What Are Medicare Supplements?
Medicare Supplement Plans provide additional coverage beyond Part A and Part B known as Original Medicare. Medicare is great coverage but it does have gaps and holes. It doesn’t cover everything 100%. Medicare Supplement, also called Medigap, helps to fill in those gaps that Original Medicare Parts A and B don’t cover.
Medicare Supplement Eligibility Guidelines
You need to be enrolled in Medicare Part A and Part B in order to get a Medicare Supplement plan. Medicare Part A is your hospital coverage and Part B covers your medical up to 80%. If you only have Original Medicare Parts A and B by itself then you could be out of pocket an unlimited amount, with no maximum of cap. This could be equivalent to 20% of all your medical costs plus co-pays and deductibles associated with Medicare Parts A and B. So it makes sense for you to pick up a plan that puts a cap on your possible out of pocket responsibility. One way to do this is by purchasing a Medicare Supplement plan which would be a secondary insurance to your Medicare.
How Do Medicare Supplements Work?
Medicare Supplements work with original Medicare. Medicare supplement plans are administered by private insurance companies. If the medical treatment or service is covered by Medicare, then by law, the insurance company has to pay their portion of the bill. You’ll pay a monthly premium in addition to your Part B of Medicare premium. The monthly cost of a supplement can vary greatly and is based on factors such as age, location, tobacco use, and possibly medical conditions. There are no networks and you can see any doctor or provider nationwide that accepts Medicare.
Types of Medicare Supplement Plans
Medicare Supplement Plans are lettered A through N. They’re standardized by the government and this means that benefits for each plan offered are exactly the same from company to company. A plan G with one company is the exact same plan G with another company. The only difference is the price.
In the Choosing a Medigap Policy Guide, published by the Centers for Medicare Services, it states that Different insurance companies may charge different premiums for the same exact policy.
The 3 most popular Medicare Supplement plans are Plan F, Plan G and Plan N.
Medicare Supplements and Medicare Advantage
It’s important for you to know that you can’t have a Medicare Supplement plan at the same time you have a Medicare Advantage plan. They’re two different types of coverage. Medicare advantage plans are not Medicare Supplement plans. Medicare Advantage is called Part C of Medicare. Some common types are HMO’s or PPOs.
Plans that are not Medicare Supplements:
- Part D drug plans
- Employer plans
- Veterans benefits
- Long Term Care insurance
When To Enroll In A Medicare Supplement Plan
The best time to buy a Medicare supplement is when you’re in your Open enrollment period. Open Enrollment begins the first day of the month that you turn age 65 and start Part B of Medicare, This period lasts for 6 months. If you’re over age 65 and you’ve delayed Part B because you or your spouse were still working, then your open enrollment will start on the effective date of your Part B and lasts for 6 months. During this time you can apply for a Medicare supplement without having to answer health questions or medical qualify. You don’t pay any more for this right and you’re guaranteed acceptance.
You can submit your application for a Medicare supplement up to 6 months prior to the effective date of your Part B. This would allow you to possibly get the lowest prices by shopping ahead of time.
If You’re Outside Your Open Enrollment Window
After you’re outside of your Open enrollment window which ends 6 months after your Part B effective date, then you will have to medically qualify by answering health questions on the application, and each company has their own health questionnaire. Every company has their own guidelines, and some companies are more lenient than others when it comes to things like heart issues, diabetes, or cancer history.
Getting Approved For A Medicare Supplement
If your health has been good then more than likely you won’t have a problem getting an approval, but if you have pre-existing conditions, depending on what it is and for how long, then some companies may not approve your application. There may be other guaranteed issue situations where you have the rights to buy a Medicare supplement policy. We’re familiar with each company’s medical underwriting. We can recommend companies where you’ll have the best chance of getting approved.
Can You Switch Your Plan At Any Time?
If you want to switch your Medicare supplement plan because you want to save money on your premiums or some other reason, you can do so at any time of the year, as long as you can qualify with the new company. You won’t have to wait for an Annual Enrollment period like there is for Medicare Advantage plans or Prescription drug plans.
Some states have special rules that allow you to change during certain times of the year without having to answer health questions on the application. If say you wanted to switch to another TYPE of coverage like a Medicare Advantage plan, then you would need to be in a specific enrollment period or special circumstance to do this.
What Medicare Supplements Don’t Cover
There are some things that Medicare supplement plans don’t cover:
- Medicare Part D Rx which is prescription drug coverage. You’ll need to sign up for a Part D prescription drug plan In order to avoid late enrollment penalties, unless you can get this coverage through another source such as through the VA or an employer plan. This other coverage must be considered “Creditable”. This means it has to pay at least as much as Medicare’s drug coverage.
- Vision such as Eye glasses or Contact lenses
- Hearing aids
If you want these extra benefits this is something you’ll need to purchase separately.
Key Benefits of Medicare Supplement Plans
- Covers the gaps in Medicare, Parts A & B.
- Freedom to choose your Doctors.
- No networks. You can see any provider nationwide that accepts Medicare.
- Portable coverage that follows you wherever you go, even Foreign travel emergency coverage.
- Predictable cost. You have a set premium every month.
- Guaranteed renewable. Benefits never change.
- Non cancellable as long as you continue to pay the premiums.
- Can switch plans at any time of the year, although you may have to qualify medically.
- No Annual enrollment. You don’t need to sign up every year.
- Standardized Plans. You get the same plan benefits offered by different companies, the only difference is the price.
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