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Also referred to as Medigap plans, Medicare Supplement policies help pay for your share of Medicare expenses, such as your deductibles and co-insurance. Medicare supplement insurance plans are very popular with people who want little to no co-pays when they access healthcare services.
A lot of Medicare beneficiaries are shocked to find that Medicare (Government) only covers 80% of your Part B expenses. The other 20% can be a financial catastrophe to you if you happen to have a serious illness. Medicare Supplements will cover you on the 20% that the government doesn’t cover. Seniors with Medicare that gets Supplement Insurance essentially buys them peace of mind by getting coverage on the 20% exposure.
Keep in mind that during your one-time open enrollment window, you are guaranteed the right to purchase a Medicare supplement plan. Your health status does not matter when you buy a plan during this six-month window.
Medicare Supplement is a type of health insurance sold by private insurers to cover the 20% cost that Original Medicare (Government) will not cover. Medicare Supplement is also known as “Medigap” or “Medigap Plans”
Some of the primary advantages of a traditional Medicare Supplement policy are:
Supplement insurance for seniors with Medicare is the most predictable coverage that anyone can buy. You’ll know exactly what’s covered for every inpatient or outpatient procedure based on which Medicare Supplement plan you choose.
Other things to take in consideration with Medicare Supplement insurance:
Once Medicare (Government) approves and pays it’s share of your claim, Medicare Supplement plans will pay the remaining 20% of all medicare covered services. Supplement Plans help cover the gaps in Medicare (Government) that normally you would have to pay: Co-Pays, Coinsurance and Deductibles.
You can use your Medicare Supplement plan at any provider in the nation that accepts Medicare. This makes Medicare supplements great for travel or for people who live in more than one state throughout the year.
Medicare Supplements plans do not include retail drug coverage, so you’ll need to get a standalone Part D drug plan for your medications. A Medicare Supplement also does not cover routine, dental, vision or hearing services. Since Medicare (Government) itself does not cover these services, your supplement cannot pay anything toward those type of services either.
To see a list of all the Medicare supplemental plans available – Click on the Medicare Supplement chart below.
*Supplement Plan F is also offered as a high-deductible plan by some insurance companies. If you choose the high-deductible option, it means you must pay for Medicare-covered costs (coinsurance, co-payments, deductibles) up to the deductible amount of $2340 in 2020 before your policy will pay anything.
**For Supplement Plans K and L, after you meet your annual out-of-pocket limit and your annual Part B deductible ($198 in 2020), the Medicare Supplement plan pays 100% of covered services for the rest of that calendar year.
***Plan N pays 100% of the Part B coinsurance, except for a co-payment of up to $20 for some office visits and up to a $50 co-payment for emergency room visits that don’t result in an inpatient admission.
Some beneficiaries want a plan that covers all the gaps and leaves them with no worries about the cost of medical procedures. Other beneficiaries prefer a Medicare supplement plan in which they cover some of their deductibles and co-pays out of pocket in order to achieve lower premiums.
Picking a Medicare Supplement Plan will depend on your financial capacity. There is no right or wrong, what matters is what will make the most cents to you. For most of the people we talk to everyday, every penny counts and a dollar goes very far. At Nevada Medicare we can help you evaluate all the coverage options, help you understand and find the plan that meets your needs – at no cost to you.
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Medicare Open Enrollment is a one-time window to enroll in any Medicare supplement plan in your area. The best time to buy a supplement policy is during your one-time open-enrollment window. This window begins on the first day of your birth month, or the month that you enroll in Part B. It lasts for six months and is a “use it or lose it” enrollment period and you can’t get it back.
Open Enrollment only lasts for six months and is a “use it or lose it”
Your one-time Medicare Supplement open enrollment is the only time the Medicare supplement company cannot ask you any medical questions. They cannot turn you down for any health conditions. They cannot refuse you a policy or charge you any additional amount due to health conditions, medications or pre-existing illnesses.
After this window passes, insurance companies that you might apply with can accept or decline you based on health.
