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Medicare Supplemental Insurance

You can find a ton of information online regarding Medicare Supplemental Insurance (also known as “Medigap” and “Medicare Supplement”). But if you’re like me, most of the information is written in a way you don’t fully understand. On this website you find everything you need to know about Medicare Supplement plans in a way you’ll understand.

When you approach retirement age you should start gathering information about Medicare, so you don’t have to rush at the last minute.  As a rule of thumb you should start making decisions 6 month prior your retirement.  Even though you are covered by Medicare doesn’t mean visits to the Doctor or emergency rooms are fully covered. Medicare Part A and Part B only cover around 80% of your medical expenses; you are responsible for the other 20%. These 20% can include deductibles, copays, prescriptions and other things. All it needs is for you to slip on the wet bathroom floor and fall awkwardly for a big chunk of your retirement savings to disappear. If you are in need of therapy, have to stay hospitalized for a longer period of time (60 days and up), or if you are a fan of alternative medicine such as acupuncture you NEED Medicare Supplemental Insurance.

We all know the process of aging can come with certain disadvantages; you may bruise easier, your eyesight decreases, your teeth need some extra attention. The costs of supplemental Medicare Insurance can add up quickly and become a financial burden.  But please don’t believe only “inactive” or “fragile” seniors need Medicare Supplemental Insurance. Let’s say you’re used to scuba diving or hiking or plan on travelling the world in your retirement. Most people never want to think about the worst case scenario but IF it happens you want to be covered; you don’t want to spend all your hard earned savings on one accident while trying to climb Mount Everest or while exploring the wonderful nature of South Asia.

This is where Medicare Supplemental Insurance comes in. Medigaps are sold by private insurance companies. It is there to reduce the cost out of your own pocket; it fills in the GAPS so you have to pay less. Luckily for seniors, a Medicare Supplemental Insurance is very easy to get and doesn’t require a medical exam if done within the open enrollment period. A Mediap plans does not cover a spouse, which means both must have a separate Medigap insurance plan.

When is the best time to enroll in a Medicare Supplemental Insurance plan?

The best time to buy a Medicare Supplemental Insurance is during the Open Enrollment Period (also known as “Guaranteed Issue Period”). The Open Enrollment Period begins on the first day of the month in which you turn 65 or is enrolled in Medicare Part B. During those 6 months an Insurance company can’t turn you down due to preexisting medical conditions. In fact, no medical exam is needed during this period, which makes it perfect for seniors with preexisting medical conditions.  Two other advantages are that your plan never expires and is renewed automatically and if you enroll during this period your premiums will not go up at any time; you’ll “lock them in”. However, after this time it might be difficult to get the plan you want or to the rate you would have gotten it during the open enrollment period.

Following scenarios are amongst the exceptions to the Open Enrollment Period which means you may not be denied the above mentioned enrollment benefits if your case falls under any scenarios listed below:

·    You used to have Employer or Union Coverage but it ended
·    A Medicare Advantage Plan is no longer available in your area
·    Your current Medicare Supplement Plan agency goes bankrupt
·    Client drops Medicare Advantage Plan because the agency did not follow the guidelines or the client feels misled

If your Open Enrollment Period expired, your application will be subject to underwriting. There is a chance for Medicare Supplemental Insurance if you can answer most of the questions on the application with “No”; there is no guarantee for that though. Some insurance agencies might want to interview their prospective clients on the phone prior to approval.

What kind of Medicare Supplemental Insurance is right for me?

Currently the available Plans offered by Insurance agencies are labeled “A” through “J”. The different plans each cover a different set of benefits.
The plans are available in all States except Massachusetts, Wisconsin and Minnesota; these three states have their own Medicare Supplemental Insurance plans.
Plan “A” has the most basic coverage, and as you move on in the alphabet it adds coverage with Plan “N” having the most coverage.
Here is a basic overview of coverage (this list is just a guideline and does not cover all the benefits):

·    Hospital annual deductible (Plans “B” to “L”)
·    Skilled nursing facility coinsurance (Plans “C” to “L”)
·    Part B annual deductible (Plans “C”, “F” and “J”)
·    Emergency care during foreign travel (Plans “C” to ”J”)
·    At-home recovery care (Plans “D”, “G”, “I” and “J”)
·    Preventive care not covered by Medicare (Plans “E” and “J”)
·    Medicare Part B excess doctor charges (Plans “F”, “G”, “I” and “J”) – is the amount above Medicare approval a Doctor, who does not participate in the Medicare program, charges.

ALL Medicare Supplemental Insurance plans MUST cover following:
·    Inpatient Hospital Care, covers 365 days after Medicare coverage ends (excludes Part A annual deductible)
·    Medical Costs; covers the Medicare Part B coinsurance BUT NOT the annual deductible (Coinsurance usually is 20% of Medicare approved amount for the service)
·    Blood; covers three pints of blood transfusion each year

Which Medigap Insurance Company is the right one for me?

There are many Insurance Companies offering Medicare Supplemental Insurance.  The choice is up to you and your individual financial and medical needs. One of the most popular plans is medicare supplement plan f, just remember to enroll early to benefit from the Open Enrollment Period.

Whatever plan you end up enrolling in, the best Medicare Supplemental Insurance plans are highly recommended to ensure you can enjoy retirement with all its benefits and less worries.