Medicare Supplements
You probably like having your Medicare benefits because they help you pay for all of the health care services you need to stay healthy.
Though, it isn’t likely that you enjoy the out-of-pocket costs you are left over with after Medicare pays their approved portion. We have a potential solution you should definitely consider. That solution is Medigap, or Medicare Supplement Insurance.
With one of these plans, you can mitigate some of the out-of-pocket costs associated with Medicare, lowering your overall health care expenses.
Here is what you need to know about Medigap plans.
What is Medigap?
Medigap plans have the same product offering or policies as a Medicare Supplement (descriptions are used interchangeably.) These insurance policies provide secondary coverage paying for all or a portion of the services not covered by Original Medicare.
Choice and coverage options are important in our health care decisions as one size does not fit all. There are ten Medigap plans with each plan expressed with a different corresponding letter. Certain plan benefits from the most basic coverage to the most comprehensive coverage are offered within those ten Medigap plans. Premiums are higher for a more comprehensive coverage option.
Coverage benefits are the same in all states no matter where you have purchased the supplement provided you are comparing the same lettered plan. Each plan has outlined the terms of coverage at the beginning of each year and covers differing costs, like max out of pocket, copays, coinsurance, deductibles, excess charges, and foreign travel. Some companies offer additional benefits like gym memberships when purchasing their Medicare supplement policies and these benefits are not part of the standard Medigap plan offering.
Enrolling In Medigap Plans
Enrolling in Original Medicare as a Medicare beneficiary is necessary to being eligible to enroll in a Medigap plan. Unlike enrolling in Original Medicare through the Social Security Administration, Medigap plans are offered through private companies.
You pay no fees when using an agent/broker to help guide you through the enrollment process with additional information that will help you make informed decisions. Agents are on the ground each day gathering information through hands-on experience of which companies are best to work with and have managed their medical loss ratio (expenses) to minimize rate increases.
We highly recommend the use of a professional when enrolling in private Medicare plans. It costs you nothing as a consumer; all fees for service are paid by the company to the agent/broker. You have a personal Medicare licensed representative to help you through all your plan needs and questions.
When To Buy Medigap Coverage
Medigap Open Enrollment Period lasts for 6 months, starting your first day of your 65th birth month. If you were born on the first day of the month your enrollment period begins one month earlier, and that day will be the date for the start of your 6-month open enrollment opportunity. Open enrollment provides a period when anyone can obtain a Medigap policy without having to show proof of insurability. If you are already on Original Medicare prior to your 65th birthday you will be granted another open enrollment period.
If you don’t enroll within the Open Enrollment Period, which lasts for 6 months after you become eligible for Medicare, you may be required to answer health questions before you can purchase a Medigap plan. Your answers to those questions may disqualify you from getting Medigap coverage from that provider, or they could classify you at a standard or higher risk charging you more premium for the policy.
There are no required Special Enrollment Periods that would prevent you from applying to make a change from one Medigap plan to another during the year or initializing application when you have Original Medicare as your primary insurance.
Being enrolled in a Medicare Part C, Medicare Advantage plan will prohibit you from filling out an application for a Medigap policy as there are certain times only when you may disenroll from those plans. The annual enrollment period October 15th – December 7th allows for disenrollment from a Medicare Advantage plan effective January 1st following year. You will then have an option to go back to Original Medicare with or without a drug plan. This now gives you an enrollment opportunity for a Medigap plan.
Types of Medicare Supplement Plans
There are ten different Medicare Supplement Insurance plans with a competitive field of companies wanting your business. It is vital to your financial health to make an informed decision when starting Medicare as you may be permanently attached to that initial company of choice if your health deteriorates, or you no longer qualify to make a change with another company years down the road.
Rates do increase with time and as we age, and our medical claims go up. They are accelerated when healthy members leave to a company with a lower premium. If you have health conditions that prevent you from making a change to a company that has a lower rate for individuals in your age group, you want a company that has a historical track record of managing rate increases with expertise. Experience and stability win every time even if you pay a little more in monthly premiums in the beginning.
Medigap plans are all standardized across the country and assigned a specific letter so no matter where they are purchased the benefits and payouts are the same. Consumers have an array of choices from basic coverage to moderate benefits and those who wish to insure everything possible.
As indicated, Medigap plans are organized using letters. Plan A is the most basic plan offering. The other plans that are offered include plans B, C, D, F, G, K, L, M, N. Plans C and F are available only to those who turned age 65 prior to January 1,2020 and cover everything not paid by Original Medicare. Plans G and D are the most comprehensive plans offered for those who have turned 65 after January 1, 2020 and covers everything except the Medicare Part B annual deductible of $203.
All gap plans offer some assistance paying for Medicare Part A coinsurance and hospital costs, as well as coverage for Part B coinsurance and copayments. You also get three pints of blood to be used in a medical procedure with every plan. While most of the plans cover these basic costs in full, Plans K and L are cost-sharing plans, so they only cover 50% and 75% of the costs respectively up to the annual stop loss limit for that year.
Find The Right Medigap Coverage
You have options when it comes to Medigap coverage. Start shopping now to find the best solution. Larry Klein would be glad to speak to you about your future Medigap plan.