The Secrets of Medicare Supplements

(WHAT I WISH SOMEONE WOULD HAVE TOLD ME AT AGE 65)

Here are some general “good things to know about Medicare Supplement Insurance (Medigap) Plans”:

-A Medicare supplement and a Medigap policy are the same thing.

-You can choose a Medicare supplement policy only if you are in Original Medicare.

-A Medicare supplement will pay health care costs only if those costs are approved by Medicare and Medicare pays its portion first.

-Original Medicare and a Medicare supplement offer coverage throughout the country to any doctor or provider who accepts Medicare.

-A Medicare supplement policy must be clearly identified as “Medicare Supplement Insurance”. If the literature promoting the plan does not say “Medicare Supplement Insurance”, then it is a Medicare Advantage Plan (see Article 9).

-Medigap insurance companies can sell you only a “standardized” Medigap policy identified in most states by letters (A-N). All plans (with the same letter) offer the same basic benefits.

For example, plan F with any insurance company has the same coverage. Plan G with any insurance company has the same coverage.

-Insurance companies may charge different premiums for exactly the same Medigap coverage. The only real difference in Medigap policies with the same plan coverage is cost.

-The best time to buy a Medigap policy is during the 6-month period that begins on the first day of the month in which you are 65 and older and enrolled in Part B.

After this enrollment period, your option to buy a Medigap policy may be limited and it may cost you more.

Generally speaking, once you go beyond the 6-month guaranteed issue period and then apply for a Medicare supplement, you will have to go through medical underwriting and must be able to answer “No” to the health questions asked on the application.

-Once I am approved for coverage with a Medicare supplement policy, I can switch to another Medicare supplement policy with another insurance company at any time as long as I can answer “No” to all of the health questions on the application with the new company.

-If I have a Medigap policy and join a Medicare Advantage Plan, my Medigap policy can no longer be used to pay any of the Medicare Advantage Plan co-payments, deductibles, and premiums.

If I drop my Medigap policy to join a Medicare Advantage Plan, in most cases I will not be able to get the Medigap policy back.

-If I am in Original Medicare, I do not have to choose to have Medicare Supplement coverage.

However, it is better to have even the most basic Medicare supplement policy than to have no Medicare supplement policy at all.

The most basic Medicare supplement plan (Plan A) will limit my out of pocket expenses in a catastrophic health situation to the hospital and doctor deductibles and potentially save me thousands of dollars in out of pocket expenses.

-The Original Medicare side of Medicare allows me to custom design my own health care coverage.

By that, I mean that I am in full charge of deciding the coverage I want and how much I want. I shop the open market and put my health care coverage together.

I decide if I want a Medigap policy and choose my plan and pay an extra fee if I want that coverage. I decide if I want prescription drug coverage and choose my plan and pay an extra fee for that coverage.

The same is true of additional coverage such as vision, dental, and hearing. At every stage, I make my coverage decisions and pay an extra fee for that coverage.

-Medicare supplement insurance premiums can and probably will increase every year or two.

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