What is a Medicare Supplement (MediGap)?

1. You must have Medicare Part A and Part B
2. A Medicare Supplement policy is different from a Medicare Advantage Plan.  Medicare Advantage plans are ways to get Medicare and Prescription Drug Plans all in one plan, while a Medicare Supplement policy only supplements your Original Medicare benefits
3. You pay the private insurance company a monthly premium for your medicare Supplement policy. You pay this monthly premium in addition to the monthly Part B premium that you pay to Medicare
4. A Medicare Supplement policy only covers one person. If you and your spouse both want coverage, you’ll each have to buy separate policies
5. You can get a Medicare Supplement from Nevada Medicare – Nevada Medicare contracts with all the carriers approved in the State of Nevada
6. Any standardized Medicare Supplement policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medicare Supplement policy as long as you pay the premium
7. Medicare Supplement policies sold after January 1, 2006 aren’t allowed to include prescription drug coverage. If you want prescription drug coverage, you have to get a stand alone Medicare Prescription Drug Plan (Part D)
8. You can drop your supplement at any time. There is no annual election period for Medicare Supplement plans
9. The Annual Election Period (AEP) in the fall is for drug plans. It does not apply to Medicare supplements in any way
10. Some carriers offer household discounts if two or more people enroll in Medicare supplemental plans from the same company

Each standardized plan is identified by a letter. Medicare calls them plans. The following are the different Medicare Supplement Plans available:

10 Standard Medicare Supplement Plans

Every one of these policy plans provides the same set of benefits from insurance company to insurance company. The only difference between each supplement plan with the same letter is the monthly premium. The plans that gets the most requests for quotes are Medigap Plans F, G and N.

*Medicare Supplement Plan C & F will no longer be available for beneficiaries that turn 65 after January 1, 2020. If you become eligible for Medicare on or after January 1, 2020, you won’t be able to buy Plan C or F. If you already have Plan C or F, don’t worry – you can generally keep your plan. You can apply to buy Plan C or F if you become eligible for Medicare before 2020.

Contact Us and find out the insurance companies available in in Nevada so you can compare the rates.

Medicare Supplement Plan F offered the most comprehensive basic benefits out of all Medicare Supplement (Medigap) policies. Nonetheless, Medicare Supplement Plan F will no longer be available. 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, don’t worry – you can generally keep your plan. You can apply to buy Plan F if you become eligible for Medicare before 2020.

It pays 100% of the costs that Medicare would normally bill to you.  This means that when you have Medicare supplement Plan F, you will not pay any deductibles or no copays. Plan F will pay all your costs. Medigap Plan F is often the most expensive plan option out of all other Medigap plans, yet it remains as a popular choice among Medicare beneficiaries.

The following is a list of costs and benefits covered by Medigap Plan F:

• Part A Deductible – $1,408 for 2020
• Part B Deductible – $198 for 2020
• Part B Excess Charges
• Preventative Care Part B Co-Insurance
• Part A Hospital and Co-Insurance costs up to an additional 356 days after Medicare benefits are exhausted
• Part B Co-Insurance or Co-Payment
• First three pints of blood used in an approved medical procedure (annually)
• Part A Hospice Care Co-Payment or Co-Insurance
• Skilled Nursing Facility (SNF) Co-Insurance
• Foreign Travel Emergency

Medicare Supplement Plan G functions exactly like Plan F, except for the Part B deductible. With Plan G you agree to pay the Part B deductible of $198 each year, and after that, the plan will pay everything else. As far as coverages both plans are identical.

Plan G premium is less than what Plan F will cost you. Although you have to pay the Part B deductible per year, the money you save on your monthly premiums is a lot more than the $198 so in the long run you would be better off with Plan G.

