b'JUNE 2019(2) a Medicare Advantage prescription druginsurance policies that are permitted by the govern- plan (MA-PD) that covers prescriptionment (currently Plans A, B, C, D, F, G, K, L, M and N).drugs as part of the Medicare Advantage (PartThe most basic Medigap plan is Plan A. That C) coverage. Stand-alone drug plans help paysupplemental plan covers the Medicare Part A coin-for outpatient prescription drugs and vaccinessurance and hospital costs (up to an additional 365 (subject to deductibles, coinsurance and/or co- days after Medicare benefits are used). It also covers payment amounts). Medicare Advantage drugMedicare Part B coinsurance or copayment costs, plans integrate prescription drug coverage andthe first three pints of blood, and the Medicarecoordinate care and costs with other MedicarePart A hospice care coinsurance or copayment costs. benefits into one plan. Most drug plans have aThe other Medigap plans cover these same basic coverage gap (also called the donut hole) wherebenefits (most at 100%), but add varying levels of coverage is temporarily reduced after a prede- coverage for other things like skilled nursing facility termined amount is reached. It is important thatcare coinsurance, the Medicare Part A deductible, seniors not delay enrolling in a Medicare Part Dthe Medicare Part B deductible, foreign travel emer-prescription drug plan since Medicare assessesgency, and Medicare Part B excess charges.a premium penalty for each month an individualThe CMS Medigap handbook referenced above goes without prescription drug coverage. includes a helpful and easy-to-read matrix that illus-Whats the Difference Between trates the various coverages of each of the Medicare Medicare and Medicaid? Supplement policies.Medicare is an insurance program that is run by theFederal law requires that all Medigap plans must be federal government. It provides health insurancestandardized. Since there is no difference in the ben-coverage for people who are at least age 65 and forefits of the Medigap plans sold by various insurance certain disabled individuals who are younger thancompanies, most people shop for a Medigap plan 65. In contrast, Medicaid is an insurance programbased on service and price (which can vary widely). that is run jointly by the federal government andImportant Tip: The premium for most Medigapvarious state governments, and it provides long-termplans will increase annually to reflect aging. Many medical and custodial care coverage to low-incomeMedigap companies attract younger seniors by ar-individuals and families. tificially lowering the rates of the earlier entry ages What are Medicare Supplement and inflating the rates of older seniors, so be sure (aka Medigap) Insurance Policies? to also compare premiums at older ages when you Medigap policies are health insurance policies thatshop for the most affordable Medigap plan. David Leo is theare sold by private insurance companies to supple- How can I Learn More About MedicarePresident & CEO of ment or fill in the gaps of Original Medicare cover- and Medigap Insurance Policies? WMI Mutual Insurance age. Medigap policies can help pay an enrolleesIf you have questions about Medicare and MedigapCompany, a licensed share of the costs of Medicare-covered services likepolicies, I would invite you to contact me. You canhealth insurancecoinsurance amounts, copayments, or deductibles.also contact our office for your free copy of the In order to purchase a Medigap plan, the applicantreferenced CMS publication or visit our website atcompany that sellsmust be enrolled in Medicare Part A and Part B.www.wmimutual.com/medigap. Of course, the ul- various Medicare Insurance companies are prohibited from selling atimate authority on Medicare is the federal govern- Supplement policies.Medigap plan to an individual who is on a Medicarement, and you can find a lot of helpful information Advantage plan (unless that individual is droppingat the Centers for Medicare & Medicaid Services the Advantage plan). website at www.cms.gov. Finally, if youre looking Although the Medigap naming conventions are for a Medicare Part D prescription drug plan, you confusingly similar to the names of the variouscan take advantage of the helpful and user-friendly Medicare parts, the standardized Medigap plansMedicare plan finder at https://www.medicare.gov/and their alpha plan names are totally differ- part-d/index.html.ent. The word parts refers to the four Medicare programs (Parts A, B, C and D) that are run by (or under the tight supervision of) the government. The word plans refers to privately sold supplemental SWPMA News / Winter 201917'