The Medicare program provides persons on Medicare with options on how they wish to receive their health care. It is important to understand the types of Medicare health plans that are available. Any decision about your health care is an important one.
No matter which health plan option you choose to join or to continue, you are still in the Medicare program, and you will receive all services Medicare covers. The original Medicare plan does not pay all costs or cover all services. Some health plans provide coverage for services not otherwise covered by the original Medicare plan. Some Medicare Advantage or other plans can reduce out-of-pocket costs like deductibles or coinsurance.
Medicare Health Plan options that may be available in your area are listed below:
Original Medicare covers Medicare Part A and Medicare Part B and includes a broad variety of services. Medicare Part D (Prescription Drug Coverage) was implemented in January 2006. Persons with original Medicare were able to enroll in Medicare Part D and choose a prescription drug plan through May 15, 2006. If you were eligible for Medicare Part D in 2006 and did not enroll, enrollment is ongoing in November 2007, with drug coverage beginning in 2008. A penalty may be charged for late enrollment. Consider your current prescription coverage and call 1-800-633-4227 or visit www.medicare.gov for additional information on plan availability in your area. Your Medicare handbook "Medicare and You 2008" contains detailed information about plans available in your area.Persons on original Medicare most often cover the gaps in Medicare by buying a supplemental or Medigap coverage plan available through Medicare-approved private companies. Plans are available from types A through L. They will vary in cost and provide different levels of services.
Medicare Advantage Plans are plans offered by private companies that contract with Medicare to provide all your Medicare Part A and Part B benefits, as well as Medicare Part D prescription drug plans.In 2008, Medicare Advantage Plans include:
Preferred Provider Plans, Health Maintenance Organizations, and Medicare Special Needs Plans are offered by private companies that contract with Medicare to provide all Medicare Part A and Part B benefits and may include Medicare Part D benefits.
Medical Savings Accounts combine a high deductible Medicare Advantage Plan with a Medicare Medical Savings Account for medical expenses.
A Special Needs Plan is a special type of Medicare Advantage Plan (Part C) that provides more focused and specialized health care for groups of people, such as those who have both Medicare and Medicaid, reside in a nursing home, or have certain chronic medical conditions.
Medicare Cost Plans are another option. They are limited in availability. Enrollees in Medicare Cost Plans can use providers in the plan network, but services provided by non-network providers are covered by Medicare. The plans may provide prescription drug coverage but they do not provide additional savings on the Medicare Part B Premium or Prescription Drug Premium.
Additional information on all plan options is available by calling Medicare at 1-800-633-4227 (TTY: 1-877-486-2048) or by visiting www.medicare.gov. In New York, the State Healthcare Insurance Assistance Program (HIICAPS) can help with questions about appeals, buying other insurance, choosing a health plan, buying a Medigap policy, and Medicare Rights and Protections. To reach HIICAPS call 1-800-701-0501.