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 out-of-pocket costs 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 want the freedom to have coverage in any state.
Medigap Plans C and F
Starting January 1, 2020, Medigap plans won’t be allowed to cover the Part B deductible ($203 in 2021). Therefore, Plans C and F will no longer be available for people new to Medicare starting January 1, 2020. If you already have either of these two plans (C or F), you will be able to keep your plan. However, Senior Healthcare Direct recommends Medigap Plan G as the most cost-effective supplement plan.
What is Medicare Supplemental Insurance?
Medicare only covers 80% of your Part A and Part B expenses. So you are stuck paying 20% of your hospital and medical bills. This 20% can be devastating to you financially if you have a serious illness. Fortunately, Medicare supplemental insurance pays that 20%, fills this gap, and buys you peace of mind.
Furthermore, Medigap covers all coinsurance costs for Medicare Part A, including skilled nursing facility, hospice care, and part-time home health services. Most importantly, Medigap plans pay your $1484 Part A deductible in 2021 for every 60 day benefit period.
Moreover, Medicare Supplements cover coinsurance or
copay costs of Part B medical services and supplies. For example, it pay your bills for doctor visits, outpatient procedures, durable medical equipment, and lab work.
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 $371 coinsurance per day. Moreover, if your hospital stay is more the 90 days without Medigap, you will have $742 coinsurance per day!
However, Medicare supplement insurance pays this expensive hospital coinsurance. As a result, you can stay in the hospital as long as needed without worrying about the cost. Furthermore, Medigap Plans give you these 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
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. To buy a supplement policy you must have Medicare Part A and Part B. Learn more about the 4 Parts of Medicare.
Medigap Plans only cover one person. So your spouse or other family member must have a separate supplement policy. When you enroll two or more people, you can get a household discount and save money on your monthly premiums. Non-smokers can get additional discounts, as well. Call Senior Healthcare Direct at 1-855-368-4717 and find out how much you can save.
Furthermore, Medigap Plans do not include drug coverage. So if you need prescription drugs, you can add a separate Part D drug plan.
Medicare Supplement Plan 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.”
The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period.Medicare.gov
Best Time to Buy Medigap Plan
The best time to buy a Medigap policy is the 6-month period starting the first day you turn 65. For example, you turn 65 in March and enroll in Part B. The best time to buy a Medicare Supplement Plan is from March to August.
During this open enrollment period, Medicare supplement companies do not require medical underwriting. Consequently, these companies cannot deny you coverage even if you have pre-existing health problems.
In other words, Medicare Supplement companies can not turn you down for any health conditions. Furthermore, the Medigap company cannot charge you more for a supplement policy than they would charge someone with no health problems.
Thus, you will have the right to buy any Medicare supplement plans. So purchasing a Medigap Plan during your Open Enrollment Period allows you to qualify for any supplement plan at the best price.
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 Guarantee 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 Original Medicare and your employer group health coverage 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.
- You dropped a Medigap policy to join a Medicare Advantage Plan for the first time and within the first year. You can switch back to Medigap within 63 day after your coverage ends.
In general, guaranteed issue time period works just like open enrollment, except that it’s shorter time frame.
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.
- Medicare supplement companies may offer high-deductible plans F and G. According to CMS.gov, these plans require you to pay a deductible of $2370 in 2021 before your policy will pay anything.
- For Medigap Plans K and L, after you meet your annual out-of-pocket limit ($6,220 for plan K and $3,110 for plan L) and your annual Part B deductible ($203 in 2021), 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 2021, plans C and F will not be available to you.
Decide which benefits you want, then decide which of the standardized 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.