If you are already on Medicare and are thinking about getting a Humana Medicare Supplement to help with the cost of your health care, you should be aware of the important differences between the two programs. Medicare is the government’s long-term insurance program for retirees. Unlike most long-term health insurance plans, Medicare provides coverage for most medically necessary procedures.
Medicare is backed by both the federal government and the states. For those who qualify, Medicare coverage is usually comprehensive, meaning that you can see your doctor, get prescription drugs, receive inpatient hospital treatment, and get outpatient medical care without worrying about whether you will qualify for a supplemental policy at the same time. However, most people do not qualify for Medicare. The majority of the more than 51 million Americans currently enrolled in Medicare are over the age of 65.
Medicare provides benefits to people whose incomes are above a certain level. Medicare part A is the standard type of health insurance plan and covers the usual range of costs that are common in most insurance plans. Medicare part B is usually supplemental insurance, especially if you have a high medical bill.
Both Medicare Part B, in some cases, covers certain types of procedures. Those policies are called “mandatory coverage” policies and they apply to a particular procedure or group of procedures. When you get your supplement, it will include all mandatory coverage procedures, unless you pay a different premium for those services.
Medicare also pays for the doctor’s services, such as laboratory tests and x-rays. Because there is a limit on the amount of services you can receive under Medicare, it is important to understand how you can qualify for additional services. If you have been diagnosed with cancer or a certain disorder and need follow-up treatments, these services are usually not covered by your Medicare Part B insurance plan.
If you are receiving supplemental insurance through Medicare Part B, then your doctor’s office must be a participating provider of that plan. If you are in private practice, your office may still be a participating provider; however, you cannot bill Medicare for services provided in the office. Otherwise, you must bill a third party agency, called a “network” agency, for all Medicare service that is provided.
If you are taking Medicare, you are not allowed to accept any money for services you do not provide. Although, most people do not know this provision in their Humana Medicare Supplement policy. For example, if you provide a free drug counseling program, you can accept a reimbursement from Medicare, but you cannot accept money from a third party for services rendered.
Medicare does not pay for an office visit when your doctor is performing a medical procedure on you, although it may pay if it is being performed on a referral or if you are a hospital or medical facility. Also, Medicare pays if your doctor bills a third party agency for services you provided, even if they are not covered by Medicare.
If you take a Medicare supplement, your supplement is considered an optional benefit by Medicare. Therefore, if you are in a low income group and Medicare does not offer you a supplemental plan, your Medicare benefits may not be sufficient to cover all your health care needs. Your physician can help you determine if you are in this situation. You can choose to have Medicare cover part of your health care services. If you have an active supplemental policy, then you are usually able to elect to add on to the coverage by adding a second type of insurance policy.
When you add on a supplemental insurance policy, your Medicare benefits will depend on what the second policy covers. For example, if you decide to add on a health savings account (HSA) or high-deductible insurance plan, you are paying for your new coverage in the form of deductibles and monthly premiums. In order to make sure you are fully covered, contact your HSA or high-deductible insurance provider to review the annual limits of each coverage.
Just like any other insurance plan, Medicare benefits depend on the level of the policy and the deductible on the policy. Most people in the supplemental insurance category will have a deductible for some or all of their Medicare benefits, but a relatively low deductible; however, if you are self-employed and do not have supplemental insurance, you may have a higher deductible because of the risks you are taking. Interested in Humana Medicare Supplement?