Many people mistakenly believe that the Annual Election Period (AEP) in the fall from October 15th thru December 7th each year is a time when you can change Medicare Supplement plans with no health questions. This is not the case and a common mistake with seniors.The Annual Election Period (AEP) in the fall pertains only to your Part D plan, not your Medicare Supplement plan.
The guaranteed issue window works just like open enrollment, except that is a shorter period of time and that your plan choices are limited to Plans A, B, K, and L. The insurance company cannot deny your application for any health reasons. There are some other circumstances which create a guaranteed issue window as well, such as losing Medicare Advantage coverage when moving out of state. Guaranteed issue rules can vary by state, so be sure to check with us so we can inform you about the laws that apply in a particular state.
There have been a lot of seniors delay their enrollment into a supplement because they have group health coverage through an employer. Later when you retire or when that coverage ends, you have the right to purchase certain Supplement policies within the 63 days following the loss of your group coverage. This is called your Medicare supplement guaranteed issue rights.
Please keep any notices from your prior carrier that show proof of your creditable coverage for guaranteed issue and also so that you do not incur the Part D late enrollment penalty. Contact your benefits coordinator and they can give you the proper documents that you will need as well.
You can still apply for a Medicare Supplement If you miss your window for open enrollment or guaranteed issue, but you will have to answer some health questions on your application. The insurance company can accept or decline you.
Seniors are often confused by this because they believe the Annual Election Period (AEP) in the fall is a time when they can change their supplement without underwriting. Those rules are do not apply to Medicare Supplements as mentioned in the previous questions above. The Annual Election Period (AEP) only applies to drug plans and Medicare Advantage plans. Changing Supplement carriers will require underwriting in most cases.
Medicare Supplemental Plan G is the most comprehensive plan. It works exactly like Plan F except that you pay for the Part B deductible once per year. Your premiums will be lower though, and sometimes this creates annual savings. To find the best Medicare supplemental plan in your area, contact us for a free report that includes quotes and rate trend histories.
Medicare Supplemental Plan F was the plan with the highest level of coverage. It pays for all of your Medicare cost-sharing, leaving you with nothing out-of-pocket on covered services. However, Supplement Plan F will is being phased out. If you become eligible for Medicare on or after January 1, 2020, you won’t be able to buy Plan F. If you already have Plan F – you can generally keep your plan. You can apply to buy Plan F if you become eligible for Medicare before 2020.
You can buy a Medicare supplement from a variety of different insurance companies. However, plans of the same letter are standardized so that the benefits are the same. A Medicare supplement Plan F with one company has the same benefits as the next company.
Since there are several standardized plans available to you in Nevada, you will want to think carefully about which one fits your needs the best.
Most Medicare supplement companies base their rates on gender, zip code, tobacco usage, and age. Some individuals may also benefit from household discounts. Although, pricing for Medicare supplement policies varies, in Nevada they range between $52 – $170 estimated monthly at the lowest levels for a non-smoker female in good health who just turned 65. The price increases on higher levels based on area, gender, age, health question underwriting and other factors.
When you first active Medicare Part B, you have 6 months to enroll in any Medicare supplement without health questions. The insurance company will approve your application with no pre-existing condition waiting period. This called the open enrollment period – Medicare Supplements. It is a one-time window. Be aware that the Annual Election Period (AEP) that occurs each fall from October 15th thru December 7th is NOT a time when you can get a Medicare supplemental insurance plan with no health questions asked. The AEP has nothing to do with Medicare Supplement plans. Instead, it’s a time when you can change your Part D drug plan.
You can apply to change your Medicare Supplement at any time, but if you are past your open enrollment window, you will have to answer health questions.
The Medicare supplement insurance company will review your health history and medication history. They can accept or decline you.
No, Medicare Supplement is optional. However, with out any supplemental insurance, you would be frighteningly exposed on expensive hospital deductibles and co-pays as well as 20% of all outpatient services that Medicare (Government) does not cover. This includes things like surgeries and chemotherapy which could be devastating financially without some form of supplemental coverage.
If you find that a Medicare supplement is out of your budget, you should consider a Medicare Advantage plan, which has lower premiums. You just have to agree to use a network of providers in plans service area.