Delaware Medicare Supplement Plans (Medigap)
Delaware Medicare Supplement Plans are extra insurance that can be purchased in the great state of Delaware that compliments your Traditional Medicare Benefits.
These plans are called Medicare Supplement Plans and were created to provide coverage for the items such as coinsurance, copayments and deductibles that would otherwise not be covered by straight Medicare.
Independent insurance companies where you reside offer these policies. Delaware Medicare and Medicare Supplement Plans are broken down and separated into parts and plans which will be reviewed here.
Delaware Medicare Plans Broken Down
- Original Medicare: Medicare comes with Part A and Part B benefits. Medicare Part A provides your hospital, or inpatient benefits and Medicare Part B provides your doctor’s office visits and other outpatient care.
- Medicare Part C: also known as the Medicare Advantage Plan. Advantage Plans are offered through private insurance companies and offer much of the same benefits as Traditional Medicare but come with certain policy limitations.
- Medicare Part D: is a stand-alone policy that provides prescription drug benefits for Medicare beneficiaries.
- Medicare Supplement Plans: are purchasable insurance plans that pick up the Out Of Pocket (OOP) costs for medical expenses not covered with Traditional Medicare benefits.
To secure the best medical coverage with the least amount of expenses, an ideal combination of plans would include Traditional Medicare, a Medicare Supplement or, “Medigap Plan”, and a Medicare Part D or, “Prescription Drug Plan”.
What Benefits Does Medicare Cover in Delaware
Part A is hospital benefits which include:
- hospitalization for up to 60 days
- inpatient operations/procedures
- inpatient bloodwork/ diagnostic imaging
- skilled nursing facilities
- some home health/physical therapy
- hospice care
Part B is outpatient benefits which include:
- Doctor’s office visits/services
- outpatient bloodwork/diagnostic imaging
- preventive care
- physical therapy/occupational therapy
- outpatient surgery/procedures
- Mental health services
- durable medical equipment (DME)
The above Medicare Part A and Medicare Part B services are all covered at 80%. The remaining 20%, in addition to any OOP medical costs, are left for the Medicare beneficiary to pay. By obtaining a Medicare Supplement Plan, that 20% and the additional costs can be covered completely depending on which plan you choose. Call us today to see which of the 10 plans are best suited for your health care needs.
Delaware Medicare Supplement Plans Criteria for Eligibility
To be considered eligible for Medicare Supplement insurance in Delaware, there is certain criteria that must first be met. Firstly, you must already be 65 years of age and secondly, you must currently be enrolled in Medicare Part B. You are given a six-month Open Enrollment Period (OEP), which is the best time to obtain Medicare Part B insurance.
Your OEP begins the three months prior to your 65th birthday and continues on through the following 4 months.
Failure to enroll in Medicare Part B during your OEP, will result in the Part B Penalty.
With this penalty, your monthly premium will increase depending on how long you went without coverage. As of 2019 the Part B premium is $135.50 a month.
As most seniors live on a fixed income, any increase in rates makes a difference. Make sure to enroll during your OEP to avoid any unwanted added expenses.
Medicare Eligibility for the Disabled, Under 65 in Delaware
Individuals under the age of 65 who receive Social Security or disability benefits as well as individuals with certain Railroad Retirement Benefits automatically qualify for Medicare Parts A and B after 24 months. Its not required by Federal law for the different state health insurance carriers to provide Medicare Supplement Plans.
Some state laws do require supplement insurance plans and Delaware is one of them. Additionally, Delaware state law requires insurers to offer at least one plan for those under 65 that have End Stage Renal Disease (ESRD). Call us to see what options are available for you if you’re currently living in Delaware and are disabled, under 65 or have ESRD.
How to Apply for Delaware Medicare Supplement Plans
During your OEP is the best time to apply for your Medicare Supplement Plan. Remember, you have a total of 7 months to apply for the plan as long as you’re already enrolled in Medicare Part B.
For example, if your 65th birthday is October 24th and you enrolled for Medicare Part B on November 17th, then your OEP begins on December 1st and lasts through May 31st.
The beauty of purchasing your policy during the OEP is you are given the benefit of the Guaranteed Issue (GI) right. With the GI, insurance carriers are required to issue you an insurance policy and cannot increase your premium cost regardless of any pre-existing medical conditions.
You can still enroll outside of your OEP however, you open yourself up to the underwriting process which could prove difficult when trying to obtain your Medicare Supplement Plan. You also subject yourself to higher premium rates and even denial if you have an underlying health condition.
Delaware Medicare Supplement Plan Premiums
Medicare Supplement Plan costs are determined by the private insurance companies. A number of factors are used when each individual carrier considers your premium rate. Age, sex, and location play a big part when deciding the cost.
For example, insurance premiums for someone living in Wilmington will differ from that of a person living in Long Neck. Also, if your older or younger and male or female in either area will be included in that determination.
The insurance companies also use a series of 3 different methods when figuring out costs. There are community rated, issue-age-related, or attained-age-rated pricing methods and you can read more about each one here for more info.
Top Delaware Medicare Supplement Plans
Medicare Supplement Plan benefits are the same regardless of the carrier but premium costs will vary. The top 3 of the 10 letter plans are Plans F, G, and N.
Supplement Plan F has the best coverage. With it covering 100% of your Medicare Part A and Medicare Part B deductibles, the remaining 20% not covered by Traditional Medicare and foreign travel coverage, it’s easy to see why it’s also the most popular.
It also has the added benefit of covering excess charges which physicians in Delaware may choose to add to the Medicare-approved allowable.
With benefits almost exact to Medicare Supplement Plan F, Plan G is also wildly popular. The only difference with Medicare Plan G is there is no Medicare Part B deductible coverage. The $183 deductible will be paid by the insured.
Plans N is popular as it is one of the more affordable Medicare Supplement Plans. The difference with Plan N is there is no Medicare Part B deductible coverage, it doesn’t pay for excess charges and you may have small copays if you go to the ER and with some physician office visits.
Medicare Advantage Plans in Delaware
Medicare Part C aka Medicare Advantage Plans are a Medicare Replacement Plan also offered through the individual health insurance carriers.
As one could easily guess by the term, “Medicare Replacement Plan”, this insurance plan takes over coverage for Medicare Part A and Medicare Part B benefits.
Unfortunately, Medicare Supplement Plans cannot be combined with the Advantage Plans. Seniors lean towards Medicare Part C rather that Supplement Plans as it’s a less expensive alternative however, policy restrictions such as coverage limitations and cancelation restrictions are a downside to this policy.
Coupled with the fact that OOP costs end up higher in the long run with Medicare Advantage Plans, seniors end up realizing that Medicare Supplement Plans are the better route to go.
Medicare Prescription Drug Plans in Delaware
Medicare Part D is a stand-alone Prescription Drug Plan (PDP) that provides coverage for prescription medications.
Like Medicare Part B, Medicare Part D also has a late enrollment penalty. Failing to enroll for prescription coverage during your 7-month OEP will result in higher monthly premiums. The longer you go without the higher those premiums will be.
Find and Compare Delaware Medicare Rates Online
We make comparing Medicare Supplement Plans online easy for you! To make sure that 20% not covered by Medicare gets covered, our licensed insurance agents can help customize the best policy to work in conjunction with your Traditional Medicare coverage.
To answer any questions regarding coverage including rate comparison call or click today!
Medicare Savings Programs in Delaware
Medicare Savings Programs are available to Delaware seniors who are in need of financial assistance with costs associated with Medicare. Medicare beneficiaries can contact Centers for Medicare and Medicaid or the state assistance program SHIP for more information.