Seniors Choice: Medicare Supplement

Healthcare costs have been rising for decades, and when choosing Medicare supplement plan options, beneficiaries who are new to Medicare opt for lower-cost plans. If you are 65 years and above, this article will help you decide which Medicare Supplement insurance to choose.

What are Medicare supplement plans?

Medicare supplement plans (Medigap plans) are insurance contracts that help pay or cover gaps in original Medicare. The amount of coverage depends on the Medigap plan option you choose. Choose between plans A, F, G, and N, depending on the insurance coverage that best suits your needs. It makes comparing plans between private insurance providers easier. Medicare Supplement Plans are standardized. It means beneficiaries receive the same benefits regardless of their carrier.

Medigap plans usually don’t cover prescriptions. Therefore, you should consider signing up for Medicare Part D, which specifically covers prescription drugs. Additionally, suppose you don’t sign up for Part D and don’t have creditable coverage. In that case, you could wind up paying a penalty later that lasts the rest of your life.

Private insurance companies sell Medigap programs. Some companies offer additional benefits in their plans, such as gym memberships. These other benefits are usually outside the program and can be eliminated anytime. 

What does Medicare Supplement Insurance Cover?

Original Medicare requires you to pay deductibles, copayments, and excess charges if doctors don’t accept the assignment. If you use benefits for medically-approved services, you must pay deductibles and copayments unless you have insurance to cover them. Medicare supplement insurance helps cover copayments, deductibles, and Excess Doctor Charges. Medicare pays its portion of your medical expenses first, and then the Medigap plan pays its share.

The ten standard Medicare supplements are Plans A to N. The most popular among these Medicare Health supplement plans are Medigap Plans F, G, and N, 

Eligibility

First, you must enroll in Medicare Part A and B to qualify for a Medicare Supplement plan. You must also be a legal resident of the United States. Also, you should be:

• 65 or older
• Or you’ve been covered by Social Security Disability Insurance (SSDI) for two years receiving disability benefits
• Or you have an end-stage renal disease (ESRD) or Lou Gehrig’s disease.

Enrollment

Medigap Enrollment Period (OEP):

It is best to sign up for a Medigap policy when you turn 65 and sign up for Part B. You have an open enrollment period, which lasts six months and starts on the first day of the month you turn 65 or enroll in Part B. You can purchase any Medicare supplement policy without undergoing medical underwriting during your open enrollment period. Insurance companies can’t deny coverage for health reasons or charge you higher premiums. 

Guaranteed issue – Also Called “Medigap Protections

An insurance company cannot deny you a Medigap policy or set conditions for a Medigap policy, such as exclusions for pre-existing conditions, nor can it charge you higher Medigap insurance rates due to a past or present health problem. 

Outside Open Enrollment Period: 

• You can still enroll and purchase a Medigap plan outside your open enrollment period. However, there will be no guarantee that an insurance company will sell you a Medicare Supplement policy if you don’t meet the health requirements. 

Special Enrollment Period:

You’ll have a Special Election Period to enroll in a Drug Plan, AND you’ll be able to get a Medigap plan via “Guaranteed Issue” if one of the following occurs:

• You are within one year of enrollment in a Medicare Advantage plan, AND you were newly eligible for Medicare Parts A and B (i.e., you turned 65).
• You are within one year of the first time you switched from a Medigap plan to a Medicare Advantage Plan.
• Your group plan coverage, like your employer plan, is ending.
• You have a Medicare Advantage plan but are leaving the service area. 
• Your Medicare Advantage Plan is no longer offering coverage in your area.

Let’s take a look at the most popular Medigap Plans

Medigap Plan F:

Plan F is the most comprehensive Medigap plan. It covers 100% of everything that Medicare approves. You’ll have no copay or deductible on all Medicare-approved medical services. You can get a Plan F if you obtained Medicare coverage (A or B) before Jan 1, 2020.

Medigap Plan G:

• Medigap Plan G is best for newly eligible enrollees. It is a popular and comprehensive alternative to Plan F. It covers everything covered by Plan F, except for the Part B deductible. In 2022 the Part B deductible was $233, and in 2023 it is $226.

Medigap Plan N: 

The Medigap N plan typically costs less than plans F and G. 

• You’ll pay the Part B deductible (currently at $233 in 2022 and $226 in 2023).
• Pay a $20 copay to see a medical provider.
•  When you need emergency care and are not immediately admitted to the hospital, you must pay $50.
• Excess doctor fees. You pay any additional medical fees for doctors who do not accept the assignment.

It is important to note that although most doctors in the USA currently do not charge excess doctor fees, this could change. Excess Doctor Fees are 15% of the Medicare-approved rate, and there is no cap on these expenses.

Original Medicare doesn’t pay for certain expenses, such as hearing aids, routine dental, vision and hearing tests, eyeglasses, contact lenses, prescription drugs, long-term care, or custodial care. If Medicare doesn’t pay for it, neither will your Medigap plan. 

Why do you need to consider purchasing a Medicare supplement plan?

There are several things to consider when signing up for a Medicare supplement plan:

• You can see any doctor in the United States that accepts Medicare. You won’t need a referral, and there are no networks. 
• An insurance company can’t cancel your policy if you pay your premiums on time, even if you have health problems. 
• The options are less confusing because it is a standardized plan.
• Medicare supplement policies usually have a higher premium than Medicare Advantage Plans, and the premiums typically go up yearly.
• You’ll need a drug plan to avoid a future lifetime penalty, even if you don’t take any medications.

Medicare Supplement Agents Near Me

It can be confusing to figure out how Medicare works. Medicare has complicated terminology and complex deadlines, and many plans look similar. For this reason, working with a specialized insurance agent is essential. Here are several reasons why you need to work with one of our members who specialize in Medicare Insurance: 

• There is no additional charge for using one of our members. Your premium is the price you would have if you had purchased the policy directly from the carrier.
• Agents can compare different products or policies, which can save you time.
• Our member brokers can help you get another policy with another carrier in case your rates go up. 
• Agents and brokers can help you with your Medicare claims. 
• Brokers can help with your plan renewal.
• Our members can explain numerous plans, combinations of plans, benefits, rules, and exceptions. They know many insurance topics and how they can help you get the best value for Money. Medicare insurance agents must pass several courses and exams each year. 
• Our members study the market to find and offer the best policy for your needs.
• Brokers listen to and understand your insurance coverage needs. 
• Medicare agents can help you fill out your form when you enroll in the insurance plan.

Use the Certified Medicare Agents Directory, and one of our member agents can help you find the plan that fits you best!

Originally Published on https://www.certifiedmedicareagents.com/blog/

Katherine Kline Podcaster, Blogger

I host the Rock Your Retirement Show, which is about Lifestyle, not money or insurance! I started the show in 2016 before anyone knew what a podcast was, and now it's had over one million downloads. At this point, there is a lot of information in our back catalog and we try to release an episode every month.

I'm a retired Financial Advisor (after 25 years) and now I try to have fun with my husband, my dog, and my friends.

I'm also the founder of CertifiedMedicareAgents.com, a site that brings insurance agents together with people who are looking for help with Medicare.