Medicare Supplement Plans (Medigap)
Medicare Supplement plans pay the bills that Medicare Part A and Part B would normally charge you. These plans are also called Medigap plans, these policies pay your share of Medicare expenses including deductibles and co-insurance. Moreover, Medicare supplement insurance plans are available nationwide and are a good fit for people who want little to no copays for healthcare services. Since you can use your Medicare Supplement plan with any provider in the nation that accepts Medicare, it is a great choice for people who travel to more than one state throughout the year.
Medicare Part B deductible not covered in 2020
Starting January 1, 2020, Medigap plans to new people with Medicare won’t be allowed to cover the Part B deductible ($198 in 2020). Therefore, Plans C and F will no longer be available to people new to Medicare starting January 1, 2020. If you already have either of these two plans (C or F) or get covered by one of these plans before January 1, 2020, you will be able to keep your plan. So if you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans.
What is Medicare Supplemental Insurance?
Medicare only covers 80% of your Part B expenses. So you are stuck paying 20% of your medical bills. This 20% can be devastating to you financially if a serious illness arises. Medicare supplemental insurance pays that 20%, fills this Medigap, and buys you peace of mind.
Medigap covers all coinsurance costs for Medicare Part A which includes cost of hospital care, skilled nursing facility care, nursing home care, hospice, and home healthcare. Moreover, it includes coverage for Medicare Part B which includes doctor visits, outpatient procedures, durable medical equipment, lab work, and more! Medicare supplement insurance pays these expenses for you! Most importantly, Medigap covers your Part A deductible which saves you $1408 in 2020.
The Value of Medigap Insurance
The value of a Medigap plan maybe more than you think. If you have a hospital stay for more than 60 days without Medigap, you will have a copay $352 per day. Moreover, if your hospital stay is more the 90 days without Medigap, you will have a copay $704 per day! When you buy supplement insurance, you avoid paying these expensive copays. As a result, you can stay in the hospital as long as needed without worrying about the cost.
In addition to the great value you get with supplement insurance, it also come with some great benefits:
- Freedom to choose your own doctors and hospitals
- No referrals required to see a specialist
- No claim paperwork – claims are automatically filed with your supplement company
Supplement insurance buys you predictable out-of-pocket expenses for Medicare-covered services nationwide. Medigap covers your Medicare Part A deductible and copays in 2020. Based on the plan you choose, you will know exactly what’s covered for every inpatient or outpatient procedure.
Medicare Parts Vs. Medigap Plans
Although the names sound similar, Medicare Parts such as Part A and Part B is not the same as Medigap Plan A, Plan B, etc. Medicare Supplement, or Medigap, pays the 20% co-insurance expense of Medicare Part B and the deductible of Part A ($1408 in 2020). In addition, Medigap covers your co-pays for hospital stays, skilled nursing facility care, hospice and home health care. To buy a supplement policy you must have Medicare Part A and Part B.
Moreover, Medigap only covers one person. So your spouse must have his or her own supplement policy. Furthermore, many carriers offer household discounts if two or more people enroll in Medigap plans from the same company. However, Medigap plans do not include retail drug coverage. So if you need prescription drugs, you can add a separate Medicare Part D drug plan. Likewise, Medigap does not cover dental, vision or hearing services because Medicare does not cover these items.
Medicare Supplement Plans – Open Enrollment
The Centers for Medicare & Medicaid (CMS) Guide to Healthcare Insurance says, “The best time to buy a Medicare supplement policy is during Medigap Open Enrollment Period.” You will be automatically enrolled in Medicare Part A and B if you are receiving social security income. Otherwise, click here to enroll within 6 month period beginning on the first day of the month in which you are both 65 and enrolled in Medicare Part B. If you don’t apply during this Medigap Open Enrollment Period, then you may be disqualified if you have health problems. You are only guaranteed Medigap coverage when you enroll during this 6 month open enrollment period. Thus, it you don’t enroll during this time period you could be turned down and refused coverage.
