Everything You Need to Know About Medicare Supplemental Plans

Medicare don't cover everything

Medicare Supplemental Plans, also known as Medigap, may perhaps be considered as one of the essentials every boomer needs to have for their desired future. After all, these insurance policies offer coverage required to secure both a person’s health and wealth retirement needs.

We’ve compiled handy information about Medigap policies below. Please do use this page as a reference for all your Medigap inquiries. Additionally, we’ll make sure to update details here, as soon as new information comes our way. Currently, we are referring to Medicare Supplement Costs 2017 for this post.

Medicare Supplemental Plans

I. What are Medicare Supplemental Plans?

Medigap policies help pay the “gaps” (out-of-pocket expenses such as copayments, deductibles, and coinsurance fees) not covered by Original Medicare Plans (composed of Medicare Part A and Part B). Additionally, some Medicare Supplemental Plans provide extra coverage not offered by Original Medicare Plans (a particular benefit of note is foreign travel coverage).

Private insurance companies sell Medicare Supplemental Policies. As such, applicants have the advantage to choose a provider that both provides quality service and affordable policy options as well. Also, private insurance companies may also offer additional benefits not provided by others.

What is Medicare Supplement

II. Types of Medicare Supplements

There are ten standardized Medigap policies to choose from, labeled as Plan A to Plan N respectively. Please take note that Medigap Plan E, H, I, and J are already discontinued.

Medigap plans differ in terms of the amount of coverage and extra benefits offered. However, each plan provides these basics:

  • Coverage for the first three pints of blood
  • Coverage for Medicare Part A coinsurance fees
  • Coverage for Medicare Part A copayments (hospice care)
  • Coverage for Medicare Part B coinsurance costs or copayments

A high-deductible plan is offered in some states. If you opt for this option, you must pay for Medicare-covered costs (deductibles, coinsurance, and copayments) up to a deductible amount before the policy pays for anything.

Learn more about the standardized Medicare Supplemental Plans with our chart here.

III. Medicare Open Enrollment Period

The best time to purchase a Medicare Supplement Plan is during the Open Enrollment Period (OEP). The OEP is a six-month timeframe that begins when you first turn 65 and are enrolled in Medicare Part B as well. During the OEP, a private insurance company cannot turn down a Medigap application (guaranteed issue), even if an applicant has health conditions (based on medications or pre-existing illnesses). Applicants will not also go through a medical underwriting process during this period, nor will be charged additional or higher premiums.

The OEP cannot be delayed or replaced. Consequently, enrolling in a Medicare Supplemental Plan outside the timeframe may mean higher premiums and undergoing a stricter screening process.

When is the Best time to Enroll Medicare Supplement Plan

IV. How Much is Supplemental Insurance for Medicare?

Private insurance companies set premium prices for Medicare Supplemental Plans. Prices vary per company and follow a “rating” system:

  • Community-Rated – charges everyone in a given area the same rate, regardless of one’s age.
  • Issue-Age-Rated – charges a rate depending on how old an applicant purchases a policy, but price doesn’t scale as the policyholder ages.
  • Attained-Age-Rated – cheaper at age 65, but prices scale as a policyholder ages.

There are other factors to consider that affect Medicare Supplemental costs. As mentioned in the Open Enrollment Period point above, purchasing a plan during the OEP means paying for affordable premiums. Depending as well with the private insurance company, discounts for women, married couples, and non-smokers may be available.

Medicare Supplemental Plans

V. How to Choose a Medicare Supplemental Insurance?

In order to select a Medigap plan that will best suit your needs, consider these factors first:

Health Status

Identify your family medical history to choose a plan that will address your current and potential medical needs. If you have any pre-existing medical conditions, apply during the OEP to qualify for a plan (and to avoid higher premium charges).

Capability to Pay Premiums

Consider as well your spending power. Medicare Supplemental Plans differ in coverage and premium prices. As much as you’d want a plan that will provide you with lots of benefits, if you can’t pay for premiums, then it’ll lead to more problems for you to face in the future.

Drug Coverage

Medicare Supplemental Plans do not cover prescription drugs. If you require prescription medication, consider purchasing a separate Medicare Part D drug policy for additional coverage.

Planned Retirement Activities

If you plan to travel during the golden years, purchase a Medigap Plan that offers foreign travel coverage.

