Are you sure you know all about Michigan Medicare? One of the foremost reasons why state residents still end up paying huge amounts of money for out-of-pocket costs and deductibles is because they are not fully aware of the different plans and coverage of their Medicare. Today, you will learn what the different types of Medicare plans you can avail, how they differ, and how you can bridge the gaps of these differences.
Parts of Medicare
The entire Medicare plan is divided into different parts. You have part A to part D. Each of them has its own set of requirements and benefits that are being extended to its members.
For example, Medicare Part A takes care of expenses that are related to your hospitalization. It may also be used for those who are currently in a home or hospice care, provided that the reason for their stay is related to their ailments or for more thorough diagnostics of their medical condition.
You will not be compelled to pay any premium if you have your Social Security and retirement from railroad work benefits. You can also be eligible for this type of Medicare and still not pay premiums if you are a parent who is proclaimed dependent by your child who has rendered enough number of years in the government, as well as if you have paid for your Medicare taxes while you still hold your government position.
The other three parts require each member to pay a premium, though it could either be voluntary or not. If you are availing of Medicare part A, you must also get Medicare part B. The latter covers the out-of-hospital costs. These include consultations to your doctor and other medical services that are not enumerated by part A.
Part C and D are optional. Nevertheless, both of them are still very important. Part C is referred to as the Medicare Advantage plan. These plans are usually being given away by private entities such as insurance companies. You will get to know more about them later.
Part D is more specific. It is made for those people who are required to take prescription drugs. This plan offers assistance to those individuals who cannot afford to pay their expensive medications. You will only be able to obtain this one if you are enrolled in either of the other Medicare parts mentioned earlier.
Advantage Plans
As mentioned, part C is all about Medicare advantage plans. These are those that are currently being offered by health insurance companies with the approval of the federal government. After all, the government could not fully cover all the expenses of its people.
The good thing about these plans is that they are very flexible. For one, you can choose a package that fits your needs and, of course, your budget. If you want to know what this flexibility means, refer to the list below:
HMO
This stands for Health Maintenance Organization. The great advantage of this plan is that it is normally being offered by employers to their employees, as long as the number of their staff is 25 and above. This means that there is no deductible that has to be done to the salary of the employees.
However, there are certain rules that have to be followed. First, before the employees can avail any of the advanced services of the HMO, you have to be referred by your primary care physician. You also cannot avail of the services that are part of the plan from other doctors besides those that are part of the network of the insurance provider.
Medical Savings Account
HMOs and other advantage plans you will learn later on usually have limits. This means that there are certain basic services that may not be covered. For example, if you have bad eyesight, you cannot use your Medicare advantage plan to cover for the cost of getting an eyeglasses or even an eye surgery.
This is where Medicare savings account comes in. The government is going to help you build your own savings account, which you can use to pay off your future expenses and services that are already out of your health plan coverage. You just need to pay for its deductibles, which can sometimes be hefty. Nevertheless, when the time comes you will get hospitalized, you are assured that majority of the costs would not be shouldered by you.
Preferred Provider Organization
This is also called PPO. This is similar to HMO; however, employees have to contribute their own share. You really do not have to worry, though, as the contributions are not really that high. Moreover, you also have the liberty to choose your own doctor and specialist. In fact, if you do not want to change your physician, you can just avail of this plan.
PFFS Plans
PFFS stands for Private Fee for Service. This is regarded as the most flexible Medicare plan since you have the free will to choose your own doctor and health care facility. However, you are bound by certain terms and conditions that have to be accepted by your physician before he or she can treat you. These conditions, though, will be waived if your situation is considered as an emergency.
Michigan Medicare Supplement Plan
There is also another unique Medicare plan that you may want to look into, especially if you're living in Michigan. This is called the Michigan Medicare Supplement Plan.
This is a unique insurance plan since your coverage will not take effect until your original Medicare pays all the costs that it can possibly cover. The rest will then be taken care of by your supplement plan.
This type of supplement plan is also classified into 12. Each of them, like the four basic Medicare options, has its own benefits that you may want to look into prior to getting one.
If you really don't like to end spending on your health care, you may want to add supplement plan to your list of health plan policies. Even if sometimes the gap isn't too much, it's still going to create deductions into your savings account.
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