During your open enrollment period, the Medicare supplement company does not require medical underwriting. Consequently, you cannot be disqualified because of your health problems. This means you cannot be turned down for any health conditions. Furthermore, the Medicare supplement company cannot charge you more for a supplement policy than they charge someone with no health problems. Moreover, you will have the right to buy any Medicare supplement plans. Therefore, you will generally get better prices and more choices among policies.
Medigap Pre-existing Conditions
Although a Medicare supplement company cannot make you wait for coverage to start, it may be able to make you wait for coverage related to a pre-existing condition. A pre-existing condition is a health problem you have before the date a new insurance policy starts. In some cases, the supplement insurance company can refuse to cover your out-of-pocket costs for these pre-existing health problems for up to 6 months. This is called a “pre-existing condition waiting period.” After 6 months, the Medigap policy will cover the pre-existing condition.
Medigap coverage for a pre-existing condition can only be excluded if the condition was treated or diagnosed within 6 months before your Medigap coverage starts. This is called a “look-back period.” Keep in mind your original Medicare will still cover the condition, but you will be responsible for paying 20% co-insurance and copays.
Medicare Supplement Plans – Guaranteed Issue
Guaranteed issue rights are rights you have in certain situations where Medicare supplement company must offer you certain Medigap policies when you are not in your Medigap open enrollment. Some common situations where you have guaranteed issue rights to apply for a Medigap policy include:
- Medicare Advantage Plan is leaving Medicare or stops providing care in your area or you move out of the plan’s service area. You can apply as early as 60 days before your health coverage ends. Otherwise, you only have 63 days after your coverage ends.
- When you have Medicare and employer group health coverage that pays after Medicare pays and is ending. Rights are guaranteed if you apply no later than 63 days after your group coverage ends.
- When you have Medicare and Medicare Select policy and you moved out of the Medicare Select service area. You can apply as early as 60 days before Medicare Select coverage ends. Otherwise, you only have 63 days after Medicare Select coverage ends.
- Within the first year of enrolling in Medicare Part A at age 65 you decide to switch from Medicare Advantage Plan or PACE. You can apply as early as 60 days before your coverage ends. Otherwise, you only have 63 days after your coverage ends.
In general, guaranteed issue time period works just like open enrollment, except that it’s shorter time frame. Moreover, your plan choices are limited to supplement plans A, B, C, F, K, and L.
Can I Buy Medigap if I lose my health coverage?
Yes, you may have a guaranteed issue right to buy a Medigap policy. It is most important you keep these documents: Copy of any letters, notices, emails, and/or claim denials with your name on them. This proves your coverage is terminated. In addition, keep postmarked envelopes for proof of when it was mailed. You may need these documents to prove you have a guaranteed issue right.
Medicare Supplement Plans – Standardized Plans
The Medigap Benefits Chart below shows you the standard available Medicare supplement plans. This chart also appears in Choosing a Medigap Policy booklet at Medicare.gov. You can use the chart below to compare Medigap plans.
- Medigap Plan F is a high-deductible plan offered by some Medicare supplement companies in some states. This plan requires you to pay a deductible of $2340 in 2020 before your policy will pay anything.
- For Medigap Plans K and L, after you meet your annual out-of-pocket limit ($5,560 for plan K and $2780 for plan L) and your annual Part B deductible ($198 in 2020), the Medigap plan pays 100% of covered services for the rest of that calendar year.
- Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
How to Buy Medicare Supplement Plan
Use the Medigap Benefits Chart above to help you decide which Medicare supplement plan A – N has the benefits you want. Plans with 100% include that benefit. However, some plans only provide partial coverage such as 80%, 75%, and 50%. Plans with X do not provide that benefit. If you are new to Medicare and shop for a Medigap plan in 2020, plans C and F will not be available to you. However, if you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy plan C or F.
Decide which benefits you want, then decide which of the standadarized Medigap plans meet your needs. When deciding on a plan, think of your current and future healthcare needs because you may not be able to switch your Medigap plan later.
Find out which Medicare supplement companies sell the Medigap plans you are interested in and compare costs. Senior Healthcare Direct offers Medigap plans.
Call Medicare insurance companies that sells Medigap plans. You are welcome to call Senior Healthcare Direct at 1-855-368-4717 or get a quote.
Buy your Medigap plan.