Although Original Medicare is the normal minimum coverage that most seniors live with it is not the end of the options available.
Seniors who only have Parts A and B may only have them and nothing else because of many reasons:
- Other options too expensive
- Lack of knowledge or understanding of options
- Unavailability of some of the options in some states or counties
- In some cases having too poor health
The information I'll be presenting here, at first, will be a general overview and identification of the various options. The combinations that can be put together of Parts A and B and the other options are many and can be very confusing.
Add to that the numerous election periods for first enrolling in and subsequently making changes to due to such circumstances as:
- Changes in living conditions,
- Changes in health,
- Financial considerations,
All of the options are provided through private insurance companies that follow guidelines and meet requirements set forth by CMS, the same government organization that controls Original Medicare. CMS is very strict in what the insurance companies can or must offer in their policies and how they can be marketed.
Brokers and agents who work with or directly for these insurance companies must be licensed in the state(s) they market in and must be certified by taking specific courses and committing to rules and regulations required by CMS. This is a highly regulated industry which may at times seem very confusing and require you to meet strict requirements and eligibility as well as follow precise steps to apply for the policies.
Since these policies are provided by private insurance companies they can make their own decisions as to:
- Where they want to offer policies
- What kind of resources (hospitals, doctors, labs, etc.) they can use to supply services
- What kind of pricing programs they can use
- What kind of underwriting they will use (when allowed)
- What drugs they will cover and at what cost
- Even when they want to discontinue coverages
My next posting will actually name all of these options, so stay tuned.