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MIDSOUTH HEALTHCARE

MEDICARE SUPPLEMENTS EXPLAINED

OVERVIEW

Federal law requires that all companies sell exactly the same plans.

NO claims can be paid by any company until they receive the EOB
( explanation of medicare benefits) from medicare showing what medicare has paid.

Benefits are paid immediatly by your insurance companies computors upon receipt of the EOB.

These laws effectively make all insurance companies equal in service !

Therfore no company can claim to be “better” than any other.

Although all companies are exactly alike in benefits and service, they are not alike in price.

Each company is allowed to charge whatever they wish for the different plans available.

Prices can vary greatly from one company to another FOR THE VERY SAME PLAN !!!

"STANDARD" PLANS

Of the plans available, (A,B,C,D,E,F,G,) only 2 plans are designed to pay 100% of your bill.
these plans are “C” &  “F”
Plan “C” pays 100% of all charges not paid by medicare, to all doctors who participate in medicare.
(since nearly all doctors in Mississippi accept medicare, plan “C” is the most economical 100% plan)
Plan F” pays exactly the same as plan “C” except, plan “F” has an additional benefit that pays any “excess” charges made by non-participating doctors. This “excess” charge is limited to no more than 15% above the “reasonable” charge allowed by medicare. However, since the difference in price between plan "C" and plan "F" is usually only about $4.00, plan "F" is the better buy.

ALL other plans are various combinations of benefits including some of the above, but all these plans will leave you paying part of your medical costs. (unless you have NO medical costs for the year)

"SELECT" PLANS

Medicare "select" policies are identical to their standard equivalent policies, but are sold at a discounted price (usually about 15% less), and require use of certain key hospitals for any non-emergency, pre-scheduled, in-patient hospital stays.

A list of participating hospitals within your state is provided along with your policy when it is issued

Only in-patient stays that are pre-planned are required, in other words, if it is an emergency, or even if you think it is an emergency, you are allowed to use any facility, at any location anywhere.

All out-patient procedures are allowed in any facility.

If the hospital nearest you in the network is not equipped to handle your condition, you are allowed to go to any facility you choose that can.

MEDICARE "ADVANTAGE" PLANS

These plans "REPLACE" your regular medicare benefits with a private policy, and if prescription drug benefits are "INCLUDED" with the plan (known as all-in-one plans) you will find yourself "LOCKED" in to the plan and unable to switch back to regular medicare for an ENTIRE year !

"ADVANTAGE" plans are known as FEE-FOR-SERVICE plans or medicare part "C"plans These plans require the use of certain doctors and hospitals, except in an emergency. Some versions will allow the use of any facility that will except the plan, but will charge the customer a larger "co-pay" than the facilities on his current list. These plans usually start out at a low price ( or may even be free since they recieve the funds held out of the persons social security check, and they also recieve the contributions from the federal medicare fund ), however, they may escalate in price more rapidly than traditional medicare and, the "deductibles" and "co-pays" may be increased as well. There are no "ADVANTAGE SUPPLEMENTS" available, therfore the customer must pay his own "deductibles and co-pays" out of his own pocket. As long as the customer enjoys good health, with little more than an occasional doctors visit, these plans can save the customer money. However, a large bill involving a hospital stay, and all the testing that preceeds the stay, can become quite expensive on the customer side. Also, unlike traditional medicare and medicare supplement plans, the coverage does not provide coverage for "certain" items, and can be cancelled by the company at any time. Be sure to find out what items are NOT covered by the plan, and ask for a list of the "co-pays", and whether or not your doctor will except your plan.

If a person has traditional medicare and a medicare supplement plan with it, when he changes to an "ADVANTAGE" plan, he can switch back to traditional medicare at the end of the first year and his medicare supplement plan can be re-started reguardless of his health. However, if a person keeps the "ADVANTAGE" plan beyond the first year and then switches back, no such "GUARANTEE" applies, and if he has suffered a significant change of health, he may find himself unable to qualify for a medicare supplement plan, and still having to pay his own "deductibles and co-pays" out of his own pocket .... FOR THE REST OF HIS LIFE !

If the "ADVANTAGE" company decides to "CANCLE" a persons coverage, or goes out of business, the customer has the right to go back to traditional medicare AND purchase a medicare supplement plan reguardless of his health.

Virtually all healthcare facilities accept traditional medicare and medicare supplement plans.

FOR ADDITIONAL INFORMATION , PLEASE CLICK BELOW

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