Montana Medicare Supplement Plans
More than 50% of the Montana Medicare beneficiaries have a Part D prescription drug policy. Medicare Advantage plans are only available in some areas; the highest available plan count is 9 options in one county, some counties only have 1 MA plan option.
The plan options can seem confusing; however, it’s rather simple once we break it down. Medicare covers medical expenses; Part A handles inpatient benefits and Part B is responsible for outpatient coverage.
Beneficiaries must find medication coverage to cover prescriptions. This can be a stand-alone Part D policy or a Medicare Advantage Prescription Drug (MAPD) plan.
Those that have an MAPD or MA plan can’t have Medigap coverage in addition to that coverage. You must have one or the other.
Medigap coverage fills the gaps of Medicare. Since Medicare doesn’t cover everything, it’s beneficial to have a supplement pick up the bills you’d otherwise pay.
Montana Medicare Benefits Explained
Depending on your healthcare needs you can choose one of ten different letter plans to provide additional Medicare support. While Medicare does cover 80% of your medical expenses after deductibles are met, those expenses could be endless.
Let’s say Shannon has Original Medicare and no other coverage. Well, if Shannon has an accident that requires ambulance transportation to the hospital where she’s admitted, her out of pocket costs could be unbearable.
So, the ambulance is a Part B service, the cost for that deductible in 2019 is $185 and then Shannon will pay 20% of the bill after the deductible is met.
Next, she was an inpatient in the hospital so she has to pay the Part A deductible. This costs $1,364 for each benefit period. In addition to these costs, Shannon must pay 20% of the Part A bill after the deductible.
You can tell these costs could become overbearing if a catastrophic event were to occur. This is where Medigap coverage comes into play.
Montana Medicare Supplement Plans
Shannon chose Plan N during her Open Enrollment Period (OEP); this is six months prior to your 65th birthday and continues for the following four months. During this time, Shannon is eligible for Guarantee Issue (GI) rights.
GI rights made it possible for her to get the lowest premium and policy approval despite all her pre-existing health conditions. Plus, Plan N gives her protection against high out of pocket expenses like the scenario above.
If Shannon had Plan N, her ambulance ride would only cost the Part B deductible (and excess charges if applicable). Then, her Emergency Room copayment would be waived because of her inpatient status. So, Shannon doesn’t stress the Part A deductible or the Part A coinsurance.
Her medical expenses are manageable under Plan N and with the help of stand-along drug coverage, she isn’t at risk for penalties. Medigap coverage makes sense because as we age our likelihood of hospital admission increases and coverage to protect our savings is necessary,
It’s important to enroll during OEP to avoid any increased monthly expenses.
Certain individuals can be deemed eligible for Medicare benefits under the age of 65; however, they must meet certain criteria. They must currently carry Social Security Disability benefits or certain Railroad Retirement Benefits for at least 2 years before automatic enrollment in Medicare Part A and Medicare Part B.
Federal law does not require the individual insurance carriers to offer Medicare Supplement Plans to those under 65; however, some state laws require options. Luckily enough, the great state of Montana is one of those states that provide supplemental insurance plans to beneficiaries with disabilities.
Although, the cost of supplements for beneficiaries on disability tend to be much higher than the costs at age 65. Some beneficiaries might find more financial relief on a Medicare Advantage policy until age 65 when eligible for GI rights.
Part D Plans Plans for Medicare in Montana
Medicare Part D covers prescription medications. In Montana, the lowest-cost Part D monthly premium is $15 and the most expensive policy is $94.
Our brokers can help you identify the best coverage for you based on the prescriptions you have and the policies in your area.
If you go too long without Part D coverage, you’ll incur a Part D penalty for the entire time you have Part D. The best time to enroll is as soon as you become Medicare eligible.
Resources for Medicare Help in Montana
If you’re a senior with Medicare benefits and living on a fixed income, you may qualify for some assistance through a Medicare Savings program.
Each state has its own individual assistance program that provides free counseling and financial aid to assist in copays, deductibles, and other OOP medical expenses. You can learn more through MONTANA SHIP.
Montana Medicare Advantage Plans
Medicare Advantage Plans replace Medicare benefits; many people find this to option to be cheaper monthly and more costly long-term. While the monthly premium costs may be lower each month, MA Plans come with restrictions and coverage limitations.
Additionally, these insurance policies may require prior-authorizations that Medicare wouldn’t require. When an MA plan becomes the provider, they decide when and how you receive coverage.
Due to a large number of unsatisfied MA plan beneficiaries, Medicare brought back the Medicare Advantage Open Enrollment Period specifically for Medicare Advantage beneficiaries. This gives MA beneficiaries another chance to change coverage between January and March.
Montana Medicare Supplement vs Medicare Advantage Plans
Let’s say Shannon has MA coverage when she experiences the catastrophic event scenario. She pays a monthly premium of $50 for her PPO policy. She chose a PPO because it gives her access to her doctors that are out of network.
The ambulance costs her a $265 copayment and the hospital visit costs $360 each day for days 1 through 5. Between annual premium costs and this event, her costs total $3,265.
Now, you know for a fact she will go to the doctor anywhere between 1-6 times a year depending on her specific needs; that costs 50% of the bill when she sees her out of networks specialists.
So, if her doctor bills the plan $500, Shannon pays $250 for the visit. If she goes 6 times, that’s another $1,500 for the year; costing Shannon a total of $4,765.
