Tennessee Medicare Supplement Plans (Medigap)
Tennessee Medicare Supplement Plans are insurance policies created to work alongside Original Medicare to supplement it’s traditional coverage. These insurance plans were specifically designed to provide coverage for deductibles, copayments and coinsurance not covered by Original Medicare.
These plans are sold by independent insurance carriers in your area. Medigap is another term used for these Supplement Plans. Tennessee Medicare options are separated into parts and plans
Tennessee Medicare Plans Broken Down
Part A: Original Medicare hospital coverage
Part B: Original Medicare outpatient procedures and physician visit coverage.
Medicare Advantage: Health insurance offered by individual insurance companies. This plan provides all of the same coverage as Medicare Part A and B but also goes above and beyond in that it can also include benefits such as dental, vision and prescription drug coverage but with certain limitations.
Part D: or, “PDP”, is prescription drug coverage. These are stand alone plans and are not offered by Original Medicare or supplemental insurance policies.
Medicare Supplement Plans: additional insurance that picks up the, “gap” of what Original Medicare doesn’t cover. These policies help cover OOP costs associated with deductibles, copayments and other healthcare costs. These plans used alongside with Original Medicare and a PDP will provide the best medical coverage.
Tennessee Medicare Coverage
Part A is hospital coverage which includes:
- hospital stays up to 60 days
- inpatient labs/blood work
- inpatient operations
- diagnostic imaging/testing
- skilled nursing facilities
- some home health care
- hospice care
Part B is medical insurance that covers:
- physician visits/services
- outpatient lab work
- preventive care services
- physical/occupational therapy
- outpatient procedures
- outpatient imaging/diagnostic testing
- home health care
- durable medical equipment
All of the above services are only covered at 80%. This leaves the remaining 20%, in addition to any OOP costs, for the Medicare patient to pay. Having a Medicare Supplement plan will help with these added costs. You can choose from 10 separate policies based on your individual needs.
Requirements for Tennessee Medicare Supplement Plans
To be eligible for a Medicare Supplement plan, you must already be enrolled in Medicare Part B as well as be at least 65 years of age. The best time to do so is during your six-month Medigap Open Enrollment Period (OEP). This period begins begins three months prior to your 65th birthday, the month of and three months after. If you fail to enroll in Part B during your OEP, you may be penalized.
The Part B penalty is a 10% increase in your monthly premium for each full 12-month period that you went without benefits. In 2018, the Medicare monthly premium is $134.00 a month. Make sure to enroll as soon as possible to avoid any penalty fees.
Your Medicare Supplement plans Open Enrollment Period beings once enrolled in Medicare Part B. You become eligible on the first day of the month your Part B came into effect and lasts for the following six months.
Medicare Eligibility in Tennessee for the Disabled Under 65
Individuals who receive Social Security Disability benefits, or certain Railroad Retirement Benefits, qualify for Medicare Parts A and B after 24 months. Federal law does not require insurance providers to offer Medicare Supplement plans. In Tennessee, there’s the opportunity to purchase a policy due to their state laws. Give us a call to see what options are available for for you if you’re disabled, under 65, and living in TN.
As stated about, the best time to apply for a supplement plan is during the Open Enrollment Period. Eligibility begins on the 1st day of the month after turning 65 and having been enrolled in Medicare Part B. The following 6 months you are given what is called a Guaranteed Issue Right.
It’s important to enroll during your OEP to avoid having the insurance companies deny you coverage. When you’re granted GI, the carriers are required to accept you regardless of any pre-existing medical conditions. Also, they cannot charge more for the condition(s).
If you purchase a Medicare Supplement plan at any other time outside of Open Enrollment, you may have a hard time finding coverage and/or have to pay more based on your healthcare needs. But keep in mind, you can still apply anytime.
Prices of Medicare Supplement Plan Premiums in Tennessee
Individual insurance carriers determine the premiums for supplement plans. Many factors are considered when determining cost, including your age, gender and location. So insurance premiums in Nashville will differ from insurance premiums in Memphis.
