Why Do People Choose Medicare Supplement Plans
There are several key benefits of supplemental plans. They include:
One way to truly understand the incredible value of Original Medicare plus a Medigap policy is to look at hospital insurance coverage. All Medicare supplements cover the Part A hospital coinsurance, and most cover all or some of the Part A deductible, too.
These are, by far, the biggest medical care costs in Original Medicare. A recent Kaiser Family Foundation study found that most people in a Medicare Advantage plan would incur higher hospitalization costs for a short inpatient stay than people with Original Medicare alone.
This fact should be a red flag warning to anyone considering Medicare Advantage, particularly people with a chronic health condition that may require inpatient care.
Medicare Supplement Plan Cost
Even though Medicare supplement plans are standard in terms of the benefits they offer, they can vary in price based on the insurance company that sells them.
Its kind of like shopping at a sale: Sometimes, the plan you want costs less at one store and more at another, but its the same product.
Insurance companies usually price Medigap policies in one of three ways:
- Community rated. Most people pay the same, regardless of age or sex. This means if a persons insurance premium goes up, the decision to increase it is related more to the economy than a persons health.
- Issue-age rated. This premium is related to a persons age when they bought it. As a general rule, younger people pay less and older people pay more. A persons premium may increase as they get older due to inflation, but not because theyre getting older.
- Attained-age rated. This premium is lower for younger people and goes up as a person gets older. It may be the least expensive as a person first buys it, but it can become the most expensive as they age.
Sometimes, insurance companies will offer discounts for certain considerations. This includes discounts for people who dont smoke, women , and if a person pays in advance on a yearly basis.
What Is The Best Supplemental Medicare Plan
Theres no single supplemental health insurance plan for seniors that fits everyone. But there is most likely a plan that will fit your specific needs. HealthMarkets can make finding a plan easy. Get a quote for supplemental health insurance for seniors, at no cost to you. You can also call to speak to a licensed insurance agent.
48203-HM-1221
Recommended Reading: When Can I Change My Medicare Prescription Drug Plan
Are Medicare Advantage Plans Worth It
Part C is also known as an Advantage plan. These plans include the same benefits as Original Medicare and often provide prescription drug coverage and other perks, including dental, vision, and hearing.Advantage plans can work well for some individuals.
If you have an Advantage plan, it acts as a substitute for Original Medicare, meaning you wont need Medigap. However, youll want to make sure your preferred doctors are in your network.
Also, keep in mind that youll likely need a referral from your Advantage plan to see a specialist. So, these plans are better suited to healthier individuals who dont need to see many doctors.
If youre choosing between Medigap and Advantage plans, make sure to keep your future health and budget needs in mind as well as your current circumstances.
Are Medicare Supplement Plans Worth It For You
Medicare has gaps in what it covers. So, what should you do when deciding what coverage to choose? For many people, the answer is to get Medicare Supplement insurance. Is it really worth it, though?
Medicare Supplement insurance, also known as Medigap, can come with a hefty premium. Should you pay it? Read on to get some of the tips that can help you when you are attempting to answer these questions and are deciding on your Medicare coverage.
Also Check: Does Medicare Cover Breast Prosthesis
Switching Back To Original Medicare
While you can save money with a Medicare Advantage Plan when you are healthy, if you get sick in the middle of the year, you are stuck with whatever costs you incur until you can switch plans during the next open season for Medicare. At that time, you can switch to an Original Medicare plan with Medigap. If you do, keep in mind that Medigap may charge you a higher rate than if you had enrolled when you first qualified for Medicare.
Most Medigap policies are issue-age rated policies or attained-age rated policies. This means that when you sign up later in life, you will pay more per month than if you had started with the Medigap policy at age 65. You may be able to find a policy that has no age rating, but those are rare.
Are Medicare Supplement Plans Worth It
For people who arent yet familiar with the out-of-pocket risks with Original Medicare, the idea of purchasing additional coverage begs the question, are Medicare Supplement Plans worth it? Ultimately, if youre on Medicare and want to protect yourself from receiving costly medical bills, you should consider your options for Medicare Supplement plans.
Recommended Reading: Does Medicare Pay For Ct Scans
Medicare Supplement Insurance Plan Benefits
There are 10 Medigap insurance plans available in most states, and each plan type is designed by a different letter . Coverage is standardized across each plan letter, which means youll get the same basic benefits for Medicare Supplement coverage within the same letter category, no matter which insurance company you purchase from. However, even if basic benefits are the same across plans of the same letter category, premium costs may vary by insurance company and location. If you live in Massachusetts, Minnesota, or Wisconsin, keep in mind that these three states standardize their Medigap plans differently from the rest of the country.