Shannon didn’t select a Medicare Advantage plan, she selected Plan N. Since Shannon is recently 65, and a non-smoker, her Plan N costs less than $1,500 a year in premiums.
Even if she goes to the doctor 6 times, takes an ambulance to the hospital, and experiences a week of inpatient services her costs will still be less than the Medicare Advantage plan.
Now, for Anna who is only 55, her premium for Plan N would be over $3,000 because she is on disability and under 65. For beneficiaries like Anna, Medicare Advantage may be more beneficial until you reach your 65th birthday.
Although, if your Medicare Advantage expenses are more than the cost of a supplement, having Medigap will make sense.
Montana Medicare Rates
Insurance premium costs have a variety of methods to determine the cost. The individual insurance carrier itself decides what to charge each individual and factors include age, gender, and location.
So a 77-year-old gentleman living in Helena generally has a different premium than an 84 year old female living in Butte. The easiest way to obtain low-cost coverage is to work with a broker that can identify a company and policy match for your situation.
Beneficiaries turning 65 have the lowest rates available, this is the best time to enroll.
Montana Medigap Eligibility
Beneficiaries turning 65 have the advantage to lower rate options. Anyone that didn’t recently turn 65 will likely need to go through underwriting to be Medigap eligible. Medicare Supplement costs reflect underwriting.
Our agents can identify eligibility options; either for GI rights or to determine the company with the most lenient guidelines for a specific pre-existing condition.
Those with employer coverage primary to Medicare can voluntarily lose coverage and qualify for GI rights.
Best Medicare Supplement Plans in Montana
Across the country, various insurance companies offer Medicare Supplement Plans. Depending on the Medigap coverage provider, the benefits stay the same; however, the premiums may vary depending on a carrier basis.
So, in the state of Montana for a 65-year-old person might find Central States Indemnity has the lowest premium. However, someone at age 68 might find Bankers Fidelity is more likely to approve their application when subject to underwriting.
The only way to find the best policy is to work with a broker; our brokers can walk you through education, eligibility, and enrollment. This can save you time and money because we have access to underwriting guidelines and rates from the top-rated insurance carriers across the nation.
The same 3 plans attract enrollees from all over the nation; each policy boasts access to any Medicare doctor in the United States, easy claims approvals (if Medicare covers, the plan covers), and little to no out of pocket expenses.
These Plans are identifiable by letter; Plan F, G, and N.
Montana Plan F
Plan F is first dollar coverage; this means, the insurance company pays the first dollar of medical expenses with no deductible. It provides 100% coverage for Part A and B deductibles with the benefit of picking up coverage for the remaining 20% Traditional Medicare doesn’t cover.
Additionally, it covers Medicare Part B copayments and coinsurance. Unlike some of the letter plans, it covers up to a certain amount of foreign travel emergency.
In 2020, Medigap Plan F won’t be available to newly eligible beneficiaries. If you’re eligible for Medicare before 2020, you can enroll in Plan F anytime; although, the cost of Plan F reflects the level of coverage it offers and buyers should fully understand this.
Plans with some out of pocket expenses can be more cost-effective long-term. Since you need to medically qualify for plan changes, choosing a life-long policy should be your goal.
Plan G in Montana
Plan G is comparable to Plan F when it comes to benefits; however, the beneficiary will pay their own Medicare Part B deductible. Although, this policy covers the “up to 15%” of physician excess charges which Plan N won’t cover.
Plan G is the runner up to first-dollar coverage plans. If you’re not Medicare eligible until after 2020, Plan G would be the next best choice. The only out of pocket expense is the Part B Deductible of $185 for the year.
For beneficiaries eligible after 2020, if you receive GI right due to loss of coverage, you’ll have GI access to Plan G. Those eligible before 2020 won’t have access to Plan G with GI rights and instead can use GI rights to select Plan F or High Deductible Plan F.
Plan N in Montana
With its less expensive monthly premiums, this cost-sharing plan brings quality coverage to many seniors. This plan “cost-sharing” options in exchange for lower premiums. Also, with Plan N, a small copayment is required for ER trips and doctor office visits.
Plan N requires beneficiaries to pay the Part B deductible and excess charges.
While this policy may have higher out of pocket expenses than the first two policies, it’s important to realize the huge potential for savings. Even with your copayments and deductible, your savings in monthly cost could still have you on top.
Plus, Plan N rate increases should remain lower than other policies because those losing coverage can’t use GI rights to purchase this coverage. Meaning this coverage bucket is full of people turning 65 or those able to qualify medically, keeping costs lower.
Another policy that could benefit people isn’t yet available for purchase; this is Medigap High Deductible Plan G, which should hit the market in 2020.
How to Apply for a Medicare Supplement Plan in Montana
For seniors residing in Montana, applying for a Medicare Supplement Plan is easy! You can either call our number above or fill out an online rate comparison form. It’s that simple!
The sooner you call, the sooner you can apply and the sooner we can start saving you money! Don’t get caught off guard by the Part B and Part D late enrollment penalty.
As always, our services are 100% free, and our Client Service Team will provide you with Medicare support as long as the plan is through us.
You must already have a Medicare Part B effective date to enroll in Medigap. If your concern is because of pre-existing conditions, contact our brokers to discover which companies are flexible enough to work with your needs.