The following is a list of costs and benefits covered by Medigap Plan G:

• Part A Deductible – $1,408 for 2020
• Part B Excess Charges
• Preventative Care Part B Co-Insurance
• Part A Hospital and Co-Insurance costs up to an additional 356 days after Medicare benefits are exhausted
• Part B Co-Insurance or Co-Payment
• First three pints of blood used in an approved medical procedure (annually)
• Part A Hospice Care Co-Payment or Co-Insurance
• Skilled Nursing Facility (SNF) Co-Insurance
• Foreign Travel Emergency

Medicare Supplement Plan N is another popular Medicare Supplement plans. Although Plan F and Plan G are the most popular options, Plan N is 3rd place in popularity for the plans that offer the most coverage. As we  know, Plan F has the most coverage and has the most expensive monthly premiums out of these three plans. Plan G has less expensive premiums but does not cover the Part B deductible of $198. Plan N is usually the least expensive of the three, however, you will do more cost-sharing along the way. You will pay a doctor copay up to $20 each time you see a doctor. Copays of up to $50 for an E.R. visit are owed by you.

You will also pay excess charges. Some doctors can bill an extra 15% above Medicare’s rate. This is called an Excess Charge. Plan F or Plan G take care of this for you. But On Plan N, you pay the excess charge yourself.

Medicare supplements only pay the 20% that Medicare does not cover. Medicare will pay its first share (80%) then your Medicare Supplement will pay the remainder on your bill, usually the 20%. The coordination of benefits between Medicare and your Medicare Supplement is that when Medicare approves a medical service and pays it, Medicare then forwards the remainder of your bill to your Medicare Supplement.

Listed below are a few things that are not covered by Medicare and your Medicare Supplement:

• Dental
• Vision
• Hearing Exams & Hearing aids
• Contacts, Eyeglasses & Lenses
• Private-Duty Nursing
• Long-Term Care
• Prescription Drugs

All  Medicare Supplement plans are standardized, there is no guessing which benefits you are purchasing as you will know what they are.

Listed below are Key Factors when selecting a Medicare Supplement Insurance Company:

1. Medicare Supplement Financial Rating: It’s a grade given to the insurance company by ratings companies like Weiss or A.M. Best.
2. Monthly Premium – What is a Medicare supplement premium? It’s the monthly rate that you pay to the insurance company that provides your coverage? Find out what premium each insurance carrier will charge you. Are they offering a low premium? Is it competitive with other Medigap insurance companies in your area?
3. Rate Increase History– Most policies will have an annual rate increase to keep up with medical inflation. Going over their rate increases in the last 3 years and reasonableness are great indicators of their financial trend.

Get a personalized analysis of which Medicare Supplement insurance carrier offers the best pricing, financial rating and rate trend history in Nevada by contacting us.

• You do not need a referral to see a specialist
• Choose your own doctors and hospitals (Freedom)
• Does not have a Network (No In-Network / Out-of Network)
• Nationwide Coverage – you can use it anywhere in the United States
• Predictable out-of-pocket expenses for Medicare-covered services (and zero out-of-pocket with Plan F)
• Guaranteed Renewability – the insurance company can never drop you or change your coverage due to a health condition
• No claims paperwork – Medicare supplement companies have crossover filing with Medicare. When your provider files a claim with Medicare, that claim is automatically filed with your supplement company too

With a Medicare Supplement for Seniors in Medicare you will know exactly what’s covered for every inpatient or outpatient procedure based on which plan you choose.

Medicare Part A Coinsurance – all Medigap plans offer this benefit. It covers the very expensive daily hospital copays that you begin accruing after your 60th day in the hospital.

Medicare Part B Coinsurance or Co-Payment – every supplement also covers this benefit, which is one of the most important. Since Medicare only covers 80% of your Part B outpatient expenses, this benefit is what pays the other 20% for you. This can be crucial for high-ticket items like cancer treatments or dialysis.

Blood (First 3 pints) – Blood is very expensive! This is a great coverage for you as this is on all plans and pays for the first 3 pints of blood in a blood transfusion. Medicare will not cover your first 3 pints and will only cover you for the 4th pint and above.

Part A Hospice Care Coinsurance or Co-Payment – Medicare Supplements pay for the parts of Hospice that Medicare doesn’t cover.

