It is a fact that though you are under an Original Medicare plan still your policy does not cover all the medical costs that you may need in the due course of time. Therefore there is the need to have a Medicare Supplement Plan so that you can bear those extra costs that are not under the policy coverage of your Original Medicare plan. Here in this article we shall discuss about some of those gaps in your Original Medicare policy for which you may need to have a Medigap policy. As it is well known to all that there are twelve standard Medicare Supplement Plans and all these provide their own set of benefits. But it is to be kept in mind that almost all of these policies provide the basic benefits of the plan A and B.
Now let us discuss about some of the gaps of the Original Medicare for which you will be needing some Medicare Supplement Plans. Let us start from Medicare Part A plan. The Medicare Part A plan is also known as the Hospital insurance plan and covers impatient hospital, skilled nursing facility, home health and hospice services. Medicare covers the first 60 days in full after the deductible has been met; the daily coinsurance payment for days 61 to 90 is $267 per day in 2009, and for days 91 to 150, the “lifetime reserve days,” $534. But it does not pay for Hospital services beyond 150 days per spell of illness. Again in case of skilled nursing facility the gap is beyond 100 days per spell of illness. And also there is a gap in Home Health nursing and aid services where there is no longer a skilled care component.
The Medicare Part B is sometimes also known as Supplementary Medical Insurance, which provides coverage for a variety of outpatient and physician services. It also pays for durable medical equipment, prosthetic devices and also for ambulance transportation. But there are some gaps in coverage that are not reimbursed by Medicare like the Part B deductible. The fact is that an annual deductible of $135 in 2009 must be met before Medicare will make payment for covered services. Another gap is also there in the Medicare which is that Medicare pays 80% of the approved charge for all Part B services and items, an amount that varies according to the services and items provided, and there remains a gap of 20% coverage. However there is also another important thing to be noticed and that is many physicians and providers charge more than the amount Medicare approves.
However it is to be kept in mind that if you are in Medicare Advantage plan you are not eligible to enroll for Medicare Supplement Plans unless you switch over to the Original Medicare. And also before choosing a Medicare Supplement Plan you should be careful of choosing the right one so that it may cover your particular needs. However, it is always better to get enrolled for a Medicare Supplement Plan within thirty days of receiving the Original Medicare policy as it can help in cost reduction and deductibles.