COMPARE INSURANCE

What is the Medicare?

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease, permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

What is Supplement plan?

Medigap Supplemental Plans help if you’re concerned about Medicare costs, a Medigap health insurance policy, also called Medigap supplemental insurance or a Medicare supplemental plan which helps pay the “gap” between what Original Medicare – Medicare Parts A and B, pays and what you pay out of your own pocket. Medicare Supplement, also known as Medigap or MedSup which has policies help cover certain out-of-pocket costs that Original Medicare, Part A and Part B, doesn’t cover. There are 10 plan types available in most states, and each plan is labeled with a different letter that corresponds with a certain level of coverage.

In most states, Medigap plans have the same standardized benefits for each letter category. This means that the coverage for a Plan A, for example, is the same across every insurance company that sells Plan A, regardless of location. This makes it easy to compare Medicare Supplement plans because the main difference between plans of the same letter category will be the premium cost. Medicare Supplement insurance works differently in Massachusetts, Minnesota, and Wisconsin, which standardize their plans differently from the rest of the country. Insurance companies that sell Medicare Supplement insurance aren’t required to offer all plan types.

However, any insurance company that sells Medigap insurance is required by law to offer. Medigap Plan A. If an insurance company wants to offer other Medigap plans, it must sell either Plan C or Plan F in addition to any other plans it would like to sell. The 10 different Medicare Supplement plans have standardized benefits across each plan letter. For example, Medigap Plan A will have the same benefits regardless of which state you live in or which insurance company you buy from. If you live in Massachusetts, Minnesota, or Wisconsin, the Medigap plans in these states are standardized differently.

How to read the chart –

If “Yes” appears in a row on this chart, the Medigap policy covers 100 percent of the benefit. If a row lists a percentage, the Medicare Supplement policy covers that percentage of the benefit. If “No” appears in a row, the policy doesn’t cover that benefit.

Plan F is also available in a high-deductible version. With the high-deductible Plan F, you pay for all Medicare-covered costs until you reach the deductible of 2,180 dollars before your Medigap plan pays anything. Plan N pays 100percent of the Medicare Part B coinsurance. There are a few exceptions: Certain office visits may require a copayment of up to $20; and emergency room visits that don’t result in your being admitted as an inpatient may require a copayment of up to $50.

***Once you have reached the annual out-of-pocket spending limit and your Medicare Part B deductible, your Medigap plan pays 100% for Medicare-covered costs for the remainder of the calendar year.

MEDICARE SUPPLEMENT PLANS BENEFITS

Even though Medigap plans are run by private companies such as Blue Cross, United Healthcare, or Humana, every Medigap policy must be standardized and must follow Federal and state laws.

There are multiple “F” plans offered by multiple companies, but they’re all basically the same plan. This makes it easy to compare “F” plans between two companies, since they are the exact same coverage but not necessarily the same price. To clarify further still, that means that each private company that offers a certain plan has to offer the exact same benefits as their competition. The same can be said for the “N” plans, the “C” plans, and so on.

Each insurance company decides which Medigap policies it wants to sell, although state laws might affect which ones they offer. Insurance companies that sell Medigap policies:

a) Don’t have to offer every Medigap plan

b) Must offer Medigap Plan A if they offer any Medigap policy

c) Must also offer Plan C or Plan F if they offer any plan

With a Medicare supplement policy (Medigap) you can go to any physician, or other health care provider, anywhere in the United States, as long as that health care provider accepts Medicare.

A good starting point to compare Medicare supplement plans is Medicare’s online plan finder tool.

Here are some other important facts you must know:

a) You must have Medicare Part A and Part B to enroll in a Medigap Policy.

b) If you have a Medicare Advantage Plan, you can apply for a Medigap policy, but make sure you can leave the Medicare Advantage Plan before your Medigap policy begins.

c) You pay the private insurance company a monthly premium for your Medigap policy in addition to the monthly Part B premium that you pay to Medicare.

d) A Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you’ll each have to buy separate policies.

e) You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one.

f) Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.

g) Some Medigap policies sold in the past cover prescription treatments, but Medigap policies sold aren’t allowed to include recommended treatment coverage.