If I have Medicare or Medicaid, do I need to purchase additional policies to supplement it?

Updated: JULY 13, 2014 — 4:00 AM EDT

A reader asks if they need to purchase an additional policy to supplement Medicare or Medicaid.

by Robert Field, Ph.D., J.D., M.P.H., Professor, School of Law & Drexel School of Public Health

QUESTION: I was wondering what are people over 65 doing regarding picking plans to supplement Medicare and Medicaid. Can anyone suggest some plans that are good to fill in the gaps? What needs to be purchased to supplement Medicare and Medicaid? Thank you!

-Barbara

ANSWER: Medicaid coverage is quite comprehensive, and beneficiaries do not purchase additional policies to supplement it. Also, since Medicaid is intended for the poor, very few beneficiaries could afford it, anyway. If you are over age 65 and covered by both Medicare and Medicaid, you have one of the best insurance arrangements around. All Medicare eligible services are covered with no, or very small, copayments and deductibles.

If you are enrolled in Medicare but are not eligible for Medicaid, the ACA makes no changes to the way youpurchase a supplement policy. You have the option of either a Medigappolicy or a Medicare Advantage Plan (but not both at the same time). Medigap policies help pay for Medicare’s coinsurance and deductibles and often for some additional benefits, such as emergencies during foreign travel. However, if you want coverage for prescription drugs, you have to purchase it separately.

Medicare Advantage plans provide all of your Medicare coverage through a private insurance company, usually under a managed care arrangement. Copayments, deductibles, premiums, and covered services vary widely, so it is important to carefully research the optionsbefore choosing a plan. Many, but not all, Medicare Advantage plans include drug coverage, which eliminates the need to purchase a separate prescription plan.

Robert I. Field, Ph.D., J.D., M.P.H. is a professor of law at the Earle Mack School of Law and professor of health management and policy at the School of Public Health at Drexel University. He also writes for The Field Clinic blog. Ask Rob your questions about the new healthcare law.

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