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Medicare Supplemental Insurance Options: 10 Answers to the Most Commonly Asked Questions

23 July 2018 No Comment

When looking for Medicare supplemental insurance options (also known as Medigap), you probably have some questions. Fortunately, Medigap is easy to understand. In that case that you’d like to expand your knowledge, you’ve arrived at the right place. We’ll be discussing some of the most frequently asked questions in regard to Medigap.

  1. What is covered under Medicare supplemental insurance?

There are ten different Medicare supplement insurance options (A, B, C, D, F, G, K, L, M, and N). Each have different benefits and coverage amounts. Based on the latter, one supplemental insurance plan may not be fit for someone, but that same plan may be more suitable for someone else.

However, the most popular Medigap plans include Medicare supplemental plans G, F, N, M, and C.

Benefits may include (but are not available on all plans):

  • Medicare Part A coinsurance and hospital costs
  • Medicare Part B copayments and coinsurance
  • The first three pints of blood needed for a transfusion
  • Medicare Part A hospice care copayments and coinsurance
  • Medicare Part A coinsurance for skilled nursing care facility
  • Medicare Part A deductible
  • Medicare Part B deductible
  • Medicare Part B excess charges
  • Foreign travel emergency care

All ten Medigap plans have standardized benefits across the United States; each company must offer the exact same benefits for each plan regardless of where they are located in the country.

  1. Am I eligible for Medicare supplemental insurance?

There are a few requirements before one can be accepted for Medicare supplemental insurance:

  1. You must be enrolled in Medicare Part A and B.
  2. You must be 65-years-old or older or live in a state allowing individuals under 65 to receive supplemental insurance due to a certain disability or condition. Qualifying states include: CA, CO, CT, DE, FL, GA, HI, IL, LA, ME, MD, MA, MI, MN, MS, MO, NH, NJ, NY, NC, OK, OR, PA, SD, TN, TX, OK, VT, WI.
  3. Because not all plans are an option in every state, you must live in a state that offers the Medigap plan you wish to have.
  4. How much do Medigap plans cost?

Depending on your insurance provider, the cost for a Medigap plan can vary due to different pricing models and any discounts an insurance company may personally offer. Not only will costs vary from each insurance company, but the costs for a Medigap plan can differ based on the state as well.

Also, as mentioned, the types of plans available will vary too among each state. But one thing is for sure: You will receive the same benefits from state to state as Medigap plans are standardized.

  1. How do I enroll in Medigap?

Because Medicare supplemental insurance prices and plan availabilities can vary from each insurance company, it is a wise idea to speak to a licensed agent regarding different plans, quotes, and the process for enrollment.

If you aren’t sure where to enroll, you can find a Medicare policy in your area from the Medicare website including the types of Medigap plans available, the monthly premium and estimated annual cost, and the benefits provided by each.

  1. When can I enroll in Medigap?

The most suitable time for Medigap enrollment is during the open enrollment period which begins 1) the month you turn age 65 and 2) when you enroll in Medicare Part B. Your enrollment window will last for the next six months thereafter.

Regardless of your current health status, companies offering Medigap are required to offer you the best rates during your open enrollment period. If you are unsure if you are receiving the best rate, be sure to confirm with your SHIP.

Do keep in mind that when you apply for Medicare supplemental insurance during open enrollment that under federal law, insurers of Medigap can deny coverage for pre-existing conditions (conditions you had prior to enrollment) for the first six months.

No worries if you miss out on enrollment during your enrollment period. You can still purchase Medicare supplemental insurance if you are 65-years-old or older and have a guaranteed issue right.

  1. If I move or travel temporarily or permanently, what will happen to my Medicare supplemental insurance?

In most cases, when you move or travel out of state short- or long-term, your supplemental plan will follow you with the same benefits, even if that plan isn’t offered in that state.

To ensure that your Medicare supplemental insurance plan will stay with you through your move or long-term travel, contact your insurance agent for more information.

Even if you already know your Medigap plan will (or will not) transfer over, it is important that you still notify your plan before your move or travel. If moving, you will want to notify Social Security regarding your address change.

As for traveling outside of the country, if you have Medigap plan C, D, F, G, M, or N, you will have foreign travel emergency benefits. 80 percent of medical emergencies will be covered when you are traveling in a foreign country after you pay a $250 deductible.

If you purchased Medicare supplemental insurance before June 1, 2010, plans E, H, I, and J will also have foreign travel emergency benefits.

  1. Can a Medicare supplemental insurance plan be used with a Medicare Advantage Plan?

Unfortunately, you cannot use Medigap alongside a Medicare Advantage Plan. You can only use a Medigap plan alongside Medicare Part A and Part B. Medicare supplemental insurance cannot be used in conjunction with a Medicare Advantage Plan.

If you plan to enroll in a Medicare supplemental insurance plan, you must leave your current Medicare Advantage Plan before your Medicap plan can become active. It is against the law for an insurer to allow you to have both plans at the same time.

  1. Why should I get Medicare supplemental insurance?

Opting for Medicare supplemental insurance or Medigap is important if you want more coverage for medical expenses.

The whole point of enrolling in Medicare supplemental insurance is to receive new benefits and greater coverage for medical expenses that Medicare alone does not have. It’s a way to revamp your current coverage into something better and more versatile for your wants and needs.

Overall, opting for Medicare supplemental insurance gives you greater flexibility with potential treatment options and has more straight-forward policies. The more benefits you have from insurance or a supplemental insurance plan, the better you can be in being prepared for both expected and unexpected medical costs.

  1. What is the difference between a Medicare supplemental insurance plan and a Medicare Advantage Plan?

When deciding if you should pick between Medicare supplemental insurance or a Medicare Advantage Plan, it’s important to weigh the pros and cons of each because you can only have one or the other at a time. There really isn’t a better option; it all comes down to what is more relevant and convenient for you personally.

When it comes to the costs of each, Medigap plans usually have higher monthly costs, but the advantage over a Medicare Advantage Plan is that Medigap plans typically offer lower out-of-pocket medical expenses. On the other hand, Medicare Advantage has a wider range of benefits and often costs less to keep.

When it comes to doctor and facility choice, you’ll have more options with Medigap (and general Medicare) that you will with Medicare Advantage. Medigap will allow you to receive treatment from any doctor of facility that accepts Medicare while there are greater limitations with a Medicare Advantage Plan.

As for coverage of foreign travel medical expenses, you will have regional limitations where you can receive coverage when you have a Medicare Advantage Plan, but with a Medigap plan, you’ll not only have coverage in all 50 states in most cases, but with some plans, you will even receive coverage for expenses while traveling in another country.

  1. What are the disadvantages of Medigap?

While considering a Medigap plan can be a great step to expand your Medicare policy, there are also cons associated with this supplemental insurance, including the following:

  • Added monthly premiums (which for some, can be pricey)
  • Difficulty in switching between Medicap plans once you have already enrolled
  • Lack of coverage for acupuncture and many other traditional or holistic treatments
  • No drug coverage
  • Not all Medigap plans offer medical coverage when traveling out of the country.
  • Hospital deductibles aren’t covered by all plans.
  • Difficulty in enrolling after your enrollment period has already passed

Regardless of these cons, Medicare supplemental insurance is far greater and more powerful than Medicare on its own. When you use Medigap to cover various health expenses, the higher premiums you pay on a monthly basis can all be worth it.

Conclusion

Medicare supplemental insurance or Medigap is a great option to choose if you wish to expand on your medical benefits to reduce out-of-pocket costs. Now that you’re better informed about Medicare supplemental insurance, it’s time for you to find the Medigap plan most suitable for your medical needs and start the enrollment process.

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