Health Insurance Coverage

Order of Provider Coverage in Descending Order

1. Veteran’s benefits

2. Private Health Insurance (from a current employer)

3. Medicare or Medicare + Choice

4. Medi-Gap/Supplemental type of policies or Private Health Insurance

5. Long Term Care Insurance

6. Medicaid (payer of last resort)

Some further explanation ...

(3)  Original/Traditional Medicare (fee-for-service)

• Part A – hospital, hospice, limited nursing home and home health care

• Part B – doctor, outpatient services, some other medical services and supplies

•  Medicare + Choice HMO/ Managed Care programs (”assigned” Medicare benefits) ...

• Blue Cross Blue Shield – Senior Blue

• Independent Health – Encompass 65

• Univera – Senior Choice

This means care is provided by the providers under a contract with Medicare.  Some plans offer additional benefits (like prescription, dental or eye coverage or discounts) for a premium.

(4) Most commonly seen private health insurance providers in the area for Medi-Gap/ Supplemental policies... 

Blue Cross Blue Shield (including Community Blue), Independent Health, Univera