Medigap Plans in Philadelphia

Are you looking for Medigap plan options in Philadelphia? You’ve come to the right place!

We understand that choosing the right Medigap plan can be a difficult task. That’s why we offer free consultations with one of our experienced Medigap specialists.

What are Medigap plans?

Medigap plans are health insurance plans that help cover some of the costs that Original Medicare doesn’t cover. They are also known as “Medicare Supplement Insurance” plans. Suppose you have Medicare and a Medigap policy. In that case, Medicare will pay its share of covered healthcare costs, and your Medigap policy will pay its share. Private insurance companies offer standardized Medigap plans. It means that all programs of the same type provide the same essential benefits.

You can choose any plan type in Pennsylvania if the insurance company offers it.

 Insurance companies that sell Medigap policies: 

• Should offer Medigap Plan A if they offer any Medigap policy.
• They should offer Plan C or Plan F if they offer any plan, but you might not be able to get a Plan F if you didn’t have Medicare before 01/01/2020.
• Don’t have to offer every Medigap plan.

Ten different Medigap plans are available, each with various benefits. 

Here’s a brief overview of how Medigap plans work:

1. You must have Original Medicare Part A and B to enroll in a Medigap plan.

2. You pay a monthly premium for your Medigap policy and your Part B premium.

3. Your Medigap policy helps pay some out-of-pocket costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and deductibles.

4. You can see any doctor or other healthcare provider that accepts Medicare patients, regardless of whether they officially accept your Medigap policy. (They must accept all Medigap policies if they accept original Medicare.)

5. Some Medigap plans also offer extra coverage for certain benefits that Original Medicare doesn’t cover, such as foreign Travel emergency care.

Why are Medigap plans essential?

Medigap plans are essential to the health insurance landscape in Philadelphia and the United States. These plans help to fill in the gaps left by traditional Medicare coverage, providing vital protection for seniors in the event of an unexpected healthcare need.

Various Medigap plans are available, each with its unique benefits. Shopping for a Medigap plan can be confusing, but comparing programs and finding the one that best meets your needs is essential.

When considering a Medigap plan, comparing plans and finding the one that best meets your needs is essential. You can use the resources on this website to learn more about Medigap plans and how they work.

What are the different types of Medigap plans?

There are ten types of Medigap plans, each with different coverage. Plan A is the most basic and covers the least amount of services, while Plan G covers the most. The different types of plans are:

-Plan A

-Plan B

-Plan C

-Plan D

-Plan F

-Plan G

-Plan K

-Plan L

-Plan M

-Plan N

How to choose the right Medigap plan?

When choosing the right plan, you’ll want to consider your budget and healthcare needs.

Here are some things to consider as you compare Medigap plans:

-All plans cover primary benefits like Medicare Part A and B coinsurance, Hospice care, and the first three pints of blood for transfusions.

-Plans K and L have higher coinsurance amounts than the other plans, but they have an out-of-pocket limit.

-Plan G covers Medicare Part B excess charges. It also will pay your Medicare-approved expenses after a deductible. In 2023 that deductible is $226.

-Plan N pays for some copayments and deductibles. Still, you may have to pay a copayment of up to $20 for office visits and up to $50 for emergency room visits, along with any excess doctor charges.

Plan G is currently the most popular plan for people new to Medicare.

How to enroll in a Medigap plan?

You can enroll in a Medigap policy up to three months before your 65th birthday, your Retirement date (if you retire before age 65), or during the Medigap Open Enrollment Period, which is up to 6 months after you enroll in Part B. 

During the Medigap Open Enrollment Period, you are guaranteed to be accepted by a Medigap company, even if you have health problems. If you enroll outside this period, the company may require you to pass medical underwriting before accepting you.

Once you’ve enrolled in a Medigap plan (Medicare supplement), it is guaranteed renewable every year as long as you pay your premium.

Open Enrollment Period

The open enrollment period for Medicare runs annually from October 15 to December 7. However, this is not the case for people interested in Medigap coverage. The open enrollment period for this policy is six months, starting on the first day of the month in which you turn 65 or older and have subscribed to Part B. After this period, you may be able to purchase a Medigap policy on a limited basis which may be more expensive. 

People with Medigap plans don’t need to worry about the Medicare Enrollment Period. This is because you can change your Medigap plan anytime throughout the year. You’ll have to answer the medical questions, regardless of when you want to change plans. For this reason, we recommend you review your Medigap plan around your birthday month unless your birthday is during the enrollment period. If that is the case, review your plan in January or February. You’ll get more attention, and the insurance companies will take less time to review your application.

Benefits of enrolling in a Medigap plan

There are several benefits to enrolling in a Medigap plan, including:

– peace of mind that your health care costs will be covered

– access to a wide range of healthcare providers

– protection from high out-of-pocket costs

– coverage for preexisting conditions

What don’t Medigap Plans cover? 

When Medicare approves an application and pays the portion due by Medicare, it forwards the rest of the bill to your Medicare supplement. Medigap plans only pay after Medicare pays its share for the first time. If Medicare doesn’t cover you, your Medigap plan won’t cover you. 

For example, Medicare doesn’t pay for the following:

• Hearing aids
• Eyeglasses and contacts
• Routine dental, vision, and hearing exams
• Retail prescription drugs
• Long-term care or custodial care

Limits and Considerations

In most cases, Medigap coverage has no limit on its network and is available everywhere Medicare is accepted. 

Suppose you live in Philadelphia and need help finding the best licensed Medicare insurance agent. You can use the Medicare Certified Agent Directory website. On the website, you’ll find an experienced local Medicare insurance agent who can help you understand your plans and available products selection. 

On the home page, click the drop-down menu and select the state of Pennsylvania. Click Search Now, and you’ll get your online result.

If you click “Find Professionals” and enter your state, you’ll find certified and licensed insurance agents. You can also check their information and reviews. Get to know the agent a little before asking for help. Unlike other websites, you control who calls you, and several agents won’t contact you. We prioritize ensuring you can control who gets you when you use the “Find Professionals” button. 

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.