Our advice is to stick to traditional health insurance with medigap plans as you wish
Since 1965, the original Medicare program has brought health and economic security to millions of elderly and disabled people as well as their families. Before that time, half of Americans aged 65 or over had no health insurance. Since 1972, Medicare has also supported disabled people.
The original health insurance program alone pays most of the health care received by around thirty-four million elderly people and approximately eight million people with disabilities. Program expenses have soared in recent years as health care costs have increased more quickly than most other segments in the economy, while progress in the medical sciences have extended the lives of many of those who receive medication.
Original-maladie insurance has two main parts:
1) Medicare leaves without a monthly bonus, covers the hospital and palliative care for hospitalized patients, as well as short stays in rehabilitation establishments. Participants must pay deductible fees of $ 1,676 for each 60 -day care period in a hospital or qualified nursing establishment. For longer hospitalizations, the coastal fees are $ 419 for days 61 to 90, then $ 838 for days 61 to 90. For beneficiaries in qualified nursing facilities, the co -assurance charge for 21st days to 100 is $ 209.50. There is no limit to the number of service periods in one year.
2) Medicare Part B covers the services received in doctors’ offices and ambulatory circles. This part also pays for medical equipment such as walkers, wheelchairs, oxygen tanks, etc. About a quarter of the costs of this part of the program come from the $ 185 monthly bonus from the participants selected by the checks of social security services for most people and an additional premium retained by richer participants. Cossurance represents 20% of the amount approved by health insurance for most services after the end of the franchise. This means that for most services covered, you will pay 20% of the cost, and Medicare will pay the remaining 80%.
Medicare supplements
The elderly should consider extending health insurance coverage at the basic health insurance policy, with an additional Medicare insurance scheme, also called “medigap” plan. These plans were placed under federal surveillance in 1980. They were health insurance policies sold by private insurance companies to fill the “gaps” of the original health insurance coverage. They can help provide precious protection against thousands of dollars in medical costs that are not covered by Medicare. If you have original health insurance with a medigap plan, the two plans will pay all the covered health costs. Without a medigap plan to help pay the invoices not paid by Medicare, its health costs on foot could be substantial.
Medigap plans offer the freedom to choose all doctors, hospitals and specialists who accept health insurance, and without limiting specific networks of practitioners. So if a doctor or a hospital takes medication (most do it), he will accept all Medigap plans. All standard medigap plans are written in accordance with federal and state laws; Thus, they must be clearly identified as “the assurance of the Medicare supplements” and must have all the specific advantages which allow an easy comparison. Currently, there are ten different plans approved by the federal government to choose, each with a separate set of basic and additional advantages. These ten plans are literate (a to n) and there are two versions of the ten: F and G, with “high franchise” options. You must compare all the plans of literate medigaps because the costs can vary, but all must provide the same standard coverage. Each insurance company decides which medigap plans that it sells and establishes its own prices. Insurance companies can charge different premiums for the same Medigap coverage. However, due to intense competition, premiums are similar. In order to determine the locations for the best choices, go to the Medicare.gov website and use the Medigap Finder tool to compare and choose a policy. Enter your postal code in the Medicare research tool to see which Medigap policies are offered in your state.
The G plan (high and low deductible versions) are the most popular and will be discussed below:
MEDIGAP G plan, Low franchise: Plan G covers all Medicare gaps, with the exception of the annual franchise of part B, which represents only $ 257 in 2025. This includes all the charges of health insurance and part B of part B, palliative care expenses, expenses for the first three blood pints.
MEDIGAP G PLAN High founder: everything listed in the preceding low deductibility coverage is the same, except that the coverage does not start as long as the participant has paid the higher franchise ($ 2875) ($ 2875) for the covered services. The residential place makes a difference: the popular medigap plan G high deductibility plans are not available in each state, and premium prices may vary considerably from state to state and even between regions of a state. We can also consider the different literacy plans which can minimize the costs of health insurance.
