Medicare supplemental was not intended to replace a person’s original Medicare coverage. While there are plans that go above and beyond what the government will sponsor in Medicare Parts A, B, and D, these plans are usually run by HMOs and are called Medicare advantage plans. A person with an advantage plan does not need a supplemental plan under most circumstance. The same is also true for a person who qualifies for Medicaid who is over 65 or someone who gets enrolled in the Federal Employee Health Benefits program.
A Medicare supplemental plan, as the name suggests, exists to fill holes in coverage. The overall goal is to bring a senior citizen’s out-of-pocket health insurance costs down to a level where he can easily afford to pay it. Even though Medicare Parts A and B cover a wide ranger of services, there are tests and procedures that may require a person to pay for them without insurance coverage. Ideally, when this occurs, his Medicare supplemental plan can save him from excessive out-of-pocket costs. While all this is good, there is another reason these plans do not replace a person’s coverage under Medicare itself.
The second reason these plans don’t replace Medicare is that a company can only sell them to Medicare recipients. They do nothing for a person who cannot present a Medicare insurance card or proof of this type of coverage to a doctor or a hospital. If a patient presents a Medicare supplemental insurance card, the staff at a hospital or a doctor’s office may not know what to do with this information. If the medical billing personnel know that Medicare does not cover a necessary procedure, they may accept the supplemental card for billing information.