Virginia Medicare Supplement Plans
Roughly 15% of these individuals are eligible because of disability and under the age of 65. This percent includes about 10 million Americans receiving Medicare benefits.
Across the nation, Medicare is the health insurance program for most seniors once they reach the age of 65. Under certain circumstances, eligibility may begin earlier. People with ALS or ESRD may qualify for coverage regardless of age.
The state of Virginia offers Supplement Plans from 36 different insurance companies that work with Medicare to provide extra coverage. Approximately 400,000 Virginia residents receive Medicare benefits through a Supplement plan.
Although this number may seem high, that’s only slightly more than 17% of the entire state’s population.
Virginia Medicare Supplement Plans
Some beneficiaries receive coverage for additional costs through an employer-health plan or Medicaid. Others enroll in Medigap plans to help pay all or some of the potential expenses for health-care services.
Coverage including, costs of copayments, deductibles, and coinsurance. Policy costs and availability depend on the area and insurance carrier. However, all benefits for Medigap plans must be the same, no matter the providing company.
In Springfield, VA Medigap Policy G has monthly premium costs from $101 – $215. Medigap Policy G provides coverage and covers costs for everything but the Part B deductible and Preventive Services.
The Part B deductible is met before coverage begins. In 2019 this cost is $185.
Residents of Blackwater, VA can expect a slightly lower monthly premium amount for Medigap Policy N. However, Part B excess charges may apply; Supplement Plan N monthly premium costs $84 – $173.
Medigap Features and Benefits
In December 2018, Jason was eligible for his initial Open Enrollment Period. During OEP Jason joins a Medigap Plan F policy.
Plan F is known as the most comprehensive plan because it has the most coverage with the least (almost zero) OOP expenses. Although, in January 2020 Jason should plan for his premium rates to increase, as Plan F is retiring.
Supplement Plans C, F, and High Deductible Plan F are going into retirement starting January 1, 2020. This change impacts new-to-Medicare enrollees. Any individual eligible for Medicare coverage after December 31, 2019, is no longer able to enroll in these plans.
Michelle is celebrating her 65th birthday in February 2020. She also becomes eligible for Medicare during this time. Since she qualifies AFTER January 1, 2020, Michelle may not enroll in any of the retiring plans.
Michelle may still enroll in some similar options such as Plans G, N and High Deductible Plan G.
Medicare Supplement Plans Eligibility in Virginia
Many states don’t offer Medigap policies for individuals with disabilities that are under 65, even if they’re Medicare eligible. Virginia is one of them.
Few companies offer coverage to beneficiaries in Virginia under 65, the only policy offered is Plan A. Medigap Plan A is a high-cost basic coverage policy that wouldn’t likely provide adequate coverage.
Beneficiaries with a disabling condition may enroll in a Medicare Advantage plan for additional coverage; if they aren’t suffering from kidney failure (ESRD). Advantage plans don’t offer coverage for ESRD patients unless a specific Special Needs Plan is available.
Once a beneficiary is 65 with Part B active, or Part B has an effective date, a beneficiary can select Medigap coverage to begin the same time as Medicare.
A beneficiary that sees a substantial reduction in employer group coverage will qualify for GI rights to purchase a Medigap policy. Expect to send the insurance company documentation proving your eligibility.
Medicare Coverage Costs in Virginia
In Virginia, carriers may choose their own rating style. However, almost all plans available in the state use the attained-age rating technique. Meaning, beneficiary’s ratings likely increase as they grow older.
Some states require the community rating technique. Meaning, premiums vary depending on inflation rather than age. However, Virginia doesn’t require a specific rating approach.
The best time to join a Supplement plan is during the six-month Medigap Open Enrollment Period. This one-time six-month period begins once an individual is 65 years old and joins Medicare Part B.
During this period, beneficiaries have Guaranteed-Issue (GI) rights. Under these rights, no plan may deny coverage for a Medigap policy due to any pre-existing health conditions.
Once the open enrollment period ends, GI rights may not be available. Additionally, enrolling may become difficult if a patient has health conditions or complications. Unless certain situations apply.
For example, specific situations such as Jason’s’. Let’s say his Medigap plan went bankrupt. Due to this, Jason is able to enroll in a different Medigap plan with GI rights.
This is because his situation was out of his control. Medicare doesn’t penalize beneficiaries for a company’s misfortunes or mistakes.
Open Enrollment for 2019 benefits ended December 15, 2018. Although, during the 2019 calendar year, residents with specific qualifications may be eligible to enroll during a Special Enrollment Period.
Medicare Advantage in Virginia
Medicare Supplement alternatives are available, they’re Medicare Advantage plans. These plans replace Traditional Medicare coverage, enrollees may find extra benefits within their plan.
Jason recently came to realize that Part A and Part B coverage didn’t include routine vision. Since he has poor vision, it’s necessary he visits his ophthalmologist for routine check-ups.
Routine dental care is also something he needs. Fortunately, Jason lives in Chesterfield County, VA; he has 28 Advantage plans to choose from. Jason also has options for Stand-alone Prescription Drug plans in his area.
He may choose an Advantage plan with drug coverage or keep Medicare and join a stand-alone drug plan. Although, Jason considers his options before deciding; knowing Medigap plans don’t offer drug coverage.
Private insurance carriers offer Medicare Advantage plans in all 95 counties and 38 cities in Virginia. Although, Accomack County has only 7 Advantage plans to choose from. While Loudoun County offers 34 plans. Each plan availability varies from one service area to the next.
The state’s Medicare population made up of about 20% of Advantage plan enrollees. Although, Medicare cost plans made up a portion of this percentage. Cost plans are another private coverage option for beneficiaries.
Medicare Savings Program in Virginia
Programs in Virginia can help save beneficiaries additional money. The Extra Help program and the Medicare Savings Program may help pay for Part D premiums. Monthly income amounts at or less than $1,538 for an individual or $2,078 for married couples may qualify.
Similarly, an individual’s resources at or less than $14,100 ($28,150 – married couple) may also qualify. Beneficiary’s resources may not include homes, car, items in the house, burial plan or life insurances.
Virginia offers free counseling and assistance for those with Medicare. The Virginia Insurance Counseling and Assistance Program (VICAP) is one of the many programs within the nation’s network of Medicare professional agencies.
Among VA’s assistance programs is the VA HIV SPAP – Virginia AIDS Drug Assistance Program. Medicare Part D pays the costs for individuals with HIV/AIDS.
Eligibility requirements include being a resident of the state, actively participating in the Virginia AIDS Drug Assistance Program (ADAP), being a Part D enrollee and have income that falls 400% under the federal poverty line.
Compare Medicare Supplement Plans and Rates in Virginia
Since Medicare pays for 80% of inpatient and outpatient care, patient responsibility is the remaining 20%. Deductible expenses are a requirement for coverage to begin.
Medigap or a Medicare Supplement Insurance Plan help with out of pocket costs. Supplement plans provide consistent premium bills and no surprise costs.
Having a Medigap policy means having access to ALL the doctors in Medicare’s network, not just in a plan’s network. These policies don’t require a referral to see a specialist and they’re guaranteed renewable!
Compare Medigap plans or call us today to ask any questions you have. Our professional, licensed insurance agents are here waiting to help!
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