Medicare is a federal government health care plan which all citizens 65 years of age or older are eligible to join. The basic plan that most people refer to when they talk about Medicare actually comes in two parts: Medicare Part A, and Medicare Part B. You may also hear them referred to as “Traditional” or “Original” Medicare. While both parts A and B are intended to cover most of your health care needs, there are sometimes gaps in the plan which may require additional coverage.

There are some basic costs associated with Original Medicare. Part B requires a monthly premium, regardless of your circumstances. Part A might require a premium also, but that depends largely on your employment history. If you have worked for at least ten (10) years or at least forty (40) quarters, Part A is free. If your employment history is shorter than that, you may have to pay an additional charges.

You’re practically guaranteed Medicare benefits if you apply within your specific window after turning 65 years old. Once you qualify, you will start receiving – and be required to pay a premium for – your Part A benefits. But you don’t have to accept Part B benefits (or pay for them) right away. In some situations, Part B maybe completely optional. But if you don’t accept Part B, you will have to find another way to pay for doctor visits, medical supplies, and outpatient treatment.

Medicare Part C is 100% optional. However, if you choose to accept Medicare Part C instead of Medicare Parts A & B, There are some benefits which you cannot opt out of. Medicare Part C plans automatically come with the exact same benefits that you would get from Original Medicare (Parts A & B). Aside from optional coverages like prescription drugs, dental, or vision, you cannot choose to accept fewer benefits than the base package. Similarly, if you decide to stick with Original Medicare and decide to add Part D coverage, you must also accept Part B benefits. You cannot have only Part A and Part D benefits at the same time.

Medicare Part A (Hospital Coverage)

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
Medicare Part B (Medical Insurance)

  • Services from doctors and health providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services
Medicare Part C (Medicare Advantage)

  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • Offered by Medicare-approved private insurance companies
  • May include extra benefits and services for an extra cost
Medicare Part D (Drug Coverage)

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies
  • May help lower your prescription drug costs and help protect against higher costs in the future

Delaware Medical Plans: A Breakdown

Within the state of Delaware, there are 157,289 residents currently enrolled in the Medicare benefits program. Of those, a meager 7% (11,010) of people have instead chosen a Medicare Advantage plan. However, 32,593 people – nearly three times the number of Medicare Advantage enrollees – have chosen to supplement their Medicare benefits with a Medigap policy instead. But these popular Medicare supplement policies are only protecting 27% of the Delaware population in total.

The remaining 73% are either relying on alternative sources for health care coverage, such as an employer plan, or risking their financial future by relying on Original Medicare by itself to cover their health care needs. Keep in mind that these numbers only represent seniors 65 and over who are currently enrolled in Medicare.

Delaware may be a relatively small state, but healthcare costs are far from diminutive – especially when it comes to senior care. Understandably, this becomes extremely problematic when you are no longer working and instead of getting by on a fixed income. Medicare benefits do a great job of helping seniors cut their healthcare costs down to a manageable level. But there are other supplements out there that can assist seniors like you even further.

The two most popular options for supplementing Medicare Parts A & B are either Medicare Part C, or a Medicare supplement insurance policy. Medicare Part C is also sometimes referred to as a Medicare Advantage plan; likewise, Medicare supplement insurance policies are also known as Medigap policies. Unfortunately, the confusion doesn’t end there.

We know what you might be thinking: why is it so important to get a Medicare health insurance supplement? Doesn’t Medicare cover all of my needs? Unfortunately, the answer to that question is no. There are some little-known gaps in both Part A and Part B coverage which can cost you thousands if you aren’t careful. That’s where Medicare supplements come in. They help share that burden with you so that your savings and finances are protected. If you have yet to enroll, click this link to learn more about Federal Medicare benefits.

If you are unfamiliar with Medicare supplements, you have come to the right place. It’s important to understand the distinction between these two types of coverage. For starters, Medicare Advantage is a private health insurance plan which you purchased from an independent company. Your health care will no longer be managed by the government. Medicare supplement plans, on the other hand, do not usurp Medicare; they simply add a little bit of private health insurance coverage onto your federal Medicare benefits. They work with the government, not in place of them.

How Important Are Medicare Supplement Policies?

Depending on your circumstances, they can be essential to managing your health care needs at the most affordable cost. If something unfortunate were to happen, such as an extended hospital stay or months of rehab from a physical injury, you might be required to pay some hefty out-of-pocket prices which Traditional Medicare won’t cover. Such as:

Medicare Part A Costs in 2022 Medicare Part B Costs in 2022
  • Part A is premium-free for most
  • Part A deductible is $1,556 per benefit period
  • Inpatient hospital stay days 61-90 is $389
  • The standard Part B premium is $170.10
  • The annual deductible for Part B is $233
  • Medicare pays 80%, you pay 20% out-of-pocket

For many, especially those who are well into their golden years and living on a fixed income, leaving their health care coverage to chance is a gamble they cannot afford to make. Obtaining supplemental health insurance helps protect them from the gaps in Medicare, and eases their worries. There are two main options for supplementing Medicare which we will get into presently: Medicare Advantage, and Medigap.

Medigap Coverage: Pros and Cons

Medigap is the shorthand term for Medicare Supplement plans. It’s a sort of nickname used to reflect the fact that these policies are designed to cover the “gaps” in Original Medicare. The federal government, with Medicare gaps in mind, has designed and continues to regulate these plans to work optimally with existing Medicare coverage options. The plans are organized alphabetically: A, B, C, D, F, G, K, L, M, and N. During the summer of 2010, plans E, H, I, and J were phased out of the program due to the Medicare Modernization act. By law, each plan provides the same benefits and coverages in every state; meaning that what you get for plan A in Delaware will be the same as California or Texas. The only difference will be in how much you pay for the policy.

Below is a handy chart which explains the benefits of each individual plan:

by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
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