Medicare Supplements can be confusing. Just what are they and when would you want to choose one? Medicare Supplements, or Medigap policies, are sold by private insurance companies to fill the gaps in Original Medicare. They pay after Medicare pays and help cover the costs that Medicare leaves off (deductibles and co-insurance.)
A Medicare Supplement lowers your out of pocket hospital and doctor costs. In order to be eligible to purchase a Medicare Supplement, you must have Part A and B of Medicare. If you are enrolled in a Medicare Advantage plan, you DO NOT need to get a Supplement. Advantage Plans and Supplements cannot work together and you should not have both.
Medicare Supplements Explained
There are 10 Medicare Supplement plans: Plan A-D, F, G, and K-N. The benefits are standardized by the government which means that the benefits are exactly the same no matter which carrier you buy the plan from. Some are closed by the government and not all plans are offered by all carriers.
If you are over 65 and within your first 6 months of your Medicare Part B effective date, then you are guaranteed acceptance into any Supplement plan from any company. You can apply or change your plan at any time, but if you are outside of your Initial Enrollment Period (6 months from Part B effective,) you will have to go through underwriting (answering health questions.) Companies typically do a 5-year look-back on illnesses and hospital stays and will consider the medications you take.
If you are covered by a retiree group health plan, you may not need a Supplement because your employer coverage may act like a Supplement. When you lose employer coverage, you have 63 days to get a Medicare Supplement with no underwriting.
Medicare for Those Under Age 65
The rules for Medicare Supplements for Medicare beneficiaries under 65 years old and on disability vary by state. In the states where we sell insurance, they are either not available or are subject to underwriting. There are limited circumstances where you can get a policy without underwriting. Premiums will be higher than for someone over age of 65.
At Imagine Insurance Advisors, we not only specialize in Medicare options, but in coverage for people under age 65 who need assistance with Medicare. There are not many agents who understand this segment of the market as well as we do. We work with many people on disability and will work hard to find what coverage will work best for you if you are disabled.
Choosing a Medicare Supplement Plan
Not only do you have options of the Medicare Supplement plan you choose, but the carrier you choose to get your plan from is even more important. Every company will have rate increases. This is firstly because the deductibles in Medicare rise each year. Rate stability is just as important as the premium because of underwriting and it’s potential to restrict your options. If you choose an unstable carrier and experience a major health accident or diagnosis, you may not be accepted by another carrier with more affordable premiums because you will not be able to pass underwriting.
Some questions to ask a Medicare Supplement plan provider are:
- How long have you been in business?
- How many policyholders do you have?
- What premium percentage increase have the last two increases been?
We don’t recommend going with the lowest company out there if they don’t have long-term proof of stability. We do recommend going with a company who has been in the business a long time and is committed to the senior market for the long-term.
What About “Select” Plans?
Some carriers establish a “Select” version of a plan. “Select” means that they have a network of hospitals for a non-emergency, in-patient hospital stay (like a knee replacement or kidney transplant.) Premiums are lower and have the same benefits as their Standard counterparts. If you choose a Select plan, make sure that any hospital you may want to go to is in their network. Also, be aware that the network can change at any time and you may not be able to change your plan.
What Is Not Covered in a Medicare Supplement?
Medicare Supplements do not cover long term care (beyond Medicare’s skilled nursing benefit), dental, routine vision care and glasses, hearing aids, or prescription drugs. Basically, they only cover what Medicare covers. We can help you find plans to fill those other gaps through separate policies. The best meal is the one that you get to choose each dish!
The Medicare Supplement Experts
At Imagine Insurance Advisors, we are continually evaluating the various companies to provide solutions for our clients for the long term. We can help you decide what plan and what company will be the best for you. We look for strong rate stability, competitive rates and a dedication to the senior market. Give us a call today to schedule a no obligation plan review.