In Florida, all Medigap plans are acceptable and subscribed to the age issued by all insurance companies. This means that its premiums can only increase due to the increase in health care costs for all policies of the same plan. Once accepted, bonuses will not increase due to age. However, when changing insurance companies, a premium adjusted at the applicant’s current age should be expected from the new insurance company. Plan G is acceptable in Florida and is considered a popular choice for new registrants because of its full coverage.
Prescription medication plans
Medicare Share D, introduced for the first time in 2010, is the category of prescription medication regimes (PDP) for autonomous health insurance plans which are available for people eligible for Medicare, Part A and / or Part B. These are voluntary programs offered by private insurance companies and approved by the federal government. They help the beneficiaries of Medicare to cover the cost of their drugs. The monthly bonuses go in $ 44 to $ 44 to $ 124 per person, but vary because the plans offer more or less coverage. If a PDP is not purchased when you are eligible, the premiums will be higher. In 2025, Medicare started to have a $ 2,000 ceiling, and after reaching this ceiling, all the drugs are covered for the rest of the year with only copaiaments or coasturance for each prescription. You can obtain a coverage of part of either through an autonomous plan (prescription drug plan or PDP), or within the framework of a Medicare Advantage plan. Part D is voluntary, which means that you do not have to register, but it is highly recommended if you take prescription drugs. The PDP is obtained from a private insurance company for a monthly premium, with copaiaments or coasturance for each prescription. The monthly costs for this plan depends on the selected plan. Most plans have a franchise that must be respected before the plan begins to pay for medicines. Once the franchise is reached, you will pay a copyization (a fixed amount, like $ 10) or the coastrance (a percentage of the cost of the medication) when the prescription is filled.
Maladie Insurance Advantage Plans
Medicare leaves it is the Medicare Advantage plan (MAP) which was introduced for the first time in 2003. It brings together your doctor, your hospital and most often the coverage of prescription drugs, as well as an additional coverage such as vision, hearing, dental and / or health and well-being programs, in a practical plan but without complete medigap coverage. Thus, the practical card plan covers less than the combination of Medicare, Medigap and a PDP plan. Because the cards seem to be all inclusive and have lower monthly bonuses, they seem quite attractive. For those who already have, or who are eligible, Medicare, many envisage these “Medicare admits” plans very touted. Too often, a patient is confused and thinks that he has a medication after registering for an Advantage Medicare plan. In reality, its processing options can be limited because in fact, they do not have complete health insurance, medigap and pdp, which is not the same. Once a person has signed up for a Medicare Plan Advantage, $ 185 is retained from their social security service check and handed over to a private insurance company as payment of their guard. We can expect the private insurance company to try to maximize profits. They often have networks of restricted suppliers, which means that patients cannot access care from a specific group of doctors of the plan network, which potentially limits their choice of doctors and health systems compared to traditional health insurance. Thus, the rationing of care or the refusal of certain services is more likely to occur.
Insurance companies, as we all know, earn more money when they do not pay complaints. So, unless things change, traditional health insurance is stable, healthy and effective. This means that 98% of dollars in the system go to pay for the care of medical care providers – doctors, hospitals and pharmacies. None of the benefits of the Dollars Medicare Back.
Our advice is to stick to traditional health insurance with medigap plans as you wish.
A person can go from a Medicare plan to a medication plan with a medigap policy, but only during certain periods. To go from a Medicare Advantage plan to Medigap, you must first unsubscribe from the Advantage Medicare Plan and return to home insurance. Then, a medigap policy can be purchased within specific deadlines.
Conclusion
The health insurance options for the elderly discussed in this article provide a centralized and unique model which could be used for future coverage of the entire population. Such a model could also be used to control the overall costs of health care, by placing it in accordance with other advanced Western countries.
Morton Tavel, MD, of Fort Myers is a professor of emeritus clinic, Indiana University School of Medicine; Paul F. Nolan, CPA / PFS, CSA, CFE, is a former FBI agent and wealth manager.