Skilled Nursing Facility Coinsurance – Medicare allows for 100 days of skilled nursing facility (SNF) care after you have been in a hospital and need nursing care while you recover. However, Medicare only pays for the first 20 days. A policy with SNF coverage will pay for the other 80 days.

Medicare Part A Deductible – the 2018 Part A deductible is $1,340. You can pay this more than once a year if, for example, you have two inpatient hospital stays more than 60 days apart.

Medicare Part B Deductible – in 2018, the Part B deductible is $183/year. You will pay the Part B deductible once per year for services such as doctor’s visits, lab-work, or physical therapy unless your Medicare supplement provides this benefit.

Medicare Part B Excess Charges – Medicare providers can either accept Medicare’s assigned rates for each service or, if they choose, they can charge you an excess charge. This charge can be up to 15% above the assigned rate. It can be pricey for items like diagnostic imaging or surgery. You may wish to choose a medicare supplement that covers this expense.

Foreign Travel Emergency – Medicare does not offer you coverage outside U.S. Standard Medigap Plans C, D, F, G, M, and N provide foreign travel emergency health care coverage when you travel outside the U.S.

Medigap Coverage Outside the U.S. – If you have Medigap Plan C, D, E, F, G, H, I, J, M or N, your plan:

• Covers foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn’t otherwise cover the care.
• Pays 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.

Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000.

Guaranteed issue rights (also called “Medigap protections”) are rights you have in certain situations when a Medicare Supplement must offer you certain plans. In these situations, an insurance company:

• Must sell you a Medicare Supplement policy
• Must cover all your pre-existing health conditions
• Can’t charge you more for a Medicare Supplement because of past or present health problems

If you have Employer Group Health Coverage you can delay your enrollment in a medicare supplement.  Later when you retire or lose that coverage, you can purchase certain Medicare Supplement policies following  loss of your group coverage. This is called Guaranteed Issue rights.

BE AWARE: You only have 63 days after your lose your group coverage to get Guaranteed Issue. If you miss this short window, you will be subject to Medical Underwriting and even if you pass they can still deny you.

Keep your notices from your prior carrier to show proof of your creditable coverage for guaranteed issue. You also do not want incur the Part D late enrollment penalty.

Guaranteed Issue points:

• Shorter window period of time (63 days following loss of health coverage).
• Plan choices are limited to Plans A, B,C ,F, K, and L.

Other situation that can create a Guaranteed Issue window:

• Losing Medicare Advantage coverage when move of of the service area or moving out of state.
• Your Medicare Advantage  Plan stops giving care in your area.
• You have Original Medicare (Part A and Part B) combined with an employer group health plan or union coverage that pays after Medicare pays its share of covered costs.
• You are in a trial right of Medicare Advantage, meaning that you joined a Medicare Advantage plan when you were first eligible for Medicare Part A at age 65 but you changed your mind.
• You dropped a Medicare Supplement insurance plan to join a Medicare Advantage plan.
• You lose your Medicare Supplement insurance plan. Your Medicare Supplement company goes bankrupt and you lose coverage through no fault of your own

If you missed your window to enroll in a Medicare Supplement or you no longer have a Guaranteed Issue, you can still apply, but you will go through a Medical Underwriting and will have to answer some health questions on your application. Remember when you first turn 65: You only have 6 months to Enroll in a Medicare Supplement plan without health questions. The insurance company will approve your application with no pre-existing condition waiting period.

Key points to remember on Medicare Supplements (If you miss Enrollment Window & Guaranteed Issue):

• The insurance company can accept you or deny you on your application.
• Changing carriers will require underwriting in most cases.

There’s a lot of people mistakenly think that they can change their Supplement Plans during the Annual Election Period (AEP) that runs from October 15th to December 7th. You can only change your Prescription Drug Plan during AEP every year. The Annual Election Period that occurs in the Fall of every year only applies to Medicare Advantage and Prescription Drug Plans. Be aware that the AEP 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.