Medicare Supplement or Medigap Insurance
Medicare Supplements or Medigap Policies as they are sometimes called are sold by private insurance companies to fill the gaps in original Medicare. They pay for some of the things that Medicare does not (deductibles and co-insurance). A Medicare Supplement can help you lower out of pocket costs and get more healthcare coverage.
You must have Medicare Part A AND Part B in order to get a Medicare Supplement. If you go with a Medicare Advantage plan you DO NOT need a Medicare Supplement. There are 10 standardized plans that are labeled Plans A-D, F, G, and K-N. You should not confuse a Plan A or Plan B with Medicare Part A or Part B.
Important Note on Medicare Supplements
If you are within the first 6 months of signing up for Medicare Part B, you are guaranteed acceptance for any Medicare Supplement plan from any company you choose. Outside of the initial enrollment period, there may be some health questions and underwriting that is performed. It is important that you get a Medicare supplement when you first get Part B as you may not qualify for one at a later time.
If you are covered under a group health plan when you sign up for Part B, this may act as a supplement to Medicare and cover the same sort of things a Medicare supplement does. If you lose that group coverage, you have 63 days to be guaranteed acceptance for a Medicare supplement plan from any company you choose. These dates and time frames are very important to know.
Medicare Beneficiaries Under Age 65
The rules for acceptance into Medicare of people under 65 years old on disability vary by state and company. Not all states require companies to offer policies to people under age 65. And not all companies offer plans to people under 65 as well. If they do, the premium will be higher than for someone under 65. Most companies also require underwriting (answering health questions) even if a person is in a guarantee issue situation, except in a few circumstances
Medicare Supplements DO NOT cover:
- Long Term Care
- Dental Care and Dentures
- Routine eye care and eyeglasses
- Hearing Aids
- Private duty nursing
- Prescription drugs
Not all insurance companies offer all plans. Imagine Insurance Advisors offers Medicare Supplements from many leading companies and can offer all plans at very competitive rates. While the content of the various plans does not change across insurance companies, the cost of those plans does. We can help you find the best priced plan for your needs.
There are some plans that are called "Select". These can be less expensive than a traditional plan. You can have a Plan F or a Plan F Select.
The difference between a Select plan and a non-Select plan is that if you are admitted to a hospital for a non-emergency, you need to use one of the company's network hospitals. If you don't use a hospital in their network, you will have to pay the Part A (hospital) deductible. Other than the network of hospitals, a select plan is identical to a non-select plan.
In an emergency, you can go do any hospital and receive your care and it will be covered. It can be tempting to go with a select plan from a company, but we recommend you ask for their hospital list before choosing a plan. You may find their hospital list very limited. The list of network hospitals can vary widely by company, so if you are quoted a very low price compared to other companies, ask if it is a select plan. Always check the network hospitals list.
Typically Medicare supplement prices increase each year as the deductibles in Medicare increase. It is important to find a strong company with a history of reasonable rate increases. Be wary of a plan with a very low premium or one that is new to the market. Some plans may start low and then have hefty rate increases over time.
If you want to change your plan, you must go through underwriting and you may not be eligible to change if your health is poor. Most people will pick a company and plan and never change it. We offer some of the most stable companies in the industry and have a range from which to choose.
Medicare Supplement Plan Comparison
|Skilled Nursing Coinsurance||X||X||X||X||X
|Part A Deductible||X||X||X||X||X||X
|Part B Deductible||X||X|
|Part B Excess||X
|Foreign Travel Emergency||X||X||X||X||X||X||X||X|
Note Plan K has an out-of-pocket limit of $4,960 (2016). Plan L has an out-of-pocket limit of $2,480 (2016). When you have met the annual limit, the plan pays 100% for the rest of the calendar year. Plans F has a high deductible option before the plan pays anything. The deductible is $2,180 (2016), then you will pay $0.
Choosing a Medicare Supplement does not need to be a confusing undertaking, but trying to understand it alone may not give you the coverage you are looking for. Imagine Insurance Advisors can help understand your health insurance requirements to guide you to the plan would be the most appropriate and cost affordable for you.