Medigap plans cover out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Some plans may help pay for other benefits Original Medicare doesnt cover, such as emergency health coverage outside of the country or the first three pints of blood. Medigap plans dont include prescription drug benefits. If you dont already have creditable prescription drug coverage , you should consider buying a separate stand-alone Medicare Part D Prescription Drug Plan to cover the costs of your prescription medications. Also, Medicare Supplement insurance plans generally dont offer extra benefits like routine dental, vision, or hearing coverage beyond whats already covered by Medicare.
How To Decide If Medicare Supplement Insurance Is Worth It For You
If you are covered by Medicare and are wondering whether you really need a Medicare Supplement Insurance policy, also known as Medigap, youre not alone. The Medicare website contains hundreds of pages of information, few of which are easy reading. Its hard to get an answer to the big question: Why should anyone who has Medicare get a Medigap plan? Below is our answer.
Read Also: How Do You Qualify For Medicare In Texas
Medicare Part B: What Does It Cover And How Much Will You Really Owe
Medicare Part B covers outpatient medical costs. This includes doctors office visits, blood and urine tests, x-rays, CT scans, MRIs, ER visits and any doctor who sees you in the hospital. It also covers observation stays in the hospital that arent regular admissions and IV medications that are given at a nursing home or an infusion center .
How much will you pay?
Most blood and urine tests are free. If your doctor orders a blood test to check your cholesterol, thyroid, blood count, etc every few months to check how your medications are working, those tests will cost you nothing! Preventive screening tests like routine mammograms and colonoscopies are also free now with Medicare.
For other medical services, youre only responsible for 20% of Medicares approved cost for any medical service after you pay a $203 annual deductible.
Medicares approved fee is often a source of confusion for most people because its normally only a small fraction of the billed charge for a medical service. Here are some examples:
Below is a statement from Medicare showing a patients benefits from a doctors office visit dated September 6, 2011 . As you can see, the doctor billed Medicare $279 for an office visit. Medicare approved only $82.89 for that visit so the patient was responsible for only $16.58 .
Figure 2: Bill for doctors office visit
Figure 3: Inpatient doctor fees
Is There Any Downside To Having No Supplemental Coverage Is Medigap Necessary What Are The Risks If I Choose To Have Just Medicare Parts A B And D
You might be wondering this yourself. Are Medicare supplements worth it? When Americans reach retirement age and start their Medicare coverage, many are shocked to realize that Medicare is not free. If you didnt know to save for Medicare Part B premiums during your retirement, you may find that money is tight.
However, going with just Original Medicare and no supplemental coverage is not wise.
The gaps in Medicare are substantial, leaving you to pay for expensive deductibles and 20% of all your outpatient coverage. If you dont have a Medicare Supplement plan, often referred to as Medigap coverage, or a Medicare Advantage Plan, youll have to come up with the difference yourself.
The gaps in Medicare are substantial, leaving you to pay for expensive deductibles and 20% of all your outpatient coverage. If you dont have a Medicare Supplement plan, often referred to as Medigap coverage, or a Medicare Advantage Plan, youll have to come up with the difference yourself.
You May Like: Does Medicare Cover Ice Therapy Machines
Most Dont Rely On Original Medicare Alone
So for low-income Medicare beneficiaries, public programs are available to fill in the gaps in Medicare coverage. And 30% of Medicare beneficiaries receive employer or union-sponsored benefits that supplement Medicare. But what about the rest of the population?
Is Original Medicare enough coverage on its own? Most Medicare beneficiaries dont think so: Only 19% of Original Medicare beneficiaries have no supplemental coverage .
If youve got significant funds that you wouldnt mind using to pay out-of-pocket expenses, you could get by with just Original Medicare. The main risks are the fact that it doesnt have a cap on out-of-pocket costs, and it doesnt cover outpatient prescription drugs .
Discuss your coverage options with a licensed Medicare advisor at
Should You Buy A Medicare Supplement Plan
What do you think? Is supplemental Medicare insurance worth it? It definitely is. If you can afford a Medicare Supplement policy you should shop to see which plan can meet your budget and coverage needs. If you cant afford a Medigap policy, then you should consider a Medicare Advantage plan. There are some disadvantages of MAPD plans, but theyre better than no coverage. Below are some Pros and Cons to both types of plans.
You May Like: Does Aetna Medicare Advantage Cover Dental
Medigap Pros And Cons
A Medigap plan is health insurance designed to fill the gaps of Medicare covered services not paid by Original Medicare. Medigap is also called Medicare Supplement insurance.
The Pros to having a Medigap Plan:
- Your choice of Medicare doctors anywhere in the USA!
- Your choice of Medicare hospitals anywhere in the USA!
- No networks
- No referrals needed. You have control over your healthcare!
- Comprehensive Medical Coverage
- Low to $0 out of pocket expenses
- Helps pay your share of co-insurance, co-pays, deductibles
The Cons
- No dental, vision or hearing coverage outside of Medicare approved items
A Brief Review Of Medicare Supplement Plans
When you turn 65, youre eligible to enroll in Medicare, a federally facilitated health insurance program. Original Medicare will cover some, but not all, of your medical expenses. The portion not covered is often referred to as a gap. Medicare Supplement plans, also called Medigap plans, are policies sold by private insurance companies to help pay for the expenses Medicare does not cover.
