Medicare Supplement Plans
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A Medicare supplement (also known as Medigap) insurance plan is a private form of medical insurance that covers the gaps left by Medicare. These gaps include payment of some of your Medicare health care costs like copayments, coinsurance, and deductibles.
Similar to other supplemental insurance plans Medigap aims to reduce your out-of- pocket expenses and works hand-in-hand with your Original Medicare to pay its own share of covered healthcare costs. A Medigap policy is quite different from a Medicare Advantage Plan. Medicare Advantage plans are used as ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits. When you buy a Medigap policy, you have up to 10 plan options to choose from in most states. (While other states have different options). Medigap Policy plans can be purchased from private insurance companies like Fulmer Insurance Group, not the federal government. The Various Medigap plans are Plans A, B, C, D, F, G, K, L, M, and N. They all have different combinations of coverage for medicare expenses and do affect your choices based on your needs.
Expenses covered by Medigap include:
1) Part A hospital care co-insurance
2) Part A hospice care co-insurance or co-payment
3) Part B co-insurance or co-payment
4) First 3 pints of blood
5) Part A deductible
6) Part B deductible
7) Part B excess charges
8) Skilled nursing care
9) Foreign travel emergency care
The first four items in the list are the expenses covered by all Medigap plans. The other items (called optional benefits) may or may not be covered, depending on which plan option you choose. Since each plan is different, it’s important to understand which benefits are included in the Medigap policy you plan to buy.
To be eligible for Medicare Supplement insurance, you must be:
1) Enrolled in Medicare Parts A & B (Original Medicare)
2) 65 or older, or have a disability
3) You can also buy a policy if you are 65 or older, have Part A, and are enrolling in Part B.
You cannot buy a Medicare Supplement policy if you have a Medicare Advantage Plan. These two types of coverage are incompatible. If you want to switch from a Medicare Advantage Plan to a Medicare Supplement policy, you must first disenroll from the Medicare Advantage policy before your Medicare Supplement Policy begins.
Your health history could also affect your ability to buy coverage. It’s always advisable to apply for a policy during the open enrollment period. That’s because, during this period, insurers are not allowed to deny you a policy or raise your rates because of past health problems. If you buy outside of the open enrollment period, this protection may not be there, because insurers may raise your rates or choose to not offer you a policy because of your past health problems.
2) Insurers cannot increase prices due to health issues
3) You are able to switch plans within your 6-month open enrollment period
4) You do not have to wait for coverage to begin
Technically, you can still buy Medicare Supplement insurance after your open enrollment period ends, but your health history can affect your options. It’s not a guarantee that you can buy a policy, therefore insurers can charge you higher rates because of your health history. That’s because after open enrollment, insurers are allowed to use underwriting to determine your eligibility. Underwriting lets them raise your rates or deny you coverage based on your medical history.
