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The Difference Between Medicare & Medicare Supplements
Medicare Supplement Plans
The purpose of Medigap plans is to give you supplemental coverage to fill in gaps from Original Medicare. These supplement plans help your cover out-of-pocket expenses. And there are a lot of out of pocket expenses with Medicare.
Medigap plans were designed to help you keep your expenses as low as possible when you need it the most. That’s because Medicare doesn’t cover everything. If you have Original Medicare alone, YOU are required to pay any or all of the following:
- Medicare excess charges
If you are considered low income you can get help with such out-of-pocket expenses through Medicaid or the Medicare Extra Help programs.
However, if you don’t fit into the low income category, Medicare Supplement plans are available through insurance carriers.
Medigap plans are designed to supplement traditional Medicare Part A and B programs by covering many typical out-of-pocket costs. Medicare Supplement plans are offered by private health insurance companies and are regulated by the federal and state governments.
ALL Medicare supplement plans are standardized and assigned a letter corresponding to the federally mandated benefit levels. This means the federal government, not the insurance companies) decide which plans cover what level of benefits.
This also means that each plan (A, B, and so on) is completely identical in benefits as regulated by the government. The only thing that differentiates each plan from carrier to carrier is the premium they charge.
Yes! You could pay more or less for the same exact plan coverage by going with a different insurance carrier.
That’s where we come in. We are here to help you navigate through each of the Medigap plans to find the right one for you, while finding the best possible rate.
Click Here to find out what plans you qualify for and how to get the simple tools you need to get started with Medicare.
Required Medigap Benefits
All Medicare Supplement plans are unique in what benefits they offer. However, there’s a basic level of coverage that’s required within every Medigap plans.
All Medicare Supplement plans must offer coinsurance on hospital stays with Medicare Part A up to an additional 365 days after Medicare hospital benefits have run out. They also are required to cover 50 to 100 percent of copayment and coinsurance requirements on Medicare Part B.
In the case where hospice care is needed, Medigap plans cover 50 to 100 percent of copayment and coinsurance requirements on Medicare Part A hospice care expenses.
Additional Medigap Benefits Available
In addition to the required benefits listed above, the various Medicare Supplement plans available offer some or all of the following benefits:
- Skill Nursing Facility Care Coinsurance
- Medicare Part A Deductible
- Medicare Part B Deductible
- Medicare Part B Excess Charges
- Foreign Travel Emergency (up to plan limits)
How and When do I Enroll in a Medigap Plan?
Your initial enrollment period is generally a 7 month period. That period starts 3-months prior to your birth month of your 65th birthday year...
Includes your birth month of your 65th birthday year...
And includes the 3-months that follow your birth month of your 65th birthday.
Once enrolled, your benefits will be active the first day of your birth month or the first day of the month that you enrolled within the 3-months following your birth month of your 65th birthday. Also, you must have both Medicare Parts A and B to be eligible to enroll in a Medigap Plan.
During this time a Medigap carriers cannot refuse to sell you a plan, neither can they charge you an extra premium due to your health. After this open enrollment period, you may still apply for Medigap coverage, but the insurance company can refuse to cover you because of medical conditions unless you are in one of the guaranteed issue periods or situations for Medicare Supplement plans.
Also, be aware that regular Medicare, and your Medigap plan, does not cover any outpatient prescription drugs. You should consider purchasing a separate drug plan through an approved drug plan carrier.
by Wilson Group Financial
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Orlando, FL 32801
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