Medicare and Medicare Advantage
The DCH Health System provides this overview for West Alabamians who may have questions about changes related to Medicare and Medicare Advantage insurance plans.
Medicare is a federal program created in the 1960s to pay for health care for the elderly and disabled. Folks who are for eligible for Medicare can choose to leave traditional Medicare and be covered by a Medicare Advantage Plan, also known as a Medicare Replacement Plan. As the name suggests, these plans are designed to replace Medicare coverage for people who chose to enroll in them. Medicare Advantage plans are offered by private health insurance companies who are approved by Medicare and who have a contract to provide their customers with Medicare benefits. Many Medicare Advantage Plans offer extra coverage, such as vision, hearing, dental and general checkups and other health and wellness programs.
DCH currently has a contract with three Medicare Advantage plans: Blue Advantage, HealthSpring and Humana. We will add other programs as they are approved by Medicare to operate in Tuscaloosa County and negotiate a relationship with us.
DCH is willing to negotiate a contract with any insurance company's Medicare Advantage plan that will pay us at least what we would receive from regular Medicare. Some companies have offered us considerably less than the Medicare reimbursement rate, and we have chosen not to do business with them.
For patients who choose to be covered by the traditional Medicare plan, many insurance companies offer what's known as Medicare gap policies, also known as Medigap policies or supplementary Medicare policies. Medigap policies help "fill the gap" in traditional Medicare by paying some of the health care costs not covered, costs like copays and deductibles.
DCH accepts all Medigap policies.
Existing insurance plans will likely change or disappear in the wake of health care reform, and new products will be introduced. DCH will work with any plan that is reputable and that offers us a fair rate of reimbursement.