Medicare Supplement Plans in Rhode Island
The federal Medicare program is a health insurance program for persons 65 years or older and those with qualifying disabilities. However, the federal Medicare program doesn’t cover 100%; instead, there are deductibles, copayments, and coinsurances that apply.
To help offset the out-of-pocket expenses, private insurance companies work with Medicare by offering beneficiaries additional coverage through Medigap plans.
Rhode Island Medicare Supplement Benefits for 2020
Rhode Island Original Medicare consists of Part A and Part B. Most people receive Part A for free since ten years of qualifying employment taxes go into funding Part A. Some people pay for Part A coverage, either in whole or in Part.
Part A has a deductible of $1,408 per benefit period. Beneficiaries are responsible for 20% of Part A hospital expenses.
The Part B premium depends on income. Those with a low-income could receive extra help covering Medicare premiums, deductibles, and copayments.
Part B has a deductible of $198 for the year. Beneficiaries are responsible for 20% of Part B outpatient costs.
Unless you have employer or union coverage, you could incur a Part B late enrollment penalty if you don’t sign up during your Initial Enrollment Period. Once you have a Part B effective date, you can pre-enroll in Medigap coverage to being the same day as Part B.
Medigap coverage can cover all, most, or some of these expenses depending on the Medicare Supplement Plan you select. When Medigap and Part B being on the same day, you avoid a lapse in coverage.
Rhode Island Medicare Benefits for the Disabled Under 65
Some Medicare recipients are under the age of 65 due to disability. Although most beneficiaries are 65 and over.
A person under the age of 65 may qualify for Original Medicare if they have one of the following:
- End-Stage Renal Disease (ESRD)
- Amyotrophic Lateral Sclerosis (ASL)
- Received disability benefits from Social Security for more than 24 consecutive months
- Received certain disability benefits from Railroad Retirement Board (RRB) for more than 24 straight months
Beneficiaries under 65 won’t likely find affordable Medigap coverage; however, Medicare Advantage plans can be beneficial to those under the age of 65 or those with Medicare and Medicaid.
Medicare Advantage Plan
In 2019, 37% of enrollees chose a Medicare Advantage plan.
Rhode Island Medicare beneficiaries who choose to enroll in a Medicare Advantage Plan will no longer be eligible for Original Medicare, as the Advantage plan will take the place of Original Medicare as the beneficiary primary insurance coverage.
Choosing a Medicare Advantage Plan over Original Medicare will also result in the beneficiary’s ineligibility to add a Medicare Supplement Plan.
There are pros and cons to Medicare Advantage Plans and Medicare Supplement Plans. The key is finding a plan that best fits your health and financial needs.
Medicare Advantage Plans usually have lower monthly premiums than Medicare Supplement Plans. However, they only permit benefices to see in-network hospitals and doctors (HMOs and PPO’s).
Medicare Supplement Plans, on the other hand, may have higher monthly premiums. But they don’t have a network which allows beneficiaries to go to any hospital and doctor of their choosing.
Operating without a network can alleviate much stress and surprise out-of-pocket costs when learning that a previous Medicare Advantage Plan in-network doctor is no longer. Medicare Advantage Plan networks often change throughout the year.
Rhode Island Medicare Supplement Plans
Plans are identifiable by letter; these include letters A through N, with the coverage under each letter plan being identical from company-to-company. The difference is in premium costs.
Qualifying for Medigap
If you live in Rhode Island, are 65 years or older, with Medicare Part B, then you’re eligible for a Rhode Island Medigap plan. For optimal coverage, Medicare beneficiaries should consider enrolling in Original Medicare with a Medigap Plan as well as a Medicare Prescription Drug Plan.
The best time to select a Medigap plan is during the Medicare Supplement Open Enrollment Period because, during this time, beneficiaries can enroll in a policy with Guarantee Issue Rights and no underwriting. This means the policy will have the lowest premium rate, and health won’t play a factor in eligibility.
Many seniors can obtain Medigap coverage when they go through medical underwriting and have minor pre-existing conditions.
Our brokers understand the specific rating methods behind each of our top-rated carriers. This gives our brokers the ability to identify the coverage you qualify for; this is why working with a broker saves you so much time and money.
Medigap Premiums in Rhode Island
Like traditional healthcare insurance, the cost and available coverage of these plans will vary from company-to-company. All consider factors such as; age, sex, and location.
Someone who lives in Warwick may pay $100 for Plan N, and someone in North Kingstown pays $120; the coverage is the same, but the cost is different.
Depending on your Medigap eligibility and the rating method the company chooses, your rate increases are something to consider. With Plan F going away in 2020, it’s a prediction that Plan N rate increases will remain low; also, Plan N could become the most cost-effective policy.
Rhode Island Medicare Prescription Drug Plans
Rhode Island Medicare beneficiaries can add a Medicare Prescription Drug Plan to Medicare. There are four aspects to coverage under Medicare Part D; deductibles, initial coverage, coverage gap, and catastrophic coverage.
Beneficiaries can find Part D for as low as $14 and as high as $127 a month. While the lower premium may sound like an obvious choice, it’s not that simple.
Medicare recipients need to check the plan formulary and determine which policy costs the least overall. For example, if Rachel enrolls in the $14 policy and pays $400 a month for her brand name medication copayments and the first $415 is her responsibility, her costs are going to add up fast on this plan.
However, if Rachel has the $35 policy and only pays $200 a month in copayments with no deductibles, she’s going to be in the best policy for her. Everyone’s needs are different, just because the premium is low, doesn’t mean the coverage is most suitable for your needs.
Rhode Island Medicare Resources
The Rhode Island Department of Human Resources also oversees the Rhode Island Medicaid. Medicaid offers financial assistance to Medicare beneficiaries who financially qualify that need assistance to pay their premiums and deductibles.
Low-income Medicare beneficiaries could have less out of pocket expenses on medical services if eligible for Medicaid or another Extra Help program. There are different levels of Extra Help, some pay for Part A, B, and D deductibles. Other levels just help cover the cost of medications.
Your income will determine how much coverage you’re eligible to receive from the state. The Rhode Island Senior Health Insurance Program (SHIP) can help beneficiaries with Medicare counseling services.
Choosing the Best Rhode Island Medicare Options
When it comes to choosing the best Medicare plan option, beneficiaries should consider their individual financial and medical needs.
If you have a doctor’s preference, a Medicare Supplement and Part D Plan would be best. Those under age 65 on Medicare disability or those with Medicare and Medicaid would benefit from a Medicare Advantage plan.
You can contact us by phone at the number above to speak with one of our agents. Complete our rate comparison form, and an agent can help you discover the best plans in your area.