Medicare Supplement Plans Demystified

A Medicare Supplement Plan, also called Medigap, is insurance provided by private insurance companies for a monthly/annual cost and is intended to cover costs not covered under Part A or B. Medicare Part B usually covers 80% of doctor visits and related costs. A Supplement Plan usually covers the some or all of the balance.

Currently we offer plans from Aetna, Humana, Wellcare and UnitedHealthcare®.

The first type of service that Medicare covers are those services from doctors that are considered medically necessary like office visits to diagnose illnesses and follow ups.  This includes any services or supplies that are needed during your diagnosis phase or to treat your medical condition that is regarded as meeting accepted standards of medical practice. 

The second type is Preventive services including vaccines to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

Depending upon the "Alphabet Letter" Medigap policy you choose, you pay nothing for most preventive services if you get your services from a health care provider who accepts Medicare assignment. Accepting assignment means that the provider will wait to be paid from Medicare directly. With Traditional Medicare there are no networks and you may see any provider or specialist that accepts Medicare without a referral.

If you become confused or are unsure of which plan would be best for you, someone at the Buckley Agency will calmly guide you through your choices to help you choose your best plan. We believe your money is better left in your pocket than the insurance company. 

Certain specialists may choose not to accept Medicare assignment. When this is the case these specialists are legally allowed to charge up to 115% of Medicare approved rates for their services. It is best to check with the medical professional's staff when making your appointment.

Part B covers things like:

  • Clinical research
  • Ambulance services
  • Durable medical equipment (DME) like a CPAP machine or oxygen.
  • Mental health Inpatient care which is treated like a hospital stay
  • Outpatient services like ambulatory services
  • Partial hospitalization sometimes known as Observation
  • Limited outpatient prescription drugs

If you are unsure of what might be covered you may call Medicare directly at (800) 633-4227, your healthcare professional or call us at (201) 357-0547. 

At the Buckley Agency: Insurance Is Demystified

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