The meaning of the Medicare Supplement and its benefits

Medicare Supplement is a kind of health insurance which provides part C coverage. All supplement plans are paid for health-related issue on a monthly basis or fee for services (FFS) for unmanaged services. Let discuss what Medicare Supplement is. Most plans for Medicare supplement are HMO (health maintenance organization) and PPO (preferred provider organization). Part A, B, C, D all four parts of Medicare is controlled by private companies under the CMS (Centers for Medicare and Medicaid services) contract. Almost all are insurance companies except part C plans are controlled by nonprofit charities and health delivery system under state laws or religious management or union.

Part A provides payment of skilled or trained nursing service to the patient in the hospital. Part B provides payment of surgical services, physician, x-ray services, and diagnostic tests. Part C is not only covered by A and B, it provides also dental and vision, hearing and many wellness benefits. Part D is covered with a prescription drug benefit plan.

To find out more about these plans visit https://www.medisupps.com/medicare-supplement-plans-2019/

 Capitation

The person who enrolled in part C can pay a set amount for health plan every month which driven by government management benchmark that uses in FFS cost from past year as a beginning point to determine benchmark.

Benefits

Medicare Supplement plan is needed to offer benefits package as original Medicare and covered everything medicare cover. The plan which accepts quality-based payment or rebates needed to utilize the money to give benefits not covered by traditional Medicare.

Provider network

The beneficiary can choose PCP (primary care physician) to provide referrals. If the referred patient does not avail from an in-network provider and the plans pay for the patient services at an out of network location but charge in-network rates, the necessary services are covered by the plan.

Competition

Insurance companies are participating for providing higher quality care via plans at similar or lower cost.

Rating system

MA (medicare supplement) has the five-star quality rating system on a scale of 1-5.MA and PDP are rated separately.

Bottom line

It is common that people are working after joining Medicare at the age 65 and use both original Medicare and employer sponsor insurance. Sicker and higher expenditure people switch from medicare supplement to original Medicare. It is very difficult to generalize the result of crossing that all plans participate in the program but quality performance and access metrics are different among the dozen providers of medicare supplement plan.