What is Medicare Supplement Insurance?
A Medicare supplement (Medigap) insurance, sold by private companies, can help pay some of the healthcare costs that Original Medicare doesn't cover, like copayments, coinsurance and deductibles. Some policies also cover services like medical care when you travel outside the U.S.
If you have Original Medicare and purchase a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered healthcare costs, and your Medigap policy pays its share.
Medicare Advantage Plans
A Medicare Advantage Plan — also known as a Part C Plan — is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
Part D Prescription Plans
Medicare has an optional program — called Medicare Part D — that provides insurance to help you pay for prescription drugs. If you select to have the coverage, you pay a monthly premium.
Prescription plans work with your current Medicare insurance, each plan covering its own list of drugs, placing them in tiers based on their formularies. These plans can help significantly reduce your out-of-pocket expenses
Medicare Prescription Drug Plans may have these coverage rules:
- Prior authorization: You and/or your prescriber must contact the drug plan before you can fill certain prescriptions. Your prescriber may need to show that the drug is medically necessary for the plan to cover it.
- Quantity limits: Limits on how much medication you can get at a time.
- Step therapy: You must try one or more similar, lower cost drugs before the plan will cover the prescribed drug.