This information is provided as general information about Medicare.  For specific detailed information, please visit the official U.S. Government website for Medicare, www.Medicare.gov.

Medicare is a federal health insurance program for people 65 or older. Some people under 65 with disabilities, and people with end-stage renal disease or Lou Gehrig’s disease may also be eligible for Medicare. If you are on Medicare, it will pay for much – but not all – of your health care.

There may be gaps between what Medicare pays and what you must pay for out-of-pocket for deductibles, coinsurance, and copayments.  Medicare supplement insurance fills the “gaps” between Medicare benefits and what you must pay. It is often called Medigap insurance. Medigap policies are sold by private insurance companies that are licensed and regulated by the Illinois Department of Insurance. Medigap policies only pay for services that Medicare deems as medically necessary, and payments are generally based on the Medicare-approved charge. Some plans offer benefits that Medicare doesn’t, such as emergency care while in a foreign country.

There are 10 standardized Medicare supplement insurance plans, labeled “A” through “N.” Each plan offers a different combination of benefits. Each insurance company must use these same identifying letters. All companies that sell Medigap insurance must offer Plan A, but do not have to offer the other 9 plans. In 2010, plans E, H, I & J were discontinued, meaning no NEW plans will be sold. Those individuals holding these plans may continue to do so, as long as they continue to pay the premium. The 2016 policies are plans A, B, C, D, F, G, K, L, M, & N. Additionally, all policies sold after June 1, 2010 must offer Hospice coverage; while preventive services and in-home recovery benefits are no longer sold.

Not everyone needs a Medicare supplement policy. If you have certain other types of health coverage, the gaps in your Medicare coverage may already be covered. You probably don’t need Medicare supplement insurance if:

• you belong to a Medicare Advantage plan (sometimes known as replacement Medicare plan)
• Medicaid or the Qualified Medicare Beneficiary (QMB) Program pays your Medicare premiums and other out-of-pocket costs

The best time to buy a Medigap policy is during your Medicare open enrollment period because companies must sell you any plan they offer without regard to pre-existing conditions. Consider your needs. Although it is illegal to sell you more than one Medigap policy, insurers may offer other policies with benefits that may overlap Medigap coverage. These include cancer, specified disease, hospital indemnity, and long-term care policies. Any duplication of benefits must be disclosed in writing. In general, duplicate coverage wastes money because you are paying twice for the same coverage.

Also look into Medicare prescription drug coverage. Medicare Part D can help you pay your prescription drug costs. There are exclusions for certain drugs, however, and Medicare Part D won’t pay for drugs covered by Medicare parts A or B. Medicare Part D plans are offered by private insurers approved by the Centers for Medicare and Medicaid Services. Coverage is not automatic. If you want it, you must select a Medicare-approved prescription drug plan and enroll in it. You are eligible if you have Medicare Part A or Part B. Part D enrollment may be limited at certain times of the year.

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