Maintenance Organization plan.  With a Medicare Advantage Plan you get Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance) and prescription drug coverage. These types of plans are also known as “MA-PDs” because they include the drug coverage. This plans are also gotten through a private insurance company.

     What do these plans cover?

Depending on the plan you get, the coverage will vary. However, each plan has a formulary, which is a list of covered drugs and they are placed in “tiers”, so each tier has a different cost. Medicare drug plans can make changes in their formularies, but they must inform you through a written notice at least 60 days before the changes become effective if you are taking a drug that is involved in them. Additionally, Medicare drug plans must cover all commercially available vaccines.

When and how can I enroll on a Plan with drug coverage?

You can enroll on one of these plans or make changes on the plan you already have on specific times.

The first moment in which you can get one is during the Initial Enrollment Periods for Part C & Part D, when you first get Medicare. In this case, there a few situations that influence the moment when you can get the plan.

If you are new eligibly because you just turned 65, you have a disability and you are under 65 or you have both a disability and just turned 65, you can enroll on a plan with drug coverage 3 months before you turn 65, during the month you turn 65 or 3 months after you turn 65. In case you are under 65, the month in which the person turns 65 will be replaced with your 25th month of getting disability benefits.

If you have Medicare Part A coverage and you enrolled in Mutual of Omaha Medicare Supplement during the Part B General Enrollment Period (January 1–March 31), you can sign up for a Medicare Advantage Plan between April 1 and June 30. If you do not have Medicare Part A coverage and you enrolled in Medicare Part B as previously mentioned, you can sing up for a Medicare Prescription Drug Plan between April 1 and June 30.

The second moment in which you can get a plan with drug coverage is during the Open Enrollment Period for Medicare Advantage and Medicare prescription drug coverage. The third moment in which you can get a plan with drug coverage is during the Medicare Advantage Disenrollment Period. If you do it during the MA disenrollment period, you will have to switch to Original Medicare and join a Medicare Prescription Drug Plan.