Location

Certain states, such as Massachusetts, Wisconsin, and Minnesota, provide a different set of standardized Medicare Supplemental policies to choose from. Make sure to ask the private insurance company you’re purchasing a plan from for more details.

Compare and Seek Advice

Learn more about each plan first before making a purchase. Additionally, request for both quotes and advice from multiple insurance agents – the option to shop around for a policy is one of the major benefits that Medigap provides for applicants.

Comparing all Medicare Supplement Plans side by side

VI. What Else Should I Know?

Private insurance companies may still be able to delay coverage for certain applicants, mainly because of pre-existing medical conditions (even during the OEP). Most private insurance companies have a pre-existing medical condition waiting period, which states that out-of-pocket expenses will only be covered after a certain period of time. This period is usually up to six months. Additionally, private insurers can only delay coverage if an applicant’s condition was treated or diagnosed within the stated waiting period.

However, there are ways to avoid or shorten the pre-existing medical condition waiting period. You must meet all of the following points:

  • For starters, enroll during the OEP to bypass medical underwriting procedure (do take note that the private insurer you are purchasing from must have policies with guaranteed issue rights).  
  • Another is when you are replacing creditable health coverage.
  • You must not have had a break in coverage for more than 63 days.
  • And lastly, you’ve had at least six months of continuous creditable coverage.

How Medigap plans cover some of the expenses not covered by Medicare

More About Guaranteed-Issue Rights

There are other ways to secure guaranteed-issue rights when purchasing supplements for Medicare:

  • If the private insurance company you’ve purchased a Medicare Supplemental Plan from goes bankrupt or has provided you misleading information.
  • If your Medigap coverage ends without your consent.
  • If you have enrolled in an employer-sponsored Original Medicare group plan, and the employer coverage is ending.
  • If you dropped your Medigap Plan and purchased a Medicare Advantage plan, but changed your mind during the first year and reverted back to an Original Medicare Plan.
  • If you are enrolled in a Medicare Advantage plan and transfer or move out of the plan’s coverage or service area.
  • If you are enrolled in a Medicare Advantage plan and the coverage leaves the Medicare program.
  • If you are enrolled in a Medicare Advantage plan when you are first eligible for it (when you turned 65), but changed your mind during the first year and reverted back to an Original Medicare Plan.

Download the Medigap Checklist and you will also get "Reasons Why Medigap is Worth It", a bonus part of the checklist that highlights key points why a Medicare Supplement Plan is essential in your retirement plan. 

Understanding Medigap plans


BONUS: The Matter of Relationships

We’d also like to point out the connection of Medicare Supplemental Plans and boomer relationships. Although Medigap coverage is solely for an individual, purchasing a plan may prove to be a fruitful experience for the policyholder and his or her significant other and family alike.

One of our previous posts, How Insurance Can Help Address Relationship Problems, tackled the links between Medigap and boomer relationships. Here are some takeaways that can help you see how beneficial purchasing a policy is:

 

Stronger Relationships = Brighter Future

Individuals in the baby boom generation are more likely to experience social isolation during the twilight years. And for some boomers, solitude may be a distressing experience to be in, which may lead to further conditions such as depression or anxiety. Rubbing more salt to the injury, facing a future alone may mean both emotional and financial distress.

Purchasing Medicare Supplements may help not only in the financial aspect of a boomer couple’s problems but their bond as well. Granted that money talks may lead to conflict, but offering a solution such as Medigap may be a solution worth having on the plate. A hidden benefit, perhaps, but Medigap can help in keeping relationships healthy during the golden years.

 

Health and Wealth Coverage

According to a survey conducted by the Insured Retirement Institute last year, 45% of its boomer respondents haven’t set aside funds for their retirement at all. And with divorce rates (which leads to social isolation) on the rise as well, retirement health and wealth issues are at risk.

A Medigap policy may ensure boomers that their assets are properly secured. Couples can have the peace of mind they deserve during retirement. With the gaps capable of depleting nest eggs in a fast manner, boomer couples need all the help they can get to secure their savings – and relationship – and enjoy a comfortable life together.

Stay tuned for more Medicare Supplemental information from us. We’ll be constantly updating our posts, so please do expect more news from us. Also, please let us know if you have any suggestions or feedback about our articles. Share them with us in the comments section below.

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