Medicare Supplemental Insurance has been providing people peace of mind since their inception, and for great reason. However, Medicare Part A and Part B simply won't cover all of your expenses. In fact without Medicare Supplemental Insurance to cover the additional costs you could end up in real financial trouble if a major illness or health condition comes up.
What you need to know about Medicare Supplemental Insurance Plans
When turning 65 qualifying people who have paid into the Medicare system are eligible for both Part A and Part B Medicare.
Part A (Hospital Insurance)
- Covers room and board
- Impatient care in a skilled nursing facility
- Hospice
- Home health care
Part B (Physician's Services)
- Covers Medicare-eligible Doctor's services
- Outpatient Hospital services
- Durable Medical equipment
Part A covers hospital, and Part B covers your doctors. While this may seem like enough coverage, there are some other expenses that you need to be aware of. These expenses are called the "Gaps" in Medicare. Without Medicare Supplemental Insurance, you are responsible for paying:
Part A
- A deductible if you are admitted to the hospital you are responsible for paying, which is currently $1132 in 2011. If you leave for 60 days or more and return to the hospital this must be paid again. It is not an annual deductible. Many of the more popular Medicare Supplemental Insurance Plans Covers this deductible
- Hospital Coinsurance beyond 60 days
- Skilled nursing facility coinsurance
Part B
- An annual deductible, which is $162 in 2011 and raises every year.
- 20% of all Doctor's bills!
This is Why You Need a Medicare Supplemental Insurance Plan
The most popular Medicare Supplemental Insurance Plans cover most or all of these gaps in Medicare. Therefore, as long as you pay your monthly premium and simply visit doctors that accept Medicare you could have little to no out-of-pocket expenses for your medical bills.
Medicare Supplemental Insurance Plans are offered by private insurance companies and are standardized by the government. This means they are all the exact same plans regardless of provider.
While there are several companies offering Medicare Supplemental Insurance, and they all have the exact same coverage, the prices can vary widely from company to company! This means you could pay in upwards of 50-60% more in monthly premium for the exact same coverage!
Let Us Help
After first making sure you completely understand Medicare, Medicare Supplemental insurance coverage and what's available to you, our advisors shop the market to ensure you get the very best premium that you qualify for. And if you get a rate increase, we'll be there to provide our Medicare Supplemental Insurance comparison and annual rate analysis. We'll watch the market so you don't have to, saving you money year-after-year.
Which Medicare Supplemental Insurance Plan is Best?
Medigap plans are lettered A – N. Plans E, H, I and J no longer exist. While there are several plan letters, Medicare Supplemental insurance companies are not required to carry each plan. Therefore, there are a few plan letters that remain the most popular for their outstanding coverage and relatively low premiums.
Plan F
- The most comprehensive Plan offered
- Covers 100% of the gaps in Medicare
- Visit any doctor or specialist (no referral needed!) that accepts Medicare and pay nothing for all Medicare approved expenses
- By far the most popular of all the Medicare Supplemental Insurance plans offered
Plan G
- Similar to Medicare Supplemental insurance Plan F; The only additional out of pocket expenses is you pay the Part B annual deductible
- One of the more popular plans available
- After the deductible is paid, the plan pays 100% of the gaps in Medicare
- Typically lower premiums than Plan F. This plan is often the best choice for those over the age of 70 depending on area
Plan N
- In exchange for an even lower monthly premium, this Medicare Supplemental Insurance plan has cost-sharing options such as emergency room co-pays, as well as doctor's visit co-pay up to $20 each visit after the Part B deductible is met
- Like Medicare Supplemental Plans F and G, there is NO network. Simply visit any doctor or specialist that accepts Medicare
Eligibility into a Medicare Supplemental Insurance Plan
If you are turning 65 and just entering Medicare, you are automatically put into an Open Enrollment period. This allows you to obtain any Medicare Supplemental Insurance policy you wish, with no medical question being asked. Pre-existing conditions are waived during this period, and you are guaranteed the policy.
Typically you may apply up to 6 months prior to lock in your rate on a Medicare Supplemental Insurance plan. If you choose to switch plans or wait to obtain your coverage outside of this period, you will likely be subject to medical underwriting. Therefore it is very important to secure Medicare Supplemental insurance coverage when you first are eligible into Medicare, particularly if you have a disqualifying health condition.
Other Situations Where you are Guaranteed a Medicare Supplemental Insurance Policy
There are other instances of "guaranteed coverage" into Medicare Supplemental Insurance for people who chose to work beyond the age of 65 and have maintained employer benefits. If you were still employed and had medical benefits from your employer beyond the age of 65 and you did not opt out of Part B Medicare, you still maintain a right to be guaranteed issue into a Medicare Supplemental Insurance plan.
63 Days Guaranteed into a Medicare Supplemental Insurance Plan
If you elected to remain employed and did not opt out of Part B when you turned 65, you are guaranteed issue in to a Medicare Supplemental Insurance Policy for 63 days from the time your employer benefits terminate. During this time period you may apply for a Medicare Supplemental Insurance policy and no medical questions will be asked. However, you will not be able to apply for every plan letter available. Check with one of our experienced advisors to see which plan letters you may enroll in.
If you did in fact opt out of Part B Medicare when turning 65 and retained employer benefits, then a different set of circumstances exist. Due to the fact that you will be enrolling in Part B Medicare for the first time upon retiring, you are then entitled to the same 6 month "Open Enrollment Period" into a Medicare Supplemental Insurance policy that others receive when taking Part B at age 65.
This means you will have 6 months of guaranteed issue period from the time your Part B Medicare begins to enroll in a Medicare Supplemental Insurance Plan.
Posted in: Medicare Supplemental Insurance
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