A Medicare Supplement insurance plan helps cover the costs that are left unpaid after Medicare Parts A and B pay their portion of your healthcare expenses. Unlike a Medicare Advantage plan, which is an alternative to your Medicare Parts A and B benefits, a Medicare Supplement plan is purchased to work in conjunction with your Medicare Parts A and B benefits.
Medicare Supplement policies are standardized into 10 plans - labeled "A" through "N", each with its own set of benefits.
Medicare Supplement policies are sold by private insurance companies. While the costs of these policies may vary, individual insurance companies must provide the same standardized benefits. Some companies may offer innovative benefits. To purchase a policy, in general you must be enrolled in Medicare Part A and Part B. In addition to paying the monthly Medicare Part B premium to Medicare, you will have to pay a premium to the insurance company providing your coverage.
Yes. Medicare Supplement insurance works in conjunction with your primary coverage, which must be both Medicare Part A and Part B.
Depending on the exact Plan Letter chosen, a Medicare Supplement will cover between some and all of the out of pocket costs that Medicare Part A and B leave you with. For example, the most popular plan, Plan F, will cover 100% of your out of pocket costs for hospital stays, in-patient and out-patient surgery, doctor’s office visits, diagnostic tests, medical equipment, plus more.
Medicare Supplement (Medigap) insurance enhances the basic Medicare system. On the other hand, Medicare Advantage is a completely separate program that replaces Medicare Parts A & C. Medicare Advantage plans may include vision, hearing or prescription drug insurance. Even though Medicare Advantage cover some extra things that doesn’t always mean this coverage is the best for you. You can’t use a Medicare Supplement (Medigap) policy in conjunction with this coverage. To find out which Supplemental plan is best for your needs and budget, please reach out to one of our licensed advisers.
Although there are 10 different Medicare Supplement Plans (letters A-N) that are available to consumers, the majority of seniors have either Plan F, Plan G, or Plan N due to their combination of cost efficiency and comprehensive and simple to understand benefits.
Plan F is the most popular plan, with about 50% of Medicare Supplement policy holders having this plan. Plan F is often referred to as the “Cadillac Plan” because it is the most comprehensive in terms of the benefits it offers, since it covers every deductible, copay, and coinsurance that Original Medicare leaves you with. This means you will have zero out-of-pocket liability for all of your benefits under Medicare Part A and Part B, which also gives it the most convenient and simplified experience since there will never be any out of pocket bills that will be sent to you.
Plan G is often considered the best value and most practical plan since it has all the same benefits as Plan F except that, in exchange for a lower premium, it does not cover one small deductible that Medicare leaves you with- your once-a-year Part B deductible of $147 a year. This means that, with Plan G, your first $147 of healthcare costs that fall under Medicare Part B will have to be paid out of pocket, since it will not be covered by Medicare or your Medicare Supplement plan. Once this deductible is met your Plan G will operate exactly like Plan F, with all other deductibles, copays, and coinsurance being covered by your Medicare Supplement plan. Because Plan G leaves the plan holder with this small piece of cost sharing of the once a year Part B Deductible, Plan G will have a lower monthly premium than Plan F, which usually saves more than enough to make up for the out of pocket cost.
For an even lower premium plan that still accomplishes the main features that Medicare Supplements are designed for – protection from high out of pocket costs and uncertainty, clear benefits and ability to budget, lack of confusion and inconvenience of handling complex bills, and access to your own choice of doctors, hospitals, and healthcare providers- Plan N has become an increasingly popular choice.
Like Plan G, Plan N also leaves the plan holder with the once a year Part B deductible but also includes an additional $20 copay for doctors office visits, $50 copay for emergency room visits, and also does not cover what is known as Part B excess charges. Part B excess charges are if a doctor does not accept Medicare assignment, then they can charge an "excess" over and above what Medicare Part B pays, in the amount of up to 15%, depending on which state you are in. So, for example, if you have a certain medical test or procedure, and Medicare determines that the reasonable and approved fee is $500, a provider that does not accept Medicare assignment can charge up to 15% in excess, or an additional $75. If you have Plan N, which does not cover this potential excess charge, you would be responsible for that additional $75.
All supplement insurance companies pay claims the same way, and most pay them electronically so you do not have to file any claims yourself.
