Medicare Supplement Plans: What’s Worth Considering?
A Medicare Supplement plan, sometimes called a Medigap plan, helps to cover the medical costs that Original Medicare (Parts A & B) doesn’t cover, including coinsurance, deductibles, and copayments. Medicare Supplement plans are sold through private insurance companies, but before enrolling in a Medigap plan, here are six things you should consider.
1. Original Medicare vs. Medicare Supplement Insurance
Original Medicare, or Parts A and B, cover approximately 80% of the cost for hospital and doctor services. A Medicare Supplement plan helps you cover the other 20% of your medical costs. Some Medigap plans cover services that Original Medicare doesn’t, such as medical care while traveling outside the United States. Don’t’ forget: Your Medigap plan will only cover one person—you. If you have a spouse, he/she will have to get their own separate insurance plan. The good news is couples can have different plans from different companies if they wish. That way, each Medicare member can get the insurance plan that’s best for them and their needs.
2. What Other Types of Medicare Insurance Plans Are Available?
Besides Medicare Supplement plans, the next most common type of insurance coverage available to Medicare members is Medicare Advantage plans (MAPD plans). These types of plans often have prescription drug coverage embedded into the plan and usually include additional ancillary benefits such as: chiropractic coverage, dental coverage, gym memberships, and vision and hearing benefits. Most Medigap plans do not include additional dental, vision, or hearing benefits. Check with each insurance company before choosing a Medicare Supplement plan to find out what coverage you’ll be paying for.
3. How Will You Get Prescription Drug Coverage?
Unlike Medicare Advantage plans, a Medicare Supplement plan doesn’t include prescription drug coverage or Medicare Part D. If you choose a Medicare Supplement plan, you should consider getting a separate Prescription Drug Plan to help with the cost of your medications. Even if you aren’t currently taking medications, Medicare beneficiaries are required to take out their Medicare Part D during their Initial Enrollment Period or else they may have to pay a penalty.
4. The Cost of Medicare Supplement Plans
If you sign up for a Medicare Supplement plan through an insurance company, you will pay that company a monthly premium for your Medigap policy. This monthly premium does not include your Part B monthly premium, which, in 2020, is $144.60. However, some Medicare Supplement plans cover the Part B deductible ($198 as of 2020) while others do not. As mentioned before, Medigap plans do not include prescription drug coverage, so in addition to your Medicare Supplement monthly premium, you will also pay a Prescription Drug Plan monthly premium.
5. What Doctors or Doctor Networks Are Available to You?
Medicare members with Medigap plans aren’t required to choose a primary care doctor or even stay within a single doctor network when seeing specialists. Also, if you have a Medicare Supplement plan, you don’t need to get a referral from a primary care doctor before seeing specialists. If a doctor is accepting new patients and takes your insurance, you can see them. If you travel often or live in more than one home during the year, a Medigap plan can make it easier to see doctors and specialists because you aren’t limited by doctor networks on this type of plan.
6. How Do You Sign Up?
Unless you have Medicare due to disability, most people will become eligible for Medicare when they turn 65. Your Initial Enrollment Period (IEP) includes the three months before you turn 65, the month of your 65th birthday, and the three months after you turn 65. For example, if you turn 65 in July 2020, your IEP will be April-October 2020. During this time, you can sign up for a Medicare Supplement plan without having to answer underwriting questions about your health. If you want to sign up for a Medicare Supplement plan after your IEP, you will have to answer the health questions unless you have a circumstance that will allow you to sign up for a guaranteed issue. If you’d like to know what qualifies as a guaranteed issue, speak to a local Medicare Insurance agent.
Before choosing any Medicare Insurance plan, talk to an agent to find out what plans are available in your area. Caress Insurance Agency, Inc has local agents who are ready to help you find a plan that best fits your needs and budget. We work with Scripps Affiliated Medical Groups to help answer your Medicare questions.