Vermont Medicare Supplement Plans (Medigap)

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Vermont Medicare Supplement Plans were created to work alongside Medicare. These plans work to fill the gaps left by Traditional Medicare Insurance Plans. This includes deductibles, copayments and coinsurance costs.

Medicare Supplements are sold by private insurance companies. They’re often called Medigap plans. Vermont Medicare Insurance Benefits are explained in parts and plans.

Vermont Medicare Options Explained

Vermont MedicareMedicare Part A and B is standardized health insurance offered by our government. “Original Medicare” consists of two parts. Part A is hospital insurance and Part B is medical insurance.

Medicare Advantage, Part C is offered through private insurance companies. While this option is required to offer you the same coverage as Part A & B, it does have it’s limitations. Part C does not work in conjunction with Original Medicare, but as a replacement.

Medicare Part D (PDP) is a Prescription Drug Plan created to use with Original Medicare to provide prescription drug coverage.

Medigap Supplement Plans are designed to add to Traditional Medicare. Medigap plans add additional benefits such as premiums, deductibles, and copayments. These plans are here to help fill the gap left by Traditional Medicare. Medigap, Traditional Medicare and a PDP can provide optimum healthcare coverage.

What Vermont Medicare Benefits Pay For

Medicare only pays 80% of medical bills, leaving 20% of medical costs to for the the beneficiary to pay out of pocket. This in addition to other potential fees is what makes Medigap coverage so important.

Medigap Eligibility in Vermont

It’s important for you to enroll in your Medicare Part B plan during your Open Enrollment Period. Your OEP begins the month a recipient turns 65 and they have enrolled in Part B of Medicare. It continues for 6 months.

During this time a guarantee issue is in effect and a carrier can not deny your coverage due to any current or previous health conditions.

Medicare Eligibility in Vermont for the Disabled, Under 65

Those Vermont residence that are currently receiving Railroad Retirement Benefits, have diagnosed with End Stage Renal Disease or have had social security benefits for a minimum of 24 months, are automatically eligible for a Medicare Part A and Part B health plan.

The Federal Law in the U.S. actually does not require insurance carriers to offer this type of plan, however, some state laws do. Vermont REQUIRES that insurance carriers provide at least one plan to those disabled and under 65.

How to Enroll in Medicare Supplement in Vermont

Enroll in Medicare Supplement in VermontYou are eligible to enroll in a Medicare Supplement plan during your Open Enrollment Period, which begins the first day of the month you are eligible to and you have enrolled in Medicare.

This means if you are born on May 31st and your effective date is June 17th, your OEP would begin July 1st. Additionally, this is when you are given the Guarantee Issue, previously mentioned.

Guarantee Issues right are just that, a guarantee that an applicant will receive coverage regardless of previous or current medical conditions. Applying without these rights may create additional costs and higher fees. They might need to undergo medical underwriting as well.

Cost of Medicare Supplements in Vermont

Cost of Medicare Supplements in VermontThe Cost of Supplement Plans are not regulated by the state of Vermont. The premium rates are determined by the individual company. These rates are determined by factors such as as age, gender and location and can change the amount of a policy holders monthly medicare premium. A quote received in Burlington, VT may be very different than a quote issued in Rutland, VT.

Insurance Companies can choose from the following three pricing methods:

  • Community Rated – nicknamed the “No Age Rate” means that age doesn’t matter everyone pays the same rate regardless of age.
  • Issue Age Rated – also known as “Entry Age Pricing” bases your premium off of the age when you enter the policy, so the older you are when you start your plan the higher your premium will be. However, on this policy your premium will NOT increase as you age.
  • Attained Age Rated – means that your premium is based on your current age, which means that your monthly premium WILL increase as you get older.

Comparing Vermont Medicare Supplement Plans

When comparing supplement plans it is important to know that the benefits of these plans are the same regardless of which company you choose, the difference is the rate the company chooses to charge.

The most common plans are N, F and G. We will explain these in detail below. In the state of Vermont, it is prohibited for physicians to charge excess fees.

Medicare Plan N in Vermont

Plan N is a “share of cost” plan. Therefore, depending on your needs this plan may save you money over the course of the policy. This plan option covers 100% of your Part B costs with the following expectations:

  • Copayments of $20 for some physician appointments
  • Copayments of $50 for ER visits that do not result in hospitalization

Plan F in Vermont

Medicare Supplement Plan F is the most popular supplement plan. It has the highest amount of benefits with the lowest amount of out of pocket costs. These benefits will cover any additional hospital or physician costs not covered by Medicare.

This includes coinsurance and copayments under Part B. This plan also offers a High Deductible Plan F, which is the same policy with a higher deductible and a lower monthly premium.

Medicare Plan G in Vermont

Plan G offers an affordable option with the same great coverage found Plan F. This plan covers original Medicare Part A deductibles but does NOT cover your Medicare Part B deductible. Currently in the year 2018 Part B deductible is $183.

No Part B Excess Charges in Vermont

Vermont is one of the few states that prohibits excess charges, this is important to consider when choosing your Supplemental Plan. State residents may want to select Supplement Plan F or Plan N, rather than Plan G because it covers those specific charges.

Vermont Medicare Advantage Plans

Medicare Advantage Plans are offered by private insurance agencies that have been approved by Medicare and are usually considered an HMO or PPO.

These type of plans require you to forfeit your Medicare Plans A & B and place you into a network of Physicians with their own policies and procedures.

This can be challenging as networks change throughout the year and can add additional expenses when unexpected medical needs arise while you are traveling.

Medigap works with Medicare Part A & B, allowing you the most comprehensive care and is accepted everywhere Medicare is. Medigap gives you the ease of knowing what benefits are covered without any guess work.

Part D Plans for Medicare in Vermont

Part D Plans for Medicare in VermontPrescription Drug Plans (PDP), a stand alone medicare part d prescription drug plan offers coverage for majority of the prescriptions a physician would prescribe with a few exceptions.

These plans do not cover over the counter medication. It’s important to note that Traditional Medicare does not offer a PDP. You’ll need to enroll in a Part D Plan. If you don’t enroll in a Part D plan when your first eligible, you could incur a late enrollment penalty.

Find out More about Vermont Medicare Plans

Vermont Medicare Supplement plans can provide the help beneficiaries need to supplement their Medicare Coverage. Understanding the different supplement plans can become overwhelming on your own.

Find out more about Vermont’s Medicare Plans by calling at the number listed above or fill out the form provided.

Medicare Extra Help Resources in Vermont

Each State provides a Medicare Savings program for recipients in need of help paying for the cost of Medicare. Recipients that are on a fixed income or are consider to be a part of a low income family may qualify for assistance.

Vermont Medicare FAQs:

  1. Vermont Medicare FAQsWhere can I compare Vermont Blue Cross Blue Shield Medicare Plans? It would be our pleasure to help you compare plans with Blue Cross Blue Shield. Just give us a call at the number listed. You can also compare rates online.
  2. What’s Vermont Medicare for All? A health care reform bill that proposed Vermont have it’s own universal health care system. This bill was abandoned in 2014.
  3. Are there Aetna Medicare plans in Burlington County? Yes, contact us today and we will match you with the the best Aetna plan that suits your health care needs.