Guide to Health Insurance (Medicare)

SOME BASIC THINGS YOU SHOULD KNOW

This booklet will give you a better understanding of your Medicare benefits, identify the gaps in your Medicare coverage, and provide tips on shopping for private health insurance to fill those gaps. As a Medicare beneficiary, you probably are already aware that Medicare does not cover all of your potential health care costs. For example, you are responsible for Medicare's deductibles and coinsurance and for charges for services not covered by Medicare.

Few people can afford to pay all of those expenses out of their own funds, so many rely on supplemental insurance to cover some of the costs. As you seek to limit your out-of-pocket costs for health care services, you will find that there are three basic ways of doing so:

1. Through the purchase of Medicare supplement insurance, which is also called "Medigap" or "MedSup" insurance;
2. By enrolling in a managed care plan, such as a health maintenance organization (HMO) that has a contract to serve Medicare beneficiaries; and,
3. By continuing coverage under an employer-provided health insurance policy, if you are eligible for such protection. In addition, for beneficiaries who qualify, some costs may be covered by state Medicaid programs.

Insurance Counseling

You first may want to turn to your state government for help, as all states now offer insurance counseling in one-on-one confidential sessions with trained counselors. In these sessions, you will be able to clarify insurance issues that you find confusing and receive assistance in evaluating your insurance needs. These services are provided at no charge to you.

The telephone number for your state insurance counseling office is listed in the directory of state insurance departments and agencies later.