Having Secondary Insurance to Cover Some of the Costs Medicare Doesn't Pay

Medicare coverage is a federal government program created to help people 65 years of age or older with medical costs.¹ Medicare has three parts of coverage: Part A is hospital insurance; Part B is medical insurance; and Part D covers prescription insurance.²

Understanding secondary insurance coverage and why it is helpful as an addition to Original Medicare will be the focus of this article.

Three types of Medicare options:

1. Original Medicare (Parts A and B)
2. Medicare Advantage (Part C)
3. Prescription coverage (Part D)

Original Medicare

Original Medicare health insurance does not cover all hospital and medical expenses.³

Medicare Supplement insurance is another form of medical insurance that can help offset some of the out-of-pocket expenses not covered by Original Medicare. A person has to be enrolled in Original Medicare Part A or Part B or both in order to enroll in Medicare Supplement insurance.

Original Medicare does not cover prescriptions. Medicare Part D is a Medicare approved plan offered by private companies. Prescription drug assistance programs are available if you qualify for the requirements.⁴

Medicare Advantage

Medicare Advantage is a Medicare approved plan offered by a private company as an alternative to the Original Medicare. You cannot buy additional Medicare Supplement insurance. Medicare Advantage may include prescription insurance. Pay attention to restrictions and limitations regarding where you receive medical services.

Medicare Supplement insurance

Rules set by Medicare determine the sorts of insurance plans private companies can offer for additional health insurance. Under the current plans calculated and published each year by the Centers for Medicare and Medicaid Services (CMS), there are 10 plan options. Two of those plans are available to anyone eligible for Medicare before January 1, 2020. The remaining eight plans are open and available for everyone eligible for Medicare. Medicare Supplemental insurance may help with the following costs:

1. Additional hospitalization costs including deductibles
2. Coinsurance costs – usually a percentage of the total costs
3. Emergency medical costs while traveling out of the country

The following are examples not covered by Medicare Supplement insurance:

1. Long-term care (such as a nursing home)
2. Vision or dental care
3. Hearing aids
4. Eyeglasses
5. Private-duty nursing

Medicare Supplement plans offer different premiums to meet your budget or financial needs. Two Medicare Supplement plans offer a high deductible for a lower cost premium.

Other supplemental medical insurance

Supplemental insurance is separate from Medicare and pays lump sum benefits in case of specific coverage such as cancer, critical illness, and accidents. Depending on the insurance company and the insurance policy, you still may be able to enroll in these supplemental policies at the age of 65.

Contact a licensed insurance agent who understands Original Medicare and Medicare Supplement insurance and is able to maximize your entitled benefits

Sources:

1. Medicare, https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/how-does-medicare-work. Accessed September 2023.
2. CMS, https://www.cms.gov/medicare/medicare-general-information/medicaregeninfo.Accessed September, 2023.
3. Medicare basic costs, https://www.medicare.gov/basics/costs/medicare-costs. Accessed August, 2023.
4. Coordination of benefits, https://www.cms.gov/medicare/coordination-of-benefits-and-recovery/prescription-drug-assistance-programs/overview.Accessed September, 2023.