Medicare is available in several “parts” all of which are designed to fit together to offer comprehensive coverage.
Still, gaps between the plans mean that some people experience difficulty in gaining coverage in some situations, or end up with high out-of-pocket expenses. Medicare Supplement Plans were designed to help close these gaps. That’s why Supplement plans are often called “Medigap” plans.
A Medicare Supplement plan, paired with Original Medicare, will be accepted nationwide. Out-of-pocket costs are usually lowest with this combination, and flexibility is greatest. Of course, cost is based on your age, gender, geographic location, tobacco usage, and household eligibility for discounts. As a result premiums can vary greatly based on your specific situation and the insurance carrier you select.
What is a Medicare Supplement plan?
Medicare Supplement Plans cover the costs that Medicare normally passes on to the patient. This might include deductibles, co-pays, and coinsurance.
First, Medicare pays for its usual share of expenses. Then, a Supplement plan kicks in to cover its share. In many cases the Supplement plan pays for the remaining balance of the bill, but this can vary depending upon the plan’s design.
The Ten Types of Medicare Supplement (Medigap) Plans
Medicare standardized all Supplement plans in 1990, designating each type of plan with a letter. Beneficiaries can enroll in Medigap plan A, B, C, D, F, G, K, L, M, or N. No matter which company provides the policy, plans with the same letter will offer the same benefits. The main difference between Supplement, or Medigap, plans is the premium. Beneficiaries should shop and compare plans to find the plan to meet their needs and budget.
Some items are not covered by any Medicare Supplement plan:
- Routine dental, hearing, and vision exams
- Glasses or contacts
- Hearing aids
- Retail prescription drugs
- Long-term care or custodial care
Enrolling in a Medicare Supplement plan
The Medicare Supplement Open Enrollment Period is not the same as the Annual Election Period that occurs each autumn. Open Enrollment dates for Supplement plans vary from one individual to another, so it is important to understand when you can enroll.
Here’s what you need to know:
- Medicare Supplement Open Enrollment happens one time for most individuals
- Open Enrollment is not annual; once your opportunity is gone, it is gone
- Medicare Supplement Open Enrollment lasts for six months
- You might be subject to health questions if you ever want to change plans
- Federal law does not require insurance companies to accept you into a Medicare Supplement plan in most circumstances
Medicare Supplement Open Enrollment begins on the day that your Medicare Part B activates. The window for enrollment in a Supplement plan lasts for six months, and then closes.
For most people that means you must enroll in a Supplement policy when you turn 65. However, if you delay Part B coverage because you’re still working, then your Supplement open enrollment window will occur later, when your Part B coverage goes into effect.
Either way, this Open Enrollment period is the only time you will be able to enroll in a Supplement plan without answering health questions. At any other time, a health questionnaire will be required. Your plan will be subject to underwriting and you could be denied coverage.
Those who are eligible for Medicare before they turn 65, due to disability, will experience a second Supplement open enrollment window when they turn 65. This is the only instance in which a person who previously missed enrollment will have another chance to select a Medigap policy.
Again, you must enroll in a Medicare Supplement plan during your six-month open enrollment window, or you will not get another chance to enroll without answering health questions. You can apply for a Medigap plan at any later date, but health insurance companies will require screening and might deny you coverage. Talk to a licensed insurance professional as your Open Enrollment window approaches, to understand your rights and responsibilities with regard to Medicare Supplement plans.
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