Medicare coverage is good, but it is not all-inclusive. There are many things that Medicare does not cover. For example, Medicare does not cover most dental, vision and hearing care, including hearing aids. Nor does it cover most non-emergency transportation or care outside of our country. Even when Medicare covers your care, there may be costs left to you, like copays and coinsurances—these costs can add up. An example, for an outpatient visit to a physician who accepts the assigned billing rates under Medicare, you will be responsible for twenty percent of the cost. Today I will discuss ways to add on to your Medicare to help you manages the cost of these types of care.
Consider Medicare Supplemental Insurance (Medigap)
Medicare Supplement Insurance is also known as Medigap coverage, which is a health insurance policy sold by a private insurance company offering standardized benefits to work with Original Medicare (your inpatient and outpatient medical coverage). If you have a Medigap, it pays part of, most or all the remaining cost after Original Medicare pays first. Medigaps may cover deductibles, coinsurance and copayments. Medigaps may also cover health care costs that Medicare does not cover at all, such as a portion of the cost of emergency care when travelling outside of our United States.
In partnership with our office, the State of Alaska’s Division of Insurance annually publishes a Consumer Guide, which you may find online at https://health.alaska.gov/dsds/Pages/medicare/medicaresup.aspx. Or our office can provide a printed copy. This booklet helps to provide an overview and a comparison between plans as offered by the companies approved to offer these plans to Alaskans.
Here in Alaska, you may purchase a Medigap policy from an insurance company at any time of the year, however, during the first six months after your Part B (outpatient) coverage begins, you have a guarantee right to purchase a policy without any disqualifying medical conditions. There also may be special conditions or periods during which you may also qualify for this guarantee right, as explained in the Consumer Guide. After narrowing down the choices for a Medigap policy which meets your needs and your budget, you should contact the insurance company directly to enroll.
Other options to consider
Once enrolled into Medicare, there may be other options to consider. For individuals with low income and few assets, the State of Alaska manages our Medicaid program, which in Alaska also is known as DenaliCare. Recognized as the “payer of last resort”, Medicaid may cover dental, vision, hearing, long-term care and/or transportation services. You can also find low-cost care for services not covered by Medicare, in places known as Federally Qualified Health Centers, such as the Sunshine Community Health Center in the upper Matanuska Valley, or Community Health Centers, such as the Anchorage Neighborhood Health Center.
You may also be able to obtain “standalone” insurance policies which offer dental, hearing or vision plans. Alternatively, your provider may offer a lower cost, discount option if you pay by cash. You might also contact local medical facilities to ask if they offer dental clinics, how you can become a patient there, which services they offer and at what cost, and if payment plans are available. Other options exist. An example in obtaining low-cost care is offered at the dental clinic in the University of Alaska Anchorage. Students work with patients under the supervision of experienced, licensed providers.
To discuss any Medicare bill payment concerns, or to ask any questions regarding your specific situation, please contact the State of Alaska Medicare Information Office at 800-478-6065 or 907-269-3680. Our office is also known as the State Health Insurance Assistance Program (SHIP), the Senior Medicare Patrol (SMP), and the Medicare Improvements for Patients and Providers Act (MIPPA) program.
If you are part of an agency or organization that assists seniors with medical resources, consider networking with the Medicare Information Office. Call us to inquire about our new Ambassador program.
Sean McPhilamy is a volunteer and Certified Medicare Counselor for the Alaska Medicare Information Office.
