A Guide to Medicare Supplement Plans and Coverage Options

Medicare is a health insurance program primarily designed for individuals over 65, but it also covers some younger people with specific disabilities, including advanced kidney disease. There are two main types of Medicare coverage: Original Medicare and Medicare Advantage plans.

• Original Medicare Supplement Insurance: This fee-for-service plan is funded by the government and involves direct claims to providers. It includes Part A and Part B. Part A covers hospital stays, skilled nursing facilities, and home health services, while Part B covers outpatient care, doctor visits, and other medical services.

If you contributed to Medicare during your employment, you won’t pay monthly premiums for Part A. Part B, covering outpatient services and doctor visits, requires a monthly premium.

Medicare Advantage Plans: Also known as Part C, these are offered by approved private insurers. They provide comprehensive coverage, combining Part A and Part B benefits, but plan details such as referral requirements and out-of-pocket costs can vary. Types include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for-Service (PFFS), Medical Savings Accounts (MSA), and Special Needs Plans (SNP).

Prescription Drug Plans (Part D): These optional plans are administered by private companies approved by Medicare, helping to reduce drug costs and protect against future expenses.