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In speaking about Medicare, we understand the coverages for Medicare Part A and Part B. As we discovered, many things are missing. Medicare supplements were built to supplement the benefits that Medicare offers and fill in the gaps for the missing pieces.
Medicare Supplement Insurance, also referred to as a Medigap insurance policy, is a form of private health insurance that works alongside Original Medicare Parts A and B. This coverage helps pay for out-of-pocket costs not covered under Original Medicare, including copayments, coinsurance, and deductibles.
Medicare Supplement insurance policies are federally regulated insurance policies sold by private insurance companies. Medicare Supplement Insurance policies work like Original Medicare in that there is no network of doctors that you are required to see. Typically, any doctor that accepts Medicare will also accept a Medicare Supplement.
Having a Medicare Supplement / Medigap insurance policy can help a Medicare-covered individual better plan financially for potential healthcare costs. Original Medicare has copayments, coinsurance, and deductibles. A Medicare Supplement may also have copayments or a deductible, but the potential costs are generally more predictable than relying on Original Medicare alone.
Another great benefit of Medicare Supplement insurance is that there is no doctor network. This gives the policyholder the ability to choose healthcare providers that accept Medicare.
A Medicare-covered individual has the option of purchasing a Medicare Supplement when they first become eligible for Medicare Parts A and B. In most states, a person must have both Medicare Parts A and B to qualify for a Medicare Supplement.
The Medicare Supplement Open Enrollment Period begins the month a person first becomes eligible and enrolls in Medicare Parts A and B, and lasts for six months after their month of eligibility.
A Medicare Supplement policy is an insurance contract between the insurance company and the policyholder. The contract has specific costs that are placed on the policyholder, and these expenses are reflected in the policy’s terms of coverage.
Typically, there is a premium that can be paid annually, semi-annually, quarterly, or monthly. The policy is guaranteed renewable as long as the premium is paid.
Medicare supplements have an open enrollment period in which an insurance company offering the product is required to accept the Medicare-covered individual, no matter the health condition of the individual applying. This Open Enrollment Period begins the month a person first becomes eligible and enrolls in Medicare Parts A and B, and lasts for six months after their month of eligibility.
Another enrollment period offered to a Medicare-eligible individual is called a Guaranteed Issue period. This is a time when the insurance company is required to accept a Medicare-qualified individual without requiring a health underwriting assessment.
This enrollment period can happen for many different reasons. One example is when a Medicare-qualified individual has health coverage through an employer group health plan that is considered creditable coverage by Medicare. In this situation, a person may hold off on applying for one or more parts of Original Medicare and wait until they lose employer coverage to apply.
If the eligible individual applies for Original Medicare after losing employer group health coverage, they may have a Guaranteed Issue period. For this specific scenario, the individual has up to 63 days from the date the employer coverage is ending to apply for a Medicare Supplement and be offered guaranteed issue rights. There are other reasons a person may qualify for guaranteed issue rights, and we suggest calling us for more details.
After these specific periods, the insurance company will ask a series of medical history questions to determine if they want to cover the individual applying for coverage. This process is called medical underwriting.
A Medicare Supplement policy is an insurance contract between the insurance company and the policyholder. The expenses that are the policyholder’s responsibility are reflected in the contract policy’s terms of coverage pages. These terms can vary depending on which plan a customer chooses.
Once the premium is paid, in the event the policyholder uses covered medical benefits, the insurance company is required to pay the stated coverage amount up to the policy’s allowed amounts per insurance claim. This is after the policy owner has paid any required out-of-pocket amounts according to the policy specifics.
These costs can vary by policy and typically will be in the form of a copayment or deductible, as mentioned in the policy’s terms of contract.
Click Here To See Detailed Medicare Supplemental Plan Chart
Medicare supplements are federally regulated programs run by private insurance carriers. This means that a plan through one carrier always has the same benefits through another carrier. There are a few differences allowed by the federal government between one company and the next.
