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. This means it’s important to weigh both the costs and the benefits before deciding if this type of plan is right for you.
Medigap Plans are optional insurance coverage that pays for things that aren’t covered under Original Medicare Parts A and B. There are 10 standard Medigap plans, labeled Plan A through Plan N. Each plan 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 be enrolled in Medicare Part B. If you have a Medicare Advantage plan, you cannot enroll in a supplement plan.
What are Medicare SELECT Plans?
With Original 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 certain 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.
This means you’ll be responsible for paying anything that Part A and B does not 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 offered in every state. Insurance companies decide whether they want to offer this type of plan 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. If you enroll later, you may have a harder time getting coverage and it may cost more.
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 included in the plan.
If they are not, you may save a small amount on your monthly premium, but end up paying thousands of dollars in medical expenses that would have been covered under 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 a serious 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.
And 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 plan in your area.
Medicare SELECT vs Medicare Advantage
As stated above, these plans work very similarly to an HMO Medicare Advantage Plan. There is not much of a difference. These plans were created based off available services in a specific area, but still restricting which doctors and hospitals you could visit.
History of Medicare SELECT Plans
SELECT plans were introduced back in 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 states. By 1998, SELECT plans became a permanent law.
Compare Rates on Medicare SELECT Plans
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.