If you are looking for a Medigap Plan with low monthly premiums, a Medicare SELECT plan may seem like a good option. But Medicare SELECT plans have strict limits on the doctors and hospitals you can use.
It’s important to weigh both the costs and the benefits before deciding if a plan is right for you.
Medigap Plans pay the gaps in Parts A and B. There are ten standard Medigap plans, Plan A through Plan N. Each program offers different benefits.
These supplemental plans pay for things like co-pays, deductibles, hospice care, medical emergencies while traveling, and doctors’ charges that exceed the amounts paid by Medicare.
To sign up for a Medigap Plan, you must have Part B. You can’t have both a Medicare Supplement and Medicare Advantage.
What is the Medicare SELECT Plan
With Medicare and Medigap coverage, there are no provider networks.
You don’t have to worry about whether your doctor is “in-network” or “out of network.”
You can go to any doctor or hospital you choose, as long as they accept Medicare.
However, Medicare SELECT plans limit you to a network of specific doctors, specialists, and hospitals.
If you go to a healthcare provider or hospital that is outside the network, your coverage will not pay unless it’s an emergency.
You’ll be responsible for paying anything that Part A and B don’t cover.
You usually need a referral from your primary care doctor to see a specialist or go to the hospital. In this way, Medicare SELECT operates much like an HMO.
Medicare SELECT plans are not in every state. Insurance companies decide whether they want to offer this type of policy in a particular area.
How Do I Enroll?
The best time to enroll in Medicare SELECT is during your Initial Enrollment Period that begins with the month you are 65 or older and enrolled in Part B. During this period; you can’t be denied coverage or charged extra because of your health.
When you first turn 65, you become eligible for the Guarantee Issue (GI) rights, meaning coverage and application is a guarantee. If you enroll later, you may have a harder time getting coverage, and it may cost more.
Many people apply for coverage after the IEP. The easiest way to understand your eligibility and options is to talk with an agent.
Is this Type of Plan Best for Me?
Before deciding on Medicare SELECT, find out whether the doctors and hospitals you like to use are in the policy.
If you want to see the doctor out of the network, you save a small amount of premium but end up paying more than a regular Medigap Plan.
Also, consider how important it is to be able to choose your specialists as well as where you would go for severe illness.
Think about how often you travel out of your immediate area. Consider the hassle of going to your primary care doctor every time you need a referral. Weigh these against the potential monthly savings in a SELECT plan.
If you do decide on a Medicare SELECT plan, you have 12 months to change your mind. Within this time frame, you can switch to a standard Medigap policy.
You can switch to another plan if you move out of your insurance company’s coverage area or if your insurer decides to stop offering your SELECT program in your area.
However, before signing up, understand that standard Medigap has far more significant benefits. If in the first 12 months of coverage, you decide standard Medigap is more suitable than a SELECT plan, you can switch without worrying about underwriting.
Insurance companies can charge various premiums for the same level of coverage. Be sure to compare apples to apples when researching policy options.
Medicare SELECT vs Medicare Advantage
As stated above, these plans work very similarly to an HMO Medicare Advantage Plan. There are similarities.
These plans are available in specific areas; also, they restrict doctors and hospitals.
Select plans are different from Medicare Advantage plans because they don’t have a copayment schedule like the MA plans. Additionally, SELECT plans don’t include Part D, dental, or any other benefits.
However, depending on the Medigap company, you might be able to purchase an Active & Fit benefit; or some other wellness coverage.
History of Medicare SELECT Plans
SELECT plans go back to the early 1990s. They were available in 15 states, including Florida, California, Alabama, Michigan, Ohio, and Texas. Then in 1995, these plans were made available to all regions.
By 1998, SELECT plans became a permanent law. Implementing SELECT plans is different across each state.
Compare Rates on Medicare SELECT Plans
The select Plan is basically an HMO that fills the gaps of Medicare. There is no coverage on ancillary benefits, and the doctor limits are strict.
Medigap standard options are better, especially if you can afford the slightly higher premium. The lower premium in exchange for a network may work for some, but it’s not something most will recommend starting
At MedicareFAQ, we help you find the best Medigap or Medicare SELECT policy for your needs. We answer your questions and get quotes from the top insurers in your area.
Call us today to get started or fill out our online form to compare rates online.