SEARCH BLOG: HEALTH CARE
The official Medicare site is expansive and fairly well organized... but it is intimidating and for many older Americans, it is beyond comprehension. Regardless, it is a good place to start and can greatly aid seniors getting started with the Medicare program.
But beyond that, there is the world of supplemental insurance. I would venture to say that most people approaching the Medicare-eligible age have little or no understanding of what the Medicare program entails. Most people assume that once they sign up they get health care coverage. Well, that is true; there is basic health care coverage provided by Medicare.
But be careful about using the term "provided." Medicare may be something for which you have paid taxes, but it is not free. It is deducted each month from your Social Security check. And it doesn't pay doctors much which is why many are reluctant to take only payments from Medicare for their services. That's where supplemental insurance comes in.
The two types of supplemental insurance are Medicare Advantage which covers most of what Medicare does not with low or zero deductibles, but may limit your coverage to a specific geography or health care network. The other is Medigap which is more like conventional Blue Cross insurance that can be used just about anywhere, but has more deductibles.
With Medicare Advantage, you generally get the full package including prescription coverage. With Medigap, you buy a separate prescription insurance package... and the medicines which are covered vary greatly from one insurance policy to the next. For example, Blue Cross Blue Shield of Michigan has a "formulary" that is roughly the size of a telephone book. Other companies may have a formulary that is the size of a People Magazine. So, while you may get a lower price on your insurance, you may not be covered for the medicine you need.
That is not to say that everyone needs the "Cadillac" plan. But the problem is that, as with any types of insurance, you are gambling that you don't need it ... and if you do with a low-cost plan, you may end up not being covered for some very expensive medicines.
So, what have you learned here.
- Medicare insurance is not free
- Medicare insurance is basic coverage that may not be sufficient
- Supplemental insurance comes in a variety of offerings under two categories: Medicare Advantage and Medigap
- Prescription coverage may or may not be included in the supplemental insurance
- Prescription coverage varies significantly
As much as some people would like someone to make their decisions for them, for the vast majority of people, the quality of the outcomes are related to the effort of the input. Just as one vehicle model from one automobile manufacturer would simplify the marketplace, the outcome just might not be satisfactory for everyone.