Illegal Medigap proceedings

It is acutely important to understand the different acts that might be considered illegal under law and practice. It is essential for self-protection and of others to know these activities so as to avoid them and in the case noted could be notified to the respective authorities. It is a matter of the future and health.

Here are ten Medigap practices that can be labeled as illegal:

  • If any insurance company or any agent of an insurance company pressures’ anyone to buy a Medicare advantage plan or has lied to make a person switch from one policy to another.
  • If any insurance provider sells a second Medicare advantage plans when the person already has an existing policy. This is approved only under one condition that is if the person has stated in writing that they plan to cancel the existing policy.
  • There are other plans which are mutually exclusive to Medigap policies. Medicaid is one of those policies. Under certain circumstances only having Medicaid is allowed.
  • If the insurance policy providers try to sell Medicare advantage plans when there is already an existing Medicare Advantage (MA) plan. Medigap policy can be sold only if Medicare advantage package ends before the start of Medigap policy.
  • If any insurer claims that the Medigap is a part of the Medicare program. This is absolutely not true. It is not included in the Medicare program. Medigap is a separate health insurance provided by private insurance companies.
  • If any insurer claims that the Medicare Advantage program is a Medicare advantage plans. Both policies are different from each other and cannot be applied to at the same time.
  • Different states have the same policies but may have some extra benefits. Make sure that the policies sold by the insurance provider are legitimate and are available in the state. The policy can be cross-checked with the State Insurance Department.
  • It is also illegal to sell a Medicare advantage plan if the insured has stated that they want the original Medicare and a Medigap policy. A medicare advantage plan is different from the Medigap plan and the original Medicare plans.
  • Misuse of the following names, letters or symbols:
  • CMS – Centers for Medicare & Medicaid services
  • S. Department of Health & Human Services (HHS)
  • Social security

They cannot say that the Medicare advantage plans have been recommended by the Federal government and so on.

  • If the Medigap insurance agent claims to be a Medicare representative.

Find out more by visiting

Tips to choose a Medigap plan

Most people have Medicare plans already in place but as the years pass by they realize that there are gaps in the Insurance and there is a need to fill up the gaps. There are ten Medicare supplement plans – A, B, C-G, K, L, M, N. Plans C-G Include a specific set of basic benefits while plans A, B, K, L, M, and N have another set of basic benefits.

Most of the plans have the same basic benefits across states but Massachusetts, Minnesota and Wisconsin policies are standardized differently than the rest of the states. Here are a few tips to decide on the plan best suited for different individuals:

  1. Affordability of the Medicare supplement plans:

It’s essential to keep in mind all the plan costs that can be incurred, that is, the copayments, coinsurance, deductibles in relation to the medical services needed and compare it to the monthly budget. Most policies are priced so that the insured pays now which has the property of higher premium and lower copayments or payment is later which has a higher premium and lower copayments. The timing of payment can be taken into consideration.

  1. Price of the policy:  Find out at

There are different Medicare supplement plans. For example, community-related policies cost everyone the same regardless of the age of the insured. Issue age-related policies are priced according to the age of the insured at the time of buying the plan; the premium does not increase with age but might increase due to inflation and other factors. Attained-age rated policies are priced according to the age at the time of buying and may increase with age and also because of inflation and other factors.

  1. What is the health coverage needed?

Look at the health conditions and take into consideration any health issue that needs constant attention and is there any maintenance drug involved or will there be any future treatment in the near time and the expenses involved with it.

  1. Insurance companies with a good reputation:

Look for companies which have a reputation for good customer services and are known to pay the claims promptly. There are reviews online left by customers or people nearby may know if they already have one. There are also articles related to top plans that might help to decide the best plans.

Instead of looking at the Top rated Medicare supplement plans look for policies that might be good for you. Different people have different needs and the top-rated policies might not work the best for you.

How the Changes of Medicare Advantage Plans Transformed the Hospital System?

Every new change in the one part of a facility can possibly bring changes in other related parts. The Medicare advantage plans cover the hospital services in its coverage area. When the plans are changed they also changed the system of hospitals. This change is the basic need because of the requirements of the elderly patient that are under the age 65.

It will also change the patient’s average demographic that are consuming the hospital services and using the insurance policies for paying the hospital charges. It is determined in a survey in 1965 that the 2/3 patients were of the age 65 but the survey of 2010 displayed that in this year the ½ of the patients were of the age 65 years or more. In this article, we show you the various changes that the Medicare advantage plans bring in the hospital.