In General, the top three plans can be summed up as follows:
Option 1 - Medigap Plan F- Most Comprehensive and Convenient
• Most comprehensive coverage- 100% coverage of Medicare Part A and B out-of-pocket gaps
• Most Popular – Almost 50% of Medicare Supplement Policyholders have this plan
• Easiest to Understand
• No deductibles, co-pays, or coinsurance- so no out of pocket at all
• Choose any doctor or hospital that accepts Medicare
• Most Expensive but most predictable and convenient since there is zero out of pocket
Option 2 - Medigap Plan G - Best Value and Most Practical
• Same exact coverage as Plan F except for no coverage of annual Medicare Part B Deductible
• Plan member pays the once-a-year Medicare Part B Deductible ($147 in 2015) when services are received
• No other co-pays or coinsurance
• Lower Monthly Price than Plan F and Lowest Annual Net Cost
Option 3 - Medigap Plan N - Lowest Price but More Cost Sharing
• All major gaps covered but 4 potential sources of out of pocket expenses
• Plan member pays the once-a-year Medicare Part B Deductible ($147 in 2015)
• Plan member pays $20 co-pay for doctor visits, and $50 co-pay for emergency visits
• Plan member is responsible for Part B excess charges (up to 15%) if doctor doesn’t take assignment
• You take on more cost sharing through small copays and deductibles in return for lower premiums
All individuals that are eligible for Medicare Part A and Part B are eligible to apply for a Medicare Supplement plan to work alongside their primary coverage of Original Medicare (Part A and B). However, Medicare Advantage and Employer/Group Plans often have restrictions as to when an individual may disenroll from those plans, and often are structured as 1 year contracts in which the insured commits to staying in that plan. Conversely, a Medicare Supplement offers much more flexibility by allowing individuals to sign up, drop, or change plans at any point during the year.
By law, Medicare supplement insurance plans no longer cover prescription drugs. Prescription drug coverage, also known as Medicare Part D, is available separately through private insurance companies approved by Medicare and can be purchased directly from Medicare.gov. Your Part D prescription plan does not have to be with the same carrier you have your Medicare Supplement with.
No. Your current Medicare Supplement plan continues if you do nothing.
It Depends. All individuals eligible for Medicare have the right to be “Guaranteed Issue” into any Medicare Supplement plan with any insurance carrier if they are within 6 months of their 65th birthday or their Medicare Part B effective date. There are also instances of “Guaranteed Issue” eligibility if an individual’s previous plan had terminated or been canceled involuntarily. Otherwise, if an applicant is not in one of these categories, the answer is “Yes”, the insurance company will require health questions, a prescription check, and often a brief “Personal Health Interview” phone call in order to determine one’s approval for the policy.
No. Even if you are applying in a health underwritten situation (outside of an open enrollment or guaranteed issue situation). There are no in-person exams, or testing required for an approval into a Medicare Supplement plan, however, some carriers will request a brief Phone Call with the applicant to discuss recent health conditions.
Yes, but there’s no guarantee that another insurer will accept your application. It is wise to request coverage and wait for a response before canceling your current plan. Federal law requires other insurers to serve you if your current provider shuts down.
You can do this as often as you want. Although there is a general misconception that you can only change your plan once a year, you can actually change your plan at any time, for any number of times throughout the year. However, your ultimate goal is to select the best policy and commit to it. You can purchase a Medicare Supplement insurance plan from any insurance company that is licensed in your state.
No, your Medicare Supplement Plan is guaranteed renewable and non-cancellable, which means as long as you pay your monthly premium payment the insurance company can never cancel your coverage or single you out in any way due your health. In addition, a Medicare Supplement company can never raise your rates individually based on your ongoing health or claims history. This means your company can never single you out for rate increases based on your own use of the plan or any health issues you had during the year. Even if you have had hundreds of thousands of dollars of medical costs paid for by your Medicare Supplement company, they cannot use this in any way to make you pay a higher rate than the rest of the people in your plan.
When you sign up for your Medicare Supplement insurance with claritylifeins, you are systematically put in position to receive the highest rated and most competitively priced plans in the marketplace. claritylifeins has made it our mission to deliver the absolute more clear, convenient, and costs efficient experience for you. Contact us anytime for client support at (215) 454-6154 and or our direct email at email@example.com. In addition, any policy facilitated through us will include a 30-day Free Look, which allows you to completely terminate the policy within 30 days of its issuance without incurring any penalty or fees.