Medicare Supplements – If you’ve just gotten started on your Medicare journey, you may have heard about Medicare supplements. These plans are one of two ways to reduce your medical expenses under Parts A and B of Original Medicare.
Before you decide these plans are right for you, you’ll need to know how Medicare supplements work, what they cover, what they don’t cover, and how much they cost. By the end of this article, you’ll know all that and a little bit more.
What is a Medicare supplement?
Medicare supplement plans are also called Medigap plans. They were designed to “supplement” or fill in the “gaps” left by Original Medicare. If you’ve started learning about your coverage with Part A and Part B, you know that you can incur quite a few out-of-pocket expenses if you don’t enroll in supplemental insurance. A Medigap policy will reduce your out-of-pocket costs.
Today, there are ten different Medigap plans to choose from, each named by a letter of the alphabet. You have Plan A, B, C, D, F, G, K, L, M, and N. There are also high-deductible versions of both Plans F and G. All of these plans are standardized, which means their benefits will be the same no matter where you purchase one.
How does Medicare supplement insurance work?
Your Medicare supplement plans will pay as your secondary insurance after Original Medicare pays its share. The leftover expenses it picks up will depend on which of the ten plans you have.
Any healthcare provider who accepts Medicare assignment will also accept your Medigap plan. There are no networks associated with these plans, so you won’t have to worry about being in or out of your plan’s service area. Currently, more than 96% of all providers accept Medicare, so it’s not difficult to find a provider who works with your Medigap policy.
What do Medicare supplements cover?
It’s important to know what is covered by your Medicare supplement plan. Part of that will depend on which letter plan you have, but there are also some things that are not covered under any supplement.
Let’s start with what is covered.
You might know by now that Original Medicare does not pay for all of your medical costs. In fact, if you need even average treatment, you’ll be stuck with a substantial bill. Plus, there is no maximum out-of-pocket with Original Medicare, so there is no limit on what you could be responsible for in a given year.
The expenses that your Medicare supplement plan might pay include:
- Part A deductible
- Part A coinsurance and hospital costs, plus an additional 365 days after your Part A benefits are exhausted
- Skilled nursing facility care coinsurance
- Part A hospice care coinsurance
- Part B deductible
- Part B excess charges
- Part B coinsurance and copayments
- First three pints of blood, if the procedure is Medicare-approved
- 80% of a foreign travel emergency (up to plan limits)
You can use a Medicare supplement comparison chart to determine which of those expenses will be included in your plan. One of the most popular Medigap plans, Plan G, takes care of all those expenses except for the Part B deductible.
What is not covered in Medicare supplements?
One disadvantage to Medicare supplements is that you’ll need to enroll in additional policies to have more comprehensive healthcare. If you understand what’s not covered by Original Medicare, you can quickly understand what’s not covered by a Medicare supplement. If Original Medicare doesn’t include the services, neither does the supplement plan. Let’s talk about a few of the services that won’t be covered by your Medicare supplement plan.
The first policy you’ll need to enroll in is a Part D prescription drug plan. Medicare Part B does include some coverage for medications, but it is limited mostly to injectable drugs that are typically administered by a healthcare professional. Medications for things like high blood pressure or high cholesterol are not included. Even if you are not on any prescription, you need to enroll in Part D. If you don’t, you’ll pay penalties later.
You also won’t find benefits for routine dental care, vision and hearing exams, eyeglasses, or hearing aids. These are all areas of your health you may want to consider purchasing an additional insurance policy to help pay for those expenses.
How do I enroll in a Medicare supplement?
A licensed insurance agent can help you enroll in a Medigap plan. You can also do so yourself, but you’ll have to do a lot more research and shopping to find the most competitive rates.
Once you’ve got your enrollment in Original Medicare complete, you can begin the enrollment process for a Medicare supplement plan. If you enroll during your Initial Enrollment Period (IEP), you will not have to undergo medical underwriting before being granted one of these plans. You’ll also enjoy guaranteed issue rights if you qualify for a Special Enrollment Period. Outside of those times, you’ll have to answer medical questions and pass medical underwriting in order to get a plan.
How much do Medicare supplements cost?
Medicare supplements vary in price. The first determining factor is which of the plans you choose. The more coverage the plan has, the more you can expect to pay for it. Probably the next biggest factor is where you live. If you live in a zip code with a higher cost of living, your premiums will be higher.
Other individual factors will also be considered when the insurance company sets your premium. They’ll look at your age, gender, and tobacco use. Some offer household discounts if your spouse enrolls or if you live with someone over the age of 60. Each carrier has its own discounts.
If you’re ready to enroll in a Medicare supplement plan or you’d like to learn more, don’t hesitate to reach out! Our Medicare advisors are more than happy to help you on your Medicare journey.