Get a quote for 2019 advantage plans at

Coordinated System:

The transformation brings the coordination between the different branches of the same name hospital. This will be helpful in handling a large number of the patient at the same time and can share the machine resources of high technology with each other.

medicare advantage plans for 2019

Decreased Number of Hospital Beds:

According to the survey, the number of the beds in the hospital is decreased up to 33 percent from the previous year of 1965. This is all because of the payments methods used by Medicare advantage plans. The Medicare plans prefer the outpatient costs instead of inpatient costs of hospital payments.

Change the Hospital Mission:

The most of the hospitals are working as charity and they do not work for having profit. Their mission is to serve the humanity whenever they require any help related to health.

Less Hospital Stays:

From the time 1965, the average hospital stay rate is decreased to a great extent. This is achieved by providing the outpatient treatment and the use of inpatient treatments is lower than the outpatient services.

More Benefits in Less Cost:

The old age patient is serviced better in the hospital even from the previous time. The patient with a chronic health condition that needs more care is served better by the hospital staff. The changing condition provides the more services in a few your cost.


After looking at the above changes we can see the modifications in the hospital system are making the hospitals more useful for the patient. You can get your desired treatment under complete hospital care and in the use of less reimbursement that will save your health and money together.  This is all because of the  new Medicare advantage plans.


4- Types of Medicare Advantage Plans you should know

Medicare advantage plan is also known as Medicare Part C Plan. It is provided by private insurance companies that are approved by Medicare. Original Medicare plans do not cover all medical expenses. You may also consider Medicare Supplement Plans 2019.  You might need a more advanced plan to cater for extra services that the original Medicare doesn’t provide. Medicare advantage caters for extra services like dentures, optical, hearing checkups and even foot examinations.

Medicare Advantage plan comes in six different types. The main different is with the functionality and amount of premium that come with each type. Let’s find out.


Health Maintenance Organization plan (HMO)

If you have this type of Medicare Advantage plan, you will receive medical services from hospitals and doctors that are on Medicare network except for different cases. You are allowed to have referrals from your primary doctor. The only exception are on emergency cases, when you’re on out-of –area and need an urgent care or you’re out-of-area and you need emergency dialysis.

HMO covers Prescription drugs in most cases but you will have to talk to your care provider to be sure. In case your primary doctor leaves the plan you will be notified to choose another doctor within the plan. If you sought medical services anywhere else, you are likely to pay all medical costs on your own.

Preferred Provider Organization plan (PPO)

If you have this type of plan, you are allowed to receive medical services from hospitals and care givers outside Medicare Network. However, you will pay less if you use hospitals and care givers who are on Medicare Network. This means that if you use the services of the hospitals and doctors out of Medicare Network you will pay more premiums.

If you need prescription drug to be catered for you should join PPO that has Part D in it. You cannot join Medicare Prescription Drug part C if your PPO doesn’t have an in-build part C.

Private Fees for Service plan (PFFS)

This plan doesn’t provide the original Medicare. PFFS determines the cost they shall pay and how much you hall pay for the same services. It is sort of cost sharing. You can get medical services from any doctor and hospital on PFFS Network.

You will not need to choose a primary doctor neither are you required to have a referral letter to visit other medical services on PFFS plan. You are allowed to apply for Part C plan for your drug prescription.

Special Needs Plans (SNPs)

This type is for members with special needs. You must get medical services to doctors and hospitals in the SNPs medical Networks except for emergencies. You must choose your primary doctor in this type. SNPs covers prescription drugs cost.

Apart from the above four types there are additional two special types namely, HMO Point of Service (HMOPOS) which allows you to get services from other hospitals and care givers at extra costs. The other one is Medical Savings Account Plan (MSA). This type combines your medical high deductibles with your bank such that some money will be credited to your bank account to cater for deductibles.

How To Apply For Medicare Insurance

In the United States, Medicare is a social insurance that is offered to all citizens above the age of sixty-five. It’s partially funded by the working population’s payroll taxes. Medicare insurance was enacted in 1965 by then-president Lyndon B. Johnson with former president Harry S. Truman became the program’s very first beneficiary. Those that want to apply for the program should be aware that only certain types of people will be eligible.

To apply for aarp medicare supplement plans 2019, one must be of a certain age. The insurance program was designed to provide elderly Americans with proper medical coverage. So to qualify, a person must be at least sixty-five years old. Younger applicants are approved on a case by case basis but must suffer from a disability or chronic disease. Certain other people may be eligible for their spouses.

Seniors above the age of sixty-five should be aware that if they are lately received the Social Security, they can receive Medicare Part A at no cost. The same goes for citizens who are under sixty-five, they are eligible for Medicare Part A if they are disabled and have been a recipient of Social Security for at least twenty four months.

To start the long enrollment process, call the Social Security Administration’s hotline number, visit their website, or visit one of their local offices. Through these outlets, interested parties will be able to obtain a little more information regarding Medicare and the enrollment forms.

