How Can Private Health Plans Reduce My Medicare Benefits?



Private health care plans are a good option to help a person reduce his dependence on the Federal Government programs. Even though a person may want to increase his self-reliance rather than depend entirely on Medicare, he should be aware of the affects of having private insurance and what it means for his benefits. The amount of benefits a person gets depends on the coverage he gets from his private insurance company. The level of coverage and the type of coverage a person has determine whether or not the level of benefits a person receives get reduced.

Types of Private Coverage and Medicare Benefits

The most common type of private coverage a person with Medicare buys does not reduce the benefits he receives. The supplemental plans are designed to extend standard Medicare benefits and reduce a person’s out-of-pocket costs. Medigap plans often become the secondary payer in this case. Medicare Advantage Plans do not reduce Medicare benefits, either. Medicare Advantage Plans take the place of traditional Medicare coverage and include many of the same features that standard Medicare and a Medigap Policy would cover under most circumstances. Private insurance plans that do not fall into either of these categories follow a different set of rules.

Which Benefits Are Most Likely to Be Affected?

Medicare frequently assumes the role of secondary payer when a person has a good private insurance company. If the private plan has limited coverage, a beneficiary who qualifies for Medicare may decide to have the government payer take the primary role. Benefits only get reduced based on what the plan will and will not cover and how much the plan itself covers. Both the private insurance company a person deals with and the Social Security office can provide information about how private insurance can affect a person’s Medicare benefits.



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