Medicare Supplemental Insurance
If you're just about ready, or are planning to renew, your Medicare benefits and plan options, it's a good idea to understand the variety of Medicare supplemental insurance plans available.
Known as Medigap policies, these policies help pay differences in costs that Medicare services don't cover, including portions of deductibles, co-pays, and some services.
Your geographical location or state will determine the type of Medicare gap policies available in your area. You can look up a variety of available Medicare gap policies by logging onto the main Medicare Supplemental Insurance webpage (link is on the bottom of this article).
Be prepared to answer a number of questions, including your zip code, how you rate your current health, and whether you already have Medicare supplement insurance policies in place. For example, take Los Angeles, California - a number of zip codes are available for Los Angeles, but typing in 90004 and stating that your health status is "good", and you don't have any current Medicare gap or supplemental insurance policies will offer you a page that lists the type of Medigap policies available in that area.
For example, continuing to use the Los Angeles example, you may find options for choosing a number of Medigap policies, including A, B, C, D, F, in addition to F-with a high deductible, G, and K, as well as policies L, M, and N. For Los Angeles residents, costs for such policies may average around $6,500 annually, with monthly premiums ranging from $30 to $165.
A resident from Concord, New Hampshire may be offered many of the same policies at similar prices, but not Policy D. It all depends on location.
Take the time to research and understand what each type of Medicare supplemental or Medigap insurance covers. For example, Medicare Part A covers 100% of approved amounts for the first 20 days in a skilled nursing facility.
Between 21 days up to 100 days, Medicare will pay everything except $141.50 a day. After 100 days, Medicare Part A doesn't pay at all. However, a Medigap policy may help pay for costs following the initial 100-day stay.
It can get rather confusing to compare all the benefits, restrictions, and covered services among Medigap or Medicare supplemental insurance plans, but such research will pay off in the long run, especially when you or your parents are able to enjoy the benefits of additional coverage.
It's important to realize that Medigap policies alone don't cover long-term care, such as that offered in a nursing home.
They also don't cover private-duty nursing care, hearing aids, eyeglasses, or dental care or vision services. An insurance company can sell what are known as "standardized" Medigap policies, which must contain specific benefits.
In order to qualify for a Medigap policy, you must already have Medicare Part A and Part B. Individuals who currently have a Medicare Advantage Plan may also apply for Medigap policies, but you have to cancel your Medicare Advantage Plan before the Medigap policy goes into effect. Medigap policies only cover one individual, and if a couple wishes to purchase Medigap policies, they must each purchase separate ones.
The best time to purchase a Medigap policy is during the open enrollment period. This period typically ranges six months in duration and will begin on the first day of the month in which you turn 65 years of age or older, and when you enroll in Medicare Part B. Individuals under 65 years of age may enroll at other times, depending on state.
The cost of your Medigap or Medicare Supplemental Insurance policy may be based on age, your community, or on your current age, meaning costs may increase as you grow older. Community-based payment premiums are set at the same rate for everyone in that community, regardless of age.
Age-rated pricing is determined by the age when you buy the Medigap policy, while the attained-age policy costs will rise slightly on a yearly basis as you get older.
Take your time in researching Medicare or supplemental insurance policies offered through Medicare and seek the advice of Medicare representatives in your community when necessary. Choose the best plan that suits your present and future needs, and be aware of restrictions, benefits, and costs before signing on the dotted line.