If you live in Mississippi and you are approaching the age of 65, there’s good news: you will soon be eligible to enroll in Traditional Medicare (Medicare Parts A and B). In order to enroll, you must be 65 or older. Once you are enrolled, you will have access to health care benefits from the federal government. These benefits will cover you should you require a hospital stay, outpatient rehab, or even just a primary care doctor visit. The chart below clarifies which parts of Medicare cover what treatments and procedures.
Coverage and Benefits
For many US citizens, Part A is free of charge of your work history is at least 10 years long (or 40 quarters) in total. If you have worked less than that in your lifetime, there are certain fees and premiums you will have to pay before you will have access to Part A benefits. Part B has its own fees and premiums, but they are adjusted according to income, and designed to be as affordable as possible for seniors. Specific amounts can be found here.
As a resident of Mississippi, you have access to a range of Medicare coverage options. If you enroll in basic Medicare, you’ll be automatically enrolled in Medicare Part A coverage. This is basic hospital care, inpatient services and some home health care. If you enroll in Part B coverage, for an added cost, you’ll enjoy access to more outpatient care, home health services and better medical equipment and preventable services.
There are coverage options beyond Parts A and B available to patients in Mississippi though. Medicare Plan C, also known as Medicare Advantage is a private insurance coverage option that you can obtain if you have Parts A and B and you want additional services such as prescription coverage, dental and vision. Medicare Part D is another supplemental policy that can be added on after you have Medicare A and Medicare B. Part D prescription drug coverage will help cover the cost of any medications that you need. There are many different Medicare coverage plans and it’s important to understand them before you sign up for a specific policy.
|Medicare Part A (Hospital Coverage)
||Medicare Part B (Medical Insurance)
|Medicare Part C (Medicare Advantage)
||Medicare Part D (Drug Coverage)
What are the Most Popular Medicare Plans in Mississippi?
Mississippi has a fairly significant population of Medicare beneficiaries within the state – 516,809 to be precise. Of those, a modest 13% (or 67,185 people) prefer to get their benefits and coverage through a Medicare Advantage policy. A slightly larger faction, which makes up almost 24% of beneficiaries (or 122,608 recipients) prefer to supplement their government Medicare benefits with a Medigap policy. We will discuss both Medigap and Medicare Advantage later in this article. The remaining 325,589 Mississippi seniors are either leaving themselves vulnerable to the coverage gaps which plague Traditional Medicare, or they have another form of supplement coverage through an employer.
If you are enrolled in Medicare Parts A and B and worried about your coverage gaps, keep reading. If you are not enrolled in Medicare, click the link for more information on when and how to enroll.
Why Should Seniors Think About Supplementing their Medicare Coverage?
The short answer to that question is: to protect themselves from disastrous, unexpected medical expenses later on in life. As much as the Federal Medicare Program is designed to provide hard-working seniors with comprehensive medical care, there are certain “gaps” in coverage which, at the end of the day, you may be responsible paying for if you don’t have additional coverage. Some of those expenses include:
|Medicare Part A Costs||Medicare Part B Costs|
For a minimal additional expense each month, supplemental coverage (either in the form of a Medigap or a Medicare Advantage policy) can protect you from thousands and thousands in unanticipated medical bills. Many seniors believe that it is a small price to pay for that peace of mind and financial security.
Medical costs are increasing every single year in Mississippi, making it difficult for patients to get the high-quality care that they need. As the cost of quality health care increases, more and more residents have to search out different coverage options to help them deal with those costs.
That’s why patients are investing in supplemental health insurance. These special policies are designed to offer additional coverage beyond what you get from basic Medicare. If Medicare Parts A and B aren’t giving you all the coverage you need to get good medical care, a supplement plan could be just what you need to make your expenses a bit more bearable.
The right supplemental insurance policy helps with filling your Medicare coverage gaps. You’ll get help paying co-payments, and the portion of your medical costs that just isn’t covered by your basic Medicare policy. Of course, you will have to pay for this additional coverage, but for many patients in Mississippi the supplemental insurance premiums are lower than the amount of coverage that they provide.