Don’t Miss: Does Medicare Cover Skin Removal
A Better Insurance Experience Starts With Erie
Havent heard of us? Erie Insurance started with humble beginnings in 1925 with a mission to emphasize customer service above all else. Though weve grown to reach the Fortune 500 list, we still havent lost the human touch.
Contact The Anderson Hyman Group today to experience the ERIE difference for yourself.
Is Medigap Insurance Worth It
Supplemental Medicare policies help pay some of the An amount patients pay for their share of the cost of medical service or supply, like a doctors visit, hospital inpatient visit, or prescription drug…. baked into the Medicare system. Oftentimes people look at the monthly premiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. … for a Medicare supplement and want to know if the extra coverage is really necessary? And more importantly, are they worth the cost?
Recommended Reading: How Old To Be Covered By Medicare
What Do Medicare Supplement Insurance Plans Cover
There are 10 Medicare Supplement Insurance plans from which to choose in most states, and the benefits of each type of plan are standardized, no matter what state you live in.
The chart below outlines the benefits of each type of Medigap plan:
- First three pints of blood used for a transfusion
Lastly, Plan F provides 80 percent coverage of emergency care received outside of the U.S.
Starting in 2020, newly eligible Medicare beneficiaries won’t be able to enroll in Medigap Plan F. However, if you already have Plan F prior to 2020, you will be able to keep your plan. If you are eligible for Medicare before 2020 and you don’t have Plan F, you may able to buy it in 2020 and beyond.
The Cares Act Of 2020
On March 27, 2020, President Trump signed into law a $2 trillion coronavirus emergency stimulus package called the CARES Act. It expands Medicare’s ability to cover treatment and services for those affected by COVID-19. The CARES Act also:
- Increases flexibility for Medicare to cover telehealth services.
- Increases Medicare payments for COVID-19related hospital stays and durable medical equipment.
The changes will likely continue into 2022 or whenever the pandemic ends.
You May Like: How To Choose Best Medicare Part D Plan
Want To Travel With Medical Coverage Overseas
If you are a jet-setter or wants to spend your retirement travelling across the US states and overseas, you may want a Medicare supplemental plan.
There are types of Medigap plans that cover emergency foreign travel coverage if youre outside of the country , so youll get to enjoy vacations with peace of mind.
Download our Medicare Supplement Ultimate Open Enrollment Guidelines E-Book for FREE when you get a Free Medigap Quotes here.
Think Before You Switch
So, Savage advised, “think very carefully before you switch out of traditional Medicare, which lets you see just about any doctor or go to any hospital.”
I noted a recent study by the nonprofit health care research group The Commonwealth Fund that looked at Medicare Advantage plans and traditional Medicare. Overwhelming majorities of Medicare beneficiaries in both traditional Medicare and Medicare Advantage were satisfied with their care.
The researchers discovered that the Advantage plans didn’t substantially improve beneficiaries’ health care experiences compared to traditional Medicare, but did offer somewhat more care management.
That means the Medicare Advantage enrollees were more likely to have a treatment plan where someone would review their prescriptions for them and handle medical concerns relatively quickly. “By providing this additional help, Medicare Advantage plans are making it easier for enrollees to get the help they need to manage their health care conditions,” the study said.
Of those with a health condition, a larger share of Medicare Advantage enrollees in the study said that a health care professional had given them clear instructions about symptoms to monitor and had discussed their priorities in caring for the condition.
“An excellent, fiduciary, fee-only financial planner can make sure you get the comparisons you need” during Medicare Open Enrollment.
Don’t Miss: What Is A Ppo Medicare Plan
How Does Medicare Supplement Plan N Compare To Other Medigap Plans
Medicare Supplement Plan N provides more coverage than Plans K and L. For example, it covers 100% of the Medicare Part B coinsurance and copayments, whereas K and L only pay 50% and 75%, respectively. The same is true with the Medicare Part A deductible.
Additionally, the only out-of-pocket expenses beyond the monthly premium are a $20 copay for office visits and a $50 copay for a trip to the ER.
The chart below will help you make comparisons.
Medigap Plans Cover Some Of The 20% Gap In Orginal Medicare
There are 10 lettered Medicare supplement plans . Each lettered plan represents a standardized insurance policy and covers the nine gaps in Medicare. These gaps include:
Medicare Part A is your hospital inpatient coverageMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care…. and Medicare Part B is your medical coverage. Without additional coverage, you are responsible for the shared costs listed above. This surprises many people getting their Medicare benefits for the first time. And thats why its so important to understand one basic fact.
You May Like: Who Is Eligible For Medicare Extra Help