When you start your application process, you will need to have your birth certificate, social security card, and driver’s license handy. If the documents themselves aren’t available then notarized copies will suffice. You will also be required to show proof of your other health insurance if you have any.

Although Medicare is an extremely useful and necessary program, there are some areas that it doesn’t cover. Those who are eligible for the benefits of Medicare but are concerned about certain ailments not being covered should invest in Medigap insurance. This Medigap program is available to everyone who qualifies for Medicare and will cover any gaps in the coverage that may occur.

In conclusion, Medicare is a social provided insurance which is available to people who are over a certain age or who are already enrolled in Social Security benefits. The enrollment process is a lengthy one in which a number of validated identification documents will be required.

How does Medicare Supplement Plans Insurance help Original Medicare

Traditional Medicare is referred to as the Original Medicare. It works on the basis of a fee for service. This means you can visit any hospital or doctor who is ready to accept your Medicare coverage in the United States. It implies that Medicare will pay for the bill that is considered Medicare-covered.


After the cover of Medicare-covered, you will have to bear for the rest, provided you have additional insurance covering those costs. The original Medicare offers health care supplies and services, but will not pay all the expenses.


Signing for Part A and B of Medicare means you are enrolled automatically in social security in Original Medicare. However, if you wish to get from a private Medicare Advantage plan, the care, such as PPO or HMO, you must enroll actively in a plan away from the original. Ensure it is available in your area.


You can also stay in original Medicare if it is your preference, but avail the coverage for prescription drug by enrolling a part D privately to get additional premium. You may buy the same from Medicare Supplement Plans that is a private supplemental insurance. It covers the costs out of pocket left out by the original program.


Medigap is known as Medicare supplement plans insurance. This is sold by private companies as A Medigap policy and it helps in paying the gaps, the health care costs not covered by the Original Medicare, such as Coinsurance and Medicare deductibles. There are some additional benefits with Medicare Supplement plans such as care on traveling outside the U.S. There is a six-month Medigap one-time open enrolment period starting from the first month you attain the age 65 and are also enrolled in Part B. This period assures the right to purchase Medigap policy, despite the status of your health, but ensure to buy that is sold in your state.


Having original Medicare and buying Medigap policy means that Medicare pays for Medicare-approved amount first to cover the costs of health care.  Later, the Medigap policy bears the covered benefits share. Each Medigap policy is expected to follow the state laws that protect you and should be identified clearly as Medicare Supplemental insurance. The Medigap is available by letters.

All Medicare Supplement plans provide the same benefits, though some have additional benefits.  However, the plans identified by a letter cover the same benefits, despite of the company selling it.

Compare different plans

A Clear view of Medicare Supplement Plans to choose as per the requirement

Choosing the right type of Medicare supplement plans option is required so that you are assured to receive the right coverage. Having Medicare plan options means you can feel free that your coverage will be received. Yet before enrolling it is good to compare the plans and its options or if comfortable speak to some agent who is licensed to get accurate details. This will certainly help in choosing a plan.

Find the Best supplement plans

Do you want to about Part B costs?

Medicare supplement plans are available in wide choices and so if your Part B deductible is an issue to be met, consider Plan F or C of the Medicare Supplement plans. It helps in paying the deductible of Part B, while the Plan F covers for your excess charge in Part B.  All the Medicare Supplement plans provide coverage for coinsurance and copayments Part B, while Plan K covers 50% and L &5%. Plan N covers mostly offers 100% cover, but there is an exception on copay for office visit for $20 or copay for emergency room $50 in some situations, in particular.


Are you looking for out-of-pocket plan limits so that you are protected even after spending?

The only choice is to go for Medicare Supplement Plans K or L.  This is because Plan K offers 100% cover after spending in 2017 $5,120. However, this year in 2018, the Plan L kicks with 100% coverage after spending $2,560 in 2017. However, bear in mind these two plans offer the least coverage amount before you reach the limit of out-of-pocket.


Do you need maximum coverage?

If you are looking for maximum coverage, Medicare Supplement Plans offer good options and one such is the Plan F. people using 66% Medicare may go for this plan as it provides comprehensive coverage for the plans. People get coverage to 100% with Plan F for all the benefits of Medicare Supplement except for the foreign emergency care. The Plan F is same as other Medigap plans such that it qualifies 80% of foreign expenses during emergency care.  There is the option of high-deductible known as Plan F+. The Plan F features payments of low premium, but gives no coverage until the deductible is met yearly.


Do you wish saving on premiums and also on the costs going out-of-pocket?

If yes, consider Plan G as this is the best Medicare Supplement Plans offering coverage, has monthly moderate premium, but for the deductible Part B costs.