Medical Supplements, also known as the Medigap Policies, support payment of remaining health care costs like co-payments, co-insurance, and deductibles, which are not covered under the Original Medicare Plan. Original Medicare pays for most, but not all, of the cost for health care services and supplies.
Our Specialists can work with you to provide standardized policies identified in most states by letters A through D, F through G, and K through N. Since these policies are regulated by the government, the basic benefits provided by a defined letter is the same regardless of the type of insurer you choose. These policies may vary based on the additional policies that they provide. Also remember that in states like Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a distinct way.
Plan F offers a comprehensive and high-deductible plan in some states. Which means that when you choose this option you must pay for Medicare covered costs, i.e., the co-insurance, co-payments and deductibles up to the deductible amount $2,200 in 2017, before your policy starts paying for you.
When should I buy these?
You should buy Medicare supplements during your Medigap Open Enrollment Period. This 6-month Open Enrollment Period begins on the first day of the month in which you turn 65 years or older and enrolled in Part B. (This may vary based on your residing state, as some states have additional Open Enrollment Periods) And if you apply for a Medicare supplement insurance plan outside of this Period, then your plan may be “underwrittenâ€. What does that mean? It means that you may need a physical examination, so that your plan could be processed further, and your premium could be adjusted based on your health status.
Does this cover all the “gaps�
No, Medigap is like the Original Medicare in many situations, such that it will not cover vision and dental services, meaning you cannot use it to cover the cost of exams or services, or for any eyeglasses or dentures.
Additionally, Medigap does not cover the cost of hearing aids, long-term care or private-duty nursing. (If you want these covered, Medicare Advantage Plan might be better suited for your needs by providing some coverage for medical equipment and services.) At some point, Medigap plans used to offer benefits for prescription drug coverage, but now they are no longer allowed to, which means that you will have to enroll in Medicare Part D prescription drug coverage for all those kinds of benefits.
How are my premiums calculated?
There are three ways by which an insurance company can set your Medigap policies premium rates:
“Community-rated†(or “no-age-ratedâ€) premiums: These premiums are similar for everyone, regardless of their age.
“Issue-age-rated†(or “entry-age-ratedâ€) premiums: These premiums are based on the age when you first buy a policy. The earlier you buy, the less you will have to pay.
“Attained-age-rated†premiums: These are based on your current age, which means that as you grow older, your premium rates would increase.
There are several other parameters that factor into premiums, such as inflation, geography, medical underwriting (i.e., when you did not buy the plan when first eligible), and other discounts. We can work with you to see how the Medigap prices are set before you make a purchase.