Medigap Policies Insurance Overview

Medicare supplement plans are also referred to as Medigap policies. In order to obtain a Medicare supplement plan, you must already have Medicare Parts A and B.  Medicare “Supplements” work exactly as the name suggests; thus, if Medicare provides coverage for a procedure, the supplement plan will cover the difference according to the level of coverage you have.  Medicare typically covers about 80-percent of your medical needs, which naturally leaves roughly 20% to be paid by you, the insured, out-of-pocket.  Medicare supplement plans offer 10 standard options to choose from, differing depending upon the amount of coverage you wish to obtain.  We will now begin with the basics before we come back full circle.

Medigap policies are only available for individuals qualified for Medicare.  Most commonly, in order to be eligible for Medicare, one must turn 65 years old.  A once-in-a-lifetime Open Enrollment period will then trigger with your Medicare Part B effective date, which is the first day of the month of your birth when you turn 65 years old (unless there is delay to Part B benefits or Medicare due to a disability).  If your birthday falls on the 1st, you will receive a Part B effective date on the 1st of the previous month.  The guidelines for Open Enrollment comprise a window of 7 months, which entails 3 months prior to your Part B effective date, the month of your effective date, and the three months following the effective date.  There are some companies that will extend to six months prior or six months following the seven month window just described.  During open enrollment, you are able to shop for the most suitable plan for your particular needs and budget.

Another means to qualify for Medicare is to be on disability for 24 months, who will then qualify for Medicare, and the Open Enrollment is determined by the Part B effective date.  Please note that not all states offer Medicare Supplement plans for the type of individual just described, as state guidelines and plans are subject to vary.  This type of individual will experience an additional Open Enrollment upon turning 65 years old.

Finding the Right Medigap Policies For You!

Next, you must find a plan that is most suited for your needs.  Your Medicare Supplement plan can only take effect on your Part B effective date.  This is why it is ideal to get an early jump on choosing a plan.  When researching plans, you should know that the most expensive option isn’t necessarily always the best in terms of coverage (just as the cheapest plan isn’t necessarily the most affordable).
Also note that Medicare Supplement plans do not cover Rx drugs.  You will instead need to obtain a stand-alone Prescription Drug Plan (PDP), which is also referred to as Part D Medicare.  Moreover, vision and dental is not covered unless it is a medical necessity for you.  Should you desire to obtain coverage for these, a separate plan can be obtained, which is often inexpensive.

10 Must-Know Medicare Supplement Plan Facts

  1. You must first obtain Medicare Parts A and B.
  2. There are 10 standard Medicare supplement plans that are lettered A through N.
  3. You can visit any doctor or hospital that accepts Medicare (regardless of which plan or carrier you enroll with).
  4. Should you have Medicare Advantage (Part C), you can obtain a Medicare Supplement policy; however, we recommend that you first check to ensure that you can leave your Medicare Advantage plan in order to go back to the Original Medicare Part A and B prior to the start of your policy.
  5. You pay private insurance companies a monthly premium for your policy, as well as the monthly Part B premium paid to Medicare.
  6. Medicare Supplement policies cover a single individual. Should you also wish to obtain coverage for your spouse, then you will each need to obtain separate Medicare supplement policies.
  7. A Medicare supplement plan can be obtained from any insurance company licensed in your state.
  8. Standardized policies are always guaranteed to be renewable, regardless of any health problems. You will never have your policy cancelled (provided you pay your premium).
  9. In the past, some Medigap policies did cover Rx drugs; however, any policy sold after 1/1/2016 can no longer include Rx drugs coverage. You will need to obtain a Medicare Prescription Drug Plan (Part D) for this type of coverage.
  10. If you already have a Medicare Savings Account (MSA) plan, then it is illegal for any company to try and sell you a Medicare Supplement plan.

Our licensed Medicare agents are here to assist you in choosing the most suitable plan for your needs.  We’re available to make sure that you get all of the desired coverage within the shortened timeframe.  Please feel free to give us a call (or fill out the contact form), so we can provide you with accurate estimates.