Finding the Right Medicare Supplement Plan

Finding the Right Medicare Supplement Plan

Once you’ve reached 65 years of age, you’re eligible to apply for Medicare which consists of two parts: Part A and Part B. Part A is hospital insurance, and it covers expenses including limited home health services, inpatient hospital care, hospice care, and skilled nursing facility care. Part B is the medical insurance part, and it covers medical supplies and services that are deemed necessary to treat health conditions, such as ambulance services, outpatient care, and preventative services. Medicare insurance doesn’t cover everything else.

The U.S. Census Bureau found that one in six elderly American citizens are under the poverty line, and unfortunately, more people are filing for bankruptcy now than any other time in history. Approximately 50 percent of the workforce saved less than five figures for their retirement, and 29 percent don’t have $1,000 put away for retirement, according to the EBRI.

It’s costly to retire and handle expenses that come with aging, and most people don’t have the financial ability to handle this situation. Even if you’re currently employed and can deal with your expenses, are you able to pay for raised healthcare costs? A lot of seniors discover they can’t pay for their medical expenses, resulting in poor health and treatment. Some American retirees have to make the tough choice of keeping their refrigerator stocked or paying for necessary medications and treatments. Luckily, there’s a solution: a Medicare supplement plan.

Medigap, or Medicare supplement insurance plans, help pay for expenses that aren’t covered by Plan A or Plan B Medicare insurance. Medicare covers 80 percent of doctor fees, which could leave you with an expensive bill that you can’t pay. If your financial situation won’t allow you to pay the 20 percent doctor’s visit fee out of pocket, look through the ten various Medigap coverage plans to find one that pays for doctors’ fees. Your Medigap policy can also help pay for the increased cost of seeing specialists.

Purchasing a Medicare supplement insurance plan may raise the quality of your health care, as it lets you see a specialist who you may otherwise not be able to afford, pay for outpatient care, and take advantage of preventative treatments that Medicare doesn’t cover. Enjoy superior coverage and peace of mind knowing that you and family members are able to afford required care without having to sacrifice groceries and other necessities.

As soon as you’ve reached 65 years old, apply for Part A coverage. Once you’ve reached retirement, apply for Part B. After you’ve retired, enroll in Part B and get a Medicare supplement insurance plan. The open enrollment period begins when you’re 65 or older and enrolled in Part B. While you’re in the enrollment period, you’re not subject to raised premiums and coverage can’t be denied based on your pre-existing health conditions.

A wide range of insurers, such as Humana or Anthem Blue Cross, sell Medigap plans, but no matter who you choose all ten policies are exactly the same. Standardized plans get rid of the need to search around for personalized plans that have the benefits you’re looking for, but still remember that prices can vary. Get the best possible price and coverage by consulting with your independent agent or group health insurance representative. Even if you’re not yet 65, you can learn more about the available coverage options, so you’re fully prepared once you’re eligible for a Medigap plan.

Overview of Medigap Plans

There are ten Medigap plans available: Plan A, B, C, D, F, G, K, L, M, and N. Let’s discuss each plan in detail.

Plan A

Medigap Plan A is the most basic policy available. To buy a Medigap policy, you must purchase both Medicare Plan A and Plan B.

Medigap Plan A covers 100 percent of the Medicare Part A copayment, but it doesn’t cover the deductible, and it pays for 365 additional days of hospital care once Medicare coverage expires. One-hundred percent of Medicare Part B coinsurance is covered, and this is typically about 20 percent of the Medicare-approved payment amount. The cost of drawing three pints of blood, which is often referred to as the blood deductible portion, is covered 100 percent. Medicare preventative care Part-B co-insurance is covered in full, and finally, this plan covers outpatient co-payments for drugs and medication and inpatient respite care co-insurance.

Plan B

Medigap Part B coverage pays for everything that Plan A does, but it also covers the deductible for Medicare plan A. Having Medigap Plan A and Plan B is a good way to ensure that most of the basics are covered, but if you’re looking for more extensive coverage, you’ll want to get a more thorough plan.