A person looking at purchasing a Medicare Supplement should look at the name of the insurance company offering the plan, determine how long the company has been in business, and review its financial standing in the insurance marketplace. This information is important because you want to ensure the company you choose will be there when you may need them years down the road.
The price of the plan is always a factor, but you should be cautious not to shop based only on price. Shopping by price from the beginning could cost more later through premium rate increases. It can be helpful to consider a carrier with a long-standing history in the business and one that does not have a history of spiking premiums on existing policyholders.
Some companies offer discounts for living with others. The discount is different with each carrier. Some carriers offer discounts for simply living with somebody in your household who is over 60 years old, while other carriers require both people to have a policy through their company.
Below is a chart of Medicare Supplement plans offered. It shows the different Medicare Supplement plans available. The most popular plans insurance carriers typically sell are Plans F, G, and N.
Beginning in January 2020, Plans C and F are not available for sale to new Medicare-eligible enrollees. The reason for this is that Congress signed a law called The Medicare Access and CHIP Reauthorization Act of 2015. The law prohibits insurance carriers from offering newly Medicare-eligible individuals plans that cover the Medicare Part B deductible. Individuals currently enrolled in these plans are able to keep their coverage going forward.
Plans F, G, and N are strong coverage options, but there are still missing pieces such as dental, vision, hearing, and prescription drug benefits. In addition, besides the monthly premiums involved with a Medicare Supplement, keep in mind the potential out-of-pocket costs associated with Medicare Supplement plans.
The cost of Medicare Supplement coverage varies by insurance carrier. Medicare Supplements are also priced based on age. Prices may increase with the age of the individual, and they can change for other reasons as well.
Typically, there are three pricing structures associated with the costs of a Medicare Supplement. While the coverage does not change, the price of the policy can change. As you age, the price of the policy may become more costly. In addition to age-related increases, an insurance company can also review the average costs in an area and request premium increases or decreases through the state insurance department.
Medicare Supplement plans are a great option for individuals who would like to know their potential healthcare costs. With a Medicare Supplement, the costs are simpler and more straightforward. The potential costs involved are the monthly premiums, deductibles, and copays associated with your plan, so planning for healthcare costs can be more predictable.
Medicare Supplements do not offer dental, vision, hearing benefits, or prescription drug benefits. While dental, vision, and hearing benefits are important, many people find that they get by without them. Prescription drug benefits, also known as Medicare Part D RX coverage, are very important, and Medicare may penalize a person for not signing up for coverage when required.
Medicare Supplement insurance is a great option, and we encourage you to understand the benefits. We can help provide a quote, explain the benefits, review potential subsidies provided by your state, and help determine the right coverages for you as an individual.
Contact us today for more information about Medicare Supplements and the additional coverage you may need for dental, vision, hearing, and prescription drug costs.
Medicare Supplement Insurance, also called Medigap, is private insurance that works alongside Original Medicare Parts A and B to help pay certain out-of-pocket costs such as copayments, coinsurance, and deductibles.
No. Medicare Supplement plans generally do not include prescription drug coverage. Most people who want prescription drug coverage need to enroll in a separate Medicare Part D plan.
Generally, yes. Medicare Supplement plans do not usually have provider networks. Typically, any doctor that accepts Medicare will also accept a Medicare Supplement policy.
The best time is usually during your Medicare Supplement Open Enrollment Period, which begins the month you are enrolled in Medicare Parts A and B and lasts for six months. During this time, insurance companies must generally accept you regardless of health condition.
A Guaranteed Issue period is a time when an insurance company must accept a Medicare-qualified individual without medical underwriting. This can happen in certain situations, such as losing employer group health coverage.
Yes. Medicare Supplement plans are federally regulated, so the same lettered plan provides the same benefits from one carrier to another. The main differences are the insurance company, price, and possible discounts.
Plans C and F are not available to people who became newly eligible for Medicare on or after January 1, 2020. People who already had these plans may be able to keep them.
You should compare the carrier, premium, pricing history, household discounts, plan benefits, and whether you also need separate dental, vision, hearing, or prescription drug coverage.
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