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Medicare Supplements

What are Medicare Supplement Plans?

Do You Know What a Medigap Plan Is?

While Original Medicare pays for many of your health care services and supplies, it may not cover everything you need.  You may want to consider enrolling in a Medicare Supplement plan, also known as a Medigap plan.

Unlike Original Medicare, Medigap plans are offered through private insurance companies. These plans help cover some of the hospital and medical costs that Original Medicare doesn’t cover such as copayments, coinsurance, and yearly deductibles. Some plans also help pay for services such as Part B excess charges, emergency overseas travel, and 2 out of the 10 Medigap plans include a yearly out of pocket limit, all of which Original Medicare does not.

In other words,  a Medigap policy can fill in “the gaps” of Original Medicare.

 

There are currently 10 Medigap plans offered, each one designated by a letter of the alphabet (A, B, C, D, F, G, K, L, M, N; there’s also a high-deductible version of Plan F).

In most states, the benefits are the same regardless of what insurance company you choose to purchase a plan from, though each plan covers different things. Premium prices for each one of the 10 plans will vary depending on your age, where you live, the insurer and the type of plan you select. These premium payments are separate from your regular Medicare premiums. In order to be eligible for a Medigap plan, you must already be enrolled in both Medicare Part A and Part B. You will need to stay enrolled in Original Medicare for your hospital and medical coverage as Medicare Supplement plans are not meant to provide stand-alone benefits. If you have Original Medicare and a Medigap plan, Original Medicare will pay first and then your Medigap policy will fill in the cost gaps.

 

FACTS about Medicare Supplement Plans (FAQs)

Here are some quick facts about Medicare Supplement plans:

  • Depending on which state you live in, you may be unable to purchase a Medicare Supplement plan if you are under age 65 and have Medicare due to a disability, End-Stage Renal Disease (ESRD), or Lou Gehrig’s Disease. States are not required to offer Medigap coverage to beneficiaries under age 65.
  • Medigap plans do not include prescription drug coverage (Part D), so if you are wanting help with your prescription drug costs you will need to enroll in a stand-alone Medicare prescription drug plan.
  • Medigap policies only cover one person, and so if your spouse needs additional coverage they will need to find their own policy. We can help!
  • Medigap policies usually do not cover long term care, vision or dental care, eyeglasses, hearing aids, or private duty nursing.
  • You cannot be enrolled in a Medicare Advantage Plan and a Medigap Plan at the same time.
  • Not all Medicare Supplement plans may be available in your state
  • As long as you pay your monthly premiums, Medigap policies are renewable even if you develop health problems. Your insurance carrier cannot terminate your policy.

2020 and Medigap Plans C and F

Attention to Date: In 2020 Medicare beneficiaries who don’t already have what’s known as Medigap Plan C or Plan F insurance will not be able to purchase it because the federal government will be closing those plans to new enrollments.

If you are age 65 now or will reach age 65 between now and January 1st, 2020, you can still sign up if you qualify because you will be in your Open Enrollment Period or if the insurance company admits you.

What is a Medicare Supplement?

Medicare Part A and Part B help beneficiaries pay for many health costs, but they do not pay for everything.

 

Not all medical services are even covered by either Part A or B.

Even covered services might still include copays, deductibles, and coinsurance costs.

Many Medicare beneficiaries would rather predict and control their health costs, and that is why they purchase Medicare supplement plans.

Supplements work with Original Medicare to fill in payment gaps for Medicare Approved Services, and that is why they also are sometimes called Medigap plans. Even though private companies market these plans, they are standardized into a variety of distinct benefit levels, and this makes them easier to understand than some types of long term care or health insurance plans that are not standardized at all.

 

 

Medicare Supplement Plan Coverage

While Original Medicare pays for many of your health care services and supplies, it may not cover everything you need.  You may want to consider enrolling in a Medicare Supplement plan, also known as a Medigap plan.

Unlike Original Medicare, Medigap plans are offered through private insurance companies. These plans help cover some of the hospital and medical costs that Original Medicare doesn’t cover such as copayments, coinsurance, and yearly deductibles. Some plans also help pay for services such as Part B excess charges, emergency overseas travel, and 2 out of the 10 Medigap plans include a yearly out of pocket limit, all of which Original Medicare does not.

 

In other words,  a Medigap policy can fill in “the gaps” of Original Medicare.

 

 

Different Types of Medicare Supplement Plans

There are currently 10 Medigap plans offered, each one designated by a letter of the alphabet (A, B, C, D, F, G, K, L, M, N; there’s also a high-deductible version of Plan F). In most states, the benefits are the same regardless of what insurance company you choose to purchase a plan from, though each plan covers different things.

Premium prices for each one of the 10 plans will vary depending on your age, where you live, the insurer, and the type of plan you select.

These premium payments are separate from your regular Medicare premiums. In order to be eligible for a Medigap plan, you must already be enrolled in both Medicare Part A and Part B.

You will need to stay enrolled in Original Medicare for your hospital and medical coverage as Medicare Supplement plans are not meant to provide stand-alone benefits.

If you have Original Medicare and a Medigap plan, Original Medicare will pay first and then your Medigap policy will fill in the cost gaps.

Choosing the right Medicare Supplement Plan

Supplements work with original Medicare to fill in payment gaps, and that is why they also are sometimes called Medigap plans. Even though private companies market these plans, they are standardized into a variety of distinct benefit levels, and this makes them easier to understand than some types of long term care or health insurance plans that are not standardized at all.

 

These are some things to know about standardized Medicare supplement plans:

 

  • Today, the levels are A, B, C, D, F, G, K, L, M, and N.

  • You can find a chart with information about each Medicare plan level at the official Medicare.gov website.

  • Insurers do not have to offer every plan level, but they must offer Plan A if they offer any plans. Additionally, they have to offer Plan C or Plan F if they offer any plan. The levels are different because of medical services that they cover, and the best choice depends upon your needs. These examples should help you understand how the different levels provide different types and levels of coverage:

  • Each plan covers Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.

  • Level C and F covers the Part B deductible.

  • Some plans also cover emergency care outside of the United States, but foreign medical care is very limited under original Medicare.

 

What don’t Medicare Supplements cover?

Note that supplements do not cover most prescriptions, and you still need a Part D prescription plan or a Medicare Advantage plan that includes prescription drug coverage to get medication covered. Like original Medicare, Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.  Also remember that Medicare Advantage plans are different than supplements. 

 

Medigap policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). Medigap policy only supplements your Original Medicare benefits. While supplement plans work with original Medicare to increase coverage, you have to keep Part A and Part B to be enrolled in both Original Medicare and Medicare Advantage.

 

Let us help you find the best health insurance alternative

 

You have to make a lot of choices about Medicare supplements, Medicare Advantage, and Part D prescription plans. It’s great to enjoy choices, but it can be hard for regular consumers to understand which plans will help them make the best use of their benefits. Call us at your earliest convenience to find the right plan for your own medical needs and budget.

 

 

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