Plan C

This plan builds on the previous plans and covers everything previously listed. Plan C also pays for co-insurance for skilled nursing facility care, the deductible for Medicare Part B, and it pays for foreign travel emergencies up to the coverage limits of your plan.

Plan D

This plan pays for everything that Plan C pays for except the Medicare Part B deductible. Plan D was created to work with Medicare Part A or B or original Medicare. If you’ve decided to receive coverage through Medigap Part C, then you don’t need to sign up for Medigap Plan D.

Plan F

If you’re looking for a comprehensive plan, this may be the way to go. Plan F covers the following:

  • Hospital stays
  • Hospital expenses for up to 365 days after your Medicare coverage runs out.
  • Copayments for Medicare-approved services. For comparison, Medigap Part B requires you to pay a 20 percent coinsurance payment.
  • If you need a blood transfusion, Medicare only pays out after you’ve paid out of pocket of the first three pints, but Part F coverage pays the full cost of the first three pints.
  • Copayment for hospice care services
  • Travel insurance
  • Nursing care
  • The deductible for Medicare Part A and Part B, and all fees that are above the coverage limit provided by your Part B insurance plan.

Plan G

Medigap Plan G coverage is very similar to Plan F. The major difference is that Plan F pays for the Medicare Part B deductible, and Part G makes you pay the deductible. Because of this, Plan G is available at cheaper rates than Plan F, so if you’re looking for additional medical coverage while looking to save money, look into this plan.

Plan K

If you need more hospice, hospital, and skilled nursing services than the average patient does, this plan is for you. Plan K pays for expenses that aren’t covered by a standard Medicare plan. This is a good plan for people who have a decent savings account that can be put toward medical expenses. You’re required to pay $4,800 out of pocket and your Medicare Plan B deductible, and then you plan kicks in and pays 100 percent of coinsurance and copayments, three pints of drawn blood, and coinsurance for stays in a nursing care facility.

Plan L

Insurers are allowed to offer Medigap Plan L as per federal Medicare law. This supplemental Medicare coverage has a $2,310 deductible that you have to pay out of pocket before the coverage pays for your medical expenses.

Plan M

On June 1st, 2010, Medigap Plan M supplemental Medicare coverage was introduced as part of the Medicare Improvements for Patients and Providers Act. This is a great option if you’re looking for reduced monthly premiums and a high-quality health insurance plan, but don’t mind paying higher out of pocket fees for medical expenses.

Plan N

After Plan M was introduced at the beginning of June 2010, Plan N was introduced shortly after. You’ll enjoy a wide range of benefits with Plan N supplemental medical coverage, such as co-insurance payments for hospital expenses and one year’s worth of payments once your Medicare benefits have been used fully. This policy pays 100 percent of Medicare Part B co-insurance, but you’ll have to pay up to $20 for doctor’s visits and up to $50 for emergency room visits, so if you make frequent trips to the doctor or are prone to a higher than average rate of emergency visits, you may want to look into another coverage type.

Plan N coverage pays for hospice care co-payments and co-insurance, as well as co-insurance for a stay in a skilled nursing facility. You’re also protected while you’re out of the country, thanks to the foreign travel emergency treatment coverage.

Conclusion

There’s a lot of information to digest when it comes to choosing Medigap coverage. In order to choose a plan that you’ll be happy with and avoid surprises when it’s time to pay your bill, meet with a health insurance representative to discuss the specifics of each plan. An insurance agent will be able to help you choose the best coverage type based on your specific needs and financial situation.

By |2018-09-06T17:14:36+00:00August 23rd, 2018|Medicare Supplement Insurance|

About the Author:

Matthew Carter
Matthew Carter, owner/licensed agent and Oldham County resident, graduated from the University of Louisville in 1998 with a B.A. in political science/communications and completed his M.B.A. in 2009.

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