Cathy Parvino
medicare supplement plans
Medicare comprises various “parts,” each intended to complement one another to provide comprehensive coverage.
However, discrepancies among these plans can leave individuals facing challenges in certain situations or burdened with significant out-of-pocket expenses. Medicare Supplement Plans, commonly referred to as “Medigap” plans, were introduced to address these gaps.
Medicare Supplement plans serve to bridge the coverage deficiencies inherent in Medicare. When paired with Original Medicare, they ensure nationwide acceptance and typically offer the lowest out-of-pocket costs and the highest level of flexibility. Nevertheless, the cost of these plans is contingent on factors such as age, gender, location, tobacco usage, and household eligibility for discounts. Consequently, premiums can vary significantly based on circumstances and the chosen insurance provider.
What exactly is a Medicare Supplement plan?
Medicare Supplement Plans are designed to handle expenses typically left for the patient to cover under Medicare. These expenses can encompass deductibles, co-pays, and coinsurance.
Initially, Medicare handles its portion of the expenses. Subsequently, the Supplement plan comes into play to cover its portion. While, in numerous instances, the Supplement plan takes care of the outstanding balance of the bill, the specifics can fluctuate depending on the plan’s structure.
The Ten Types of Medicare Supplement (Medigap) Plans
In 1990, Medicare standardized all Supplement plans and assigned each a letter designation. Individuals eligible for Medicare can opt for Medigap plans A, B, C, D, F, G, K, L, M, or N. Plans with the same letter provide the same benefits regardless of the insurance company. The main difference between these plans, also called Medigap, is their cost. It’s important for beneficiaries to carefully compare plans to find one that fits their needs and budget.
Certain items are not included in the coverage provided by any Medicare Supplement plan.
- Routine dental, hearing, and vision examinations
- Eyeglasses or contact lenses
- Hearing aids
- Retail prescription drugs
- Long-term care or custodial care
Enrolling in a Medicare Supplement plan
The Medicare Supplement Open Enrollment Period differs from the Annual Election Period, which occurs every autumn. The dates for Open Enrollment in Supplement plans vary individually, so knowing your specific enrollment window is essential.
Here are the key points to remember:
- Medicare Supplement Open Enrollment occurs once for most individuals.
- It is not an annual event; it's closed for good once the window closes.
- This enrollment period lasts for six months.
- Changing plans outside of this period may require answering health questions.
- Federal law generally doesn't compel insurance companies to accept you into a Medicare Supplement plan outside of Open Enrollment.
The Open Enrollment period begins when your Medicare Part B becomes active, lasting six months.
This means enrolling in a Supplement policy at age 65 for most people. However, if you postpone Part B coverage due to employment, your Supplement open enrollment window will start later, coinciding with your Part B activation.
Regardless, this Open Enrollment period is your sole opportunity to enroll in a Supplement plan without undergoing health inquiries. Otherwise, underwriting may be required, potentially leading to coverage denial.
Those eligible for Medicare before turning 65 due to disability will have a second Supplement open enrollment window upon reaching 65. This allows those who missed the initial enrollment to select a Medigap policy.
Remember, you must enroll in a Medicare Supplement plan during your six-month open enrollment period; otherwise, you won’t have another chance without answering health questions. Although you can apply for a Medigap plan later, insurance companies will likely require screening and may reject coverage. It’s advisable to consult with a licensed insurance professional as your Open Enrollment window approaches to grasp your Medicare Supplement plan rights and obligations.
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