Additionally, insurance companies use 3 different methods when determining premium costs. The carrier has the option to use community rated, issue-age-related, or attained-age-rated pricing methods. You can learn more about these pricing methods here for more info.
Top Medicare Supplement Plans for Tennessee
Regardless of which carrier you choose, the insurance benefits included in each letter plan are the same nationwide. The only difference between carriers is what they chose to charge for their premiums. Of the 10 letter Medicare Supplement plans in Tennessee, the top 3 are Plans F, G and N.
Supplement Plan F covers 100% of your Medicare Part A and Medicare Part B deductibles. It also covers most of the remaining hospital and doctor’s costs not covered by Traditional Medicare. This includes Part B’s coinsurance or copayments and provides the luxury of foreign travel coverage. This is the most popular of the 10 plans, as it provides the most coverage and leaves the least amount of OOP expenses. It has a high deductible version that allows for a lower premium with the same benefits.
Supplement Plan G is also popular, as its coverage is comparable to Plan F. Coverage for your Medicare Part B deductible is the only difference with Plan G. As of 2018, the deductible for Part B is $183.
Plans N is considered a “cost-sharing” option. You’ll be required to pay a small copayment of $20 for some office visits and a copayment of $50 for ER visits that don’t result in admittance. It also doesn’t cover excess charges, which physicians are allowed to charge in Tennessee.
Medicare Advantage Plans in Tennessee
Like Medicare Supplement plans, Medicare Advantage plans are offered by private insurance companies. This plan takes over for Part A and Part B, and come in HMO or PPO form.
Unfortunately, they also come with restrictions. Restrictions include treatment with only in-network doctors and OOP costs associated with hospitalizations.Your Max-Out-Of-Pocket cost is typically higher than that of a Medicare Supplement plan. So research thoroughly, and consider all options before going with an Advantage Plan.
Medicare Prescription Drug Plans in Tennessee
Medicare Supplement plans and Original Medicare do not cover prescription drugs. Part D provides coverage for your prescription medications. To help with the OOP costs associated with expensive medications, you’ll want to obtain a PDP. For the best coverage with the least amount of cost, you should consider Original Medicare, a Medicare Supplement Plan and a Prescription Drug Plan altogether.
To avoid a late enrollment penalty for going without a Part D Plan, it’s imperative to sign up during your 7 month enrollment period. After your IEP ends, a penalty will be added to your monthly premium which is calculated based on how long you waited to obtain PDP coverage.
How to Sign Up for Medicare in Tennessee
With Traditional Medicare only covering the beneficiary at 80%, the remaining 20% not covered as well as other OOP costs can get costly. Therefore, obtaining a Medicar
e Supplement Plan to use in conjunction with your Original Medicare and PDP Plan, you’ll have the most coverage with the least OOP cost.
Click or call today, our licensed insurance agents are here to help and our services are 100% free. You can also compare rates here.
Medicare Savings Programs in Tennessee
There are Medicare Savings Programs available to assist with the costs associated with Medicare. There’s a program called State Health Insurance Assistance program, or SHIP that can help individuals not just in Tennessee, but all over the country. These programs are free of charge and designed to help those in financial need.
Tennessee Fun Facts
- There were over 1.2 million residents receiving Medicare benefits in 2015.
- That’s 19% of the entire state population
- 21% of beneficiaries that became eligible in 2013 were disabled.
- A little less than 1.0% of recipients that started receiving benefits in 2013 were diagnosed with End Stage Renal Disease (ESRD)
- Does Medicare pay for assisted living in Tennessee? Unfortunately, not only does Medicare not pay, but no insurance carriers cover assisted living facilities. Therefore, residents will be required to pay a monthly fee/rent. Depending on any additional amenities they require, there will be additional OOP costs.
- Is Cigna Medicare Supplement insurance available in Tennessee? Yes, Cigna, and most well-known private insurance companies, offer supplement insurance in Tennessee.
- Where can I compare Medicare Plans in Nashville, TN? You can get any questions answered, including the comparison of Medicare Supplement plans in Nashville by calling or filling out our rate form. Our agents are readily available to assist with all your health care needs.