If you decide you need extra coverage, there are two different options available to you worth considering. Medicare Advantage and a Medicare Supplement insurance, also known as Medigap. An Advantage plan is a bit more comprehensive and complicated. Medigap is simple, affordable and fills in the gaps of your standard Medicare coverage. Both options are worth considering, but the one that’s right for you depends on your specific medical situation, which is why it’s so important to understand the differences between the two policies well.
Top Choices: Medicare Supplement Insurance (Medigap)
Medicare supplement insurance, also sometimes referred to as a “Medigap” policy, helps you cover the gaps in Traditional Medicare coverage without forcing you to give up any of your current benefits or making you switch networks. The available plans are labeled alphabetically A-N (with the exception of plans E, H, I, and J, which were discontinued as of 2010). The private insurance companies who sell Medigap policies work together with the federal government to make sure that each plan is as comprehensive as possible, while still offering it to seniors like you at an affordable rate. By law, Plan D in Mississippi offers the same benefits as Plan D in Texas or New York. Therefore, you only have to worry about price and provider when you shop around for a supplement.
Below is a Medigap policy comparison chart showing what each plan covers:
Top Choices: Medicare Advantage (Medicare Part C)
Another way you can cover the gaps in Original Medicare is to replace your government-sponsored benefits with a Medicare Advantage policy. These are special health insurance policies which are, by law, required to give you the same or more benefits than those available in Medicare Parts A and B. Once you purchase an Advantage policy, the federal government will no longer be responsible for managing your coverage or paying out claims – that responsibility will fall to whichever private company you choose. Some providers even try to offer additional coverage options, like dental, and a small additional price in order to bring in customers.
There is something to be said for having all of your Medicare benefits and additional coverages under a single, simple policy. And, in some markets, Medicare Advantage policies are priced very competitively. But this is mostly due to their restrictive networks. By limiting the number of doctors and hospitals you can go to, the insurance company saves money and (in theory) passes the savings along to their customers. For many seniors, however, taking on an insurance policy with a restrictive network will force them to switch doctors. And that is not a process most people feel comfortable with.
If you do decide to go with a Medicare Advantage plan, you will receive medical care from one of two sources. You will either sign up for a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO) plan.
Medigap Supplements vs. Medicare Advantage: Clearing the Confusion
Medicare Advantage and Medigap are two very different policies. The first difference is how medical costs are handled by these insurances. Medicare Advantage pays its portion of your medical costs after letting Medicare cover the first bit of your costs. If you have a comprehensive Medigap policy you may not get a bill at all.
Even though both Medicare Supplement and Medicare Advantage are handled by private insurance companies, they handled differently from one another. Medigap is a standardized program that offers the same benefits across all states and across insurance companies. You know what coverage you’re going to get regardless of who you deal with, and Medicare is allowed to function like it always does. The only change you can experience is in your monthly premium amount depending on your location and the total coverage that you get.
Advantage plans are more complicated and come with variable coverage options. These policies are handled entirely by a private insurance company, and the plans even take over standard Parts A and B coverage from Medicare itself. When you have an Advantage plan you get the basic coverage options, and you can add on additional coverage such as for prescription drugs, dental, vision and other items. These all come with an added cost, but you’re able to get the coverage that you need with Medicare Advantage.
Pricing between the two policies works very differently as well. With your Medigap plan you just have a monthly premium and then you pay health costs that are left after your coverage pays its portion. With Medicare Advantage you have more variable costs. You will be expected to pay adjusted amounts each month, and even your premium can change if your insurer decides to adjust the rates. You will need more money saved up to cover unexpected costs with an Advantage policy.
