Medicare and HealthSpring: Exploring Benefits, Pricing, Choices, and Further Details
In the world of healthcare for seniors, navigating the intricacies of Medicare can be a daunting task. Here's a simplified guide to help you understand the basics of Medicare, Medigap, and Medicare Advantage.
Medicare, a federal insurance plan, provides coverage for people aged 65 and older, as well as those under 65 with specific health conditions. It is divided into two main parts: Medicare Part A, which covers hospital stays, and Part B, which covers doctors' visits and outpatient care. These parts are administered directly through Medicare.
Monthly premiums for Part B in 2025 are set at $185, paid directly to Medicare. On the other hand, Medicare Advantage, Part D, and Medigap policies are managed by private insurance companies. For instance, Cigna administers HealthSpring Medicare health insurance policies, offering Medicare Advantage, prescription drug plans (PDPs), and Medigap.
Medigap supplement insurance is designed to help pay for out-of-pocket costs that may apply to Original Medicare, such as deductibles, copayments, and coinsurance. However, it's important to note that Medigap plans sold after 2006 no longer include coverage for prescription drugs.
During the Medigap Open Enrolment Period, which lasts for six months after a person turns 65 and enrols in Part B, they can buy a Medigap policy without the insurer taking their medical history into account. After this period, if an individual finds a plan, the insurer can include medical history when calculating cost.
Medicare Part D (PDPs) help with the cost of prescribed medication, while Medicare Part C (Medicare Advantage) offers benefits that combine those of Original Medicare and may include additional coverage. However, it's crucial to remember that Medigap plans cannot pay for coinsurance, copayments, or deductibles that apply to Medicare Advantage plans.
It's also worth mentioning that it is illegal for private health insurance companies to sell Medigap plans to their Medicare Advantage policy-holders.
Lastly, it's essential to note that Cigna-HealthSpring Medicare Advantage plans are not available in every state in the United States in 2025. To find available Medigap plans, individuals can use the Medicare search tool, 'Find a Medigap policy that works for you'.
By understanding these key points, you're well on your way to making informed decisions about your Medicare coverage. Always remember to research and consult with professionals to ensure you're making the best choices for your unique healthcare needs.
- Medicare, a federal insurance plan, covers healthcare for individuals aged 65 and older, as well as certain individuals with specific health conditions, offering two main parts: Part A for hospital stays and Part B for doctors' visits and outpatient care.
- Private insurance companies manage Medicare Advantage, Part D, and Medigap policies, with Cigna administering HealthSpring Medicare health insurance policies that include Medicare Advantage, prescription drug plans (PDPs), and Medigap.
- Medigap supplement insurance is designed to help pay for out-of-pocket costs such as deductibles, copayments, and coinsurance for Original Medicare, but it doesn't cover costs associated with Medicare Advantage plans.
- During the Medigap Open Enrollment Period, individuals can buy a Medigap policy without the insurer considering their medical history, but after this period, the insurer can take medical history into account when calculating cost.
