A Medicare Supplement insurance plan is supplemental healthcare coverage that compliments your Original Medicare benefits. It helps cover the out of pocket costs that Medicare doesn’t cover such as deductibles, coinsurance and copayments.
Understanding the changing nature and complex regulations of government health care is never easy. Leaving many beneficiaries wondering what a Medicare Supplement plan is and how they can benefit from it.
Sometimes known as “Medigap,” this term refers to supplemental insurance that provides coverage for services that standard Medicare does not cover.
What is a Medicare Supplement or Medigap Policy
Medigap policies handle the majority of your out of pocket expenses such as Part B excess charges, foreign travel emergency care, first 3 pints of blood, etc.
There are a total of 10 plan options that a carrier can offer, some offer all of them and some offer only a few. Regardless of the carrier, your benefits will be the same since all plans are standardized.
The only difference is the premium cost, which is why it’s smart to shop all the carriers.
Advantage Plans Don’t Work with Medicare Supplement Policies
It’s illegal for anyone to sell a policy to individuals already covered by a Medicare Advantage Plan ,unless the individual is in the process of switching back to Original Medicare.
But individuals unhappy with their Medical Advantage Plan can choose to dis-enroll and purchase a policy as long as the following conditions apply:
- You had a policy before joining regular Medicare
- The policy that you currently have does not have prescription drug coverage
- You bought an MA plan when you first became eligible for Medicare
Medicare Supplement Plans Description: Important Facts to Know
- Some policies sold before January 1, 2006, provided prescription drug coverage. If your policy no longer offers this, you may be eligible to join one of the Part D Medicare Prescription Drug Plans.
- Policies only provide coverage to the policyholder. If you want coverage for your spouse or family member, they will have to purchase their own policy.
- It’s only available for individuals who already have both Medicare Part A and Part B.
- By law, policies must be renewable even for individuals with health conditions. In other words, you can never lose your policy if you pay your monthly premiums.
- Any insurance company licensed to do business in your state can sell policies.
- Policy premiums are in addition to any Medicare Part B premiums.
- You cannot have overlapping coverage provided by both a Medigap and Medicare Advantage Plan policy.
- It’s illegal to sell someone a policy if they have a Medicare Medical Savings Account (MSA) plan.
Just as the name suggests, supplemental Medicare plans are designed to provide coverage for medical services that standard Medicare does not cover you for.
Before purchasing any policy, be sure to carefully read through the terms and conditions. Generally speaking, this plan does not provide any assistance for long-term care, eyeglasses or vision care, private-duty nursing, hearing aids and similar equipment or dental services.
There are a number of insurance policies that resemble Medicare Supplements but are not:
- Veterans’ benefits (VA)
- Tribal and/or Indian Health Service coverage
- Medicare prescription drug plans (Part D)
- State-level aid
- Medicare Advantage Plans (including HMOs, PPOs, and fee-for-service plans)
- Long-term care insurance
- Employer/union plans, including FEHBP (Federal Employees Health Benefits Program)
Pricing and Coverage
It’s important to note that prices and premiums vary by insurance company and state. To find a policy right for you, consult one of our state licensed senior agents today!
Medicare Supplement insurance can be helpful in paying out of pocket fees for Medicare Part B and/or Part A claims. Most policies include provisions for allowing your Medicare claim information to be sent to your insurer. They will pay the doctor or healthcare provider directly.
When shopping for a policy, be careful to assess “apples to apples.” In other words, make sure that the price you’ve been quoted for one type of coverage is equivalent to the same type of coverage provided by another company. Medicare beneficiaries should take their time when selecting a policy.
Policies provide coverage for one or more of the following:
- Part A coinsurance costs after Medicare benefits are exhausted
- Part B copayments or coinsurance payments
- Blood services
- Part A hospice care
- Foreign travel coverage
- Part B excess charges
- Skilled nursing facility care coinsurance
Depending on where you live, you may be eligible to purchase a certain kind of policy called Medicare SELECT. These Medicare SELECT policies provide a built-in escape clause to allow you to change your policy within the first year with no penalties.
What is a Good Medicare Supplement Plan?
All plans are good since they give you additional medical coverage to supplement your Original Medicare. What plan is good for you may not be good for your neighbor.
What Medicare Supplemental Insurance Do I Need?
As stated above, the right Medicare Supplemental insurance for you is dependent on your current health status and financial situation.
Recipients that are finding themselves going to the doctors office often should enroll in a plan with more coverage. However, if your financial situation puts a constraint on how much you can afford in premiums, you may have to go with a plan that has less coverage and lower premiums.
Find Prices for Medicare Supplemental Insurance Policies Online
For more information about eligibility and pricing, contact us today! Our agents are licensed in all 50 states and there is no fee for our services.
We can show you rates with all the top carriers in your area side by side. You have the option to call one of our agents directly using the number above, or you can find prices for Medicare Supplemental insurance policies online by filling out our compare rates form.