Those are the basic differences between Medicare Supplement plans and Medicare Advantage plans, but there are other differences to be aware of as well. That’s why we put together a table filled with common questions and answers for each of the two policies. Read through it to learn more about how they work. If you would like to get additional questions answered, or you want to shop a policy for yourself, call one of our representatives and we would be happy to help you figure out which policy is going to work best for your lifestyle.
|Questions||Medicare Advantage||Medicare Supplement|
|How does this policy cover my expenses?||Your private insurer creates a set of premiums and expected co-payment amounts based on estimates of healthcare costs in your part of Mississippi. Medicare pays a portion of those costs for you and you’re expected to pay the remaining premiums and co-payments yourself.||You get a set premium each month depending on your location in Mississippi and the policy you choose. You are expected to cover any medical costs that your Medigap plan doesn’t cover.|
|Am I expected to pay for Part B with this policy?||Yes||Yes|
|What can I expect to pay for this policy?||Medicare Advantage plans are large and complicated. There are lots of different medical costs, co-payments and premiums for you to think about. This makes it difficult to pinpoint an exact cost for each plan type. The more often you need care, the more you will pay.||With a Medicare Supplement plan you pay a set premium every month. You also pay any remaining medical cost after your plan covers its portion.|
|What coverage do I get with this?||You receive the coverage from Medicare A and Medicare B and then you get custom coverage based on the plan options that you choose. You can stick with the basics or add on things like prescription drug coverage, vision coverage and dental.||You get the same exact coverage that Medicare offers you. You just get additional help paying the remaining medical costs after Medicare pays its portion. A comprehensive plan will cover all the remaining costs but has the highest premium.|
|Will my health care costs be easy to budget with this?||Advantage plans are unpredictable and difficult to budget for. You’ll want more money saved up to handle unexpected costs with this policy.||Medigap policies come with a set premium amount each month making them easy to budget for. If you don’t have a comprehensive plan like Medicare F, you will be left with medical costs to pay after your coverage kicks in though.|
|Am I guaranteed to be able to keep my plan?||No, there is a chance that you can lose your policy during the renewal period for an Advantage plan. Insurers have the right to kick you off.||Yes, provided your insurer doesn’t go bankrupt and you make your payments you can’t be kicked off a Supplemental policy.|
|Is there a pre-approval process I should know about?||Yes, you will likely be required to go through a pre-approval process and could be rejected from getting an Advantage plan.||No, as long as you qualify for a Medicare policy, you qualify for a Medicare Supplement plan as well.|
|Do I have to use a set network of doctors and hospitals with this policy?||Yes, most Advantage plans have doctor and hospital restrictions. You will be expected to stick with a set network of providers. You could still have extensive options if you live in an urban area though.||No, a Medicare Supplement plan is accepted anywhere that Medicare is.|
|Which policy is the right option for me specifically?||An Advantage plan might be more affordable for you if you have few medical problems and you live in an area with many doctor and hospital options to choose from such as a city.||Medigap is likely best if you live in a rural area with few options, or you require frequent medical needs.|
Helpful Medicare Contacts in Mississippi
For your reference, we’ve included a searchable directory on this page. With it, you can find local Medicare offices and get in touch with Medicare experts near you. Feel free to ask them all the questions you want. Their job is to help you get the coverage you need.
Helpful Medicare-Related Healthcare Definitions:
HMO: Health Maintenance Organization, this refers to a network of doctors and hospitals with a plans’ network.
PPO: Preferred Provider Organization, this refers to a network of doctors and hospitals with a plans’ network.
Co-Pay: Amount of money charged per visit to doctor, specialist, etc.
Co-Insurance: A percentage required by the policyholder to pay out-of-pocket. For example, 80/20 coinsurance means the insurance company will cover 80% of the charges, and the policyholder pays the remaining 20% of the charges.
Deductible: This is the amount of money required out-of-pocket by the policyholder before the insurance will kick-in and pay for any remaining charges. For example, a policy with a $1,000 deductible means that you must pay full healthcare costs out-of-pocket up to $1,000 before the plan will start coverage.