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Speak with a Licensed Agent Now:
1-855-368-4717, TTY 711

What is a Medicare Supplement Plan?

A Medicare Supplement plan, also known as Medigap, pays the bills that Medicare Part A and Part B would normally charge you. These plans are also called Medigap plans and pay your share of Medicare expenses including deductibles and co-insurance. Supplements are a good fit for people who want little out-of-pocket costs for healthcare services.

How does a Supplement Plan Help?

Since you can use your Medicare Supplement plan with any provider in the nation that accepts Medicare, it is a great choice for people who want the freedom of nationwide coverage.

Medicare only covers 80% of your Part A and Part B expenses. So you may be stuck paying 20% of your hospital and medical bills. This 20% can be devastating to you financially if you have a serious illness. Fortunately, Medicare supplemental insurance pays that 20%, fills this gap, and buys you peace of mind.

Medigap plans may cover most or all coinsurance costs for hospitals, skilled nursing facilities, hospice care, and part-time home health services. Most importantly, Medigap plans pay your $1,484 Part A deductible in 2021 for every 60 day benefit period.

What Else Do Medigap Plans Cover?

A Medicare Supplement plan may cover coinsurance or
copay costs for Part B medical services and supplies, including:

The Value Of Medigap Insurance

The value of a Medigap plan maybe more than you think. If you have a hospital stay for more than 60 days without Medigap, you will have $371 coinsurance per day. Moreover, if your hospital stay is more the 90 days without Medigap, you will have $742 coinsurance per day!

However, Medicare supplement insurance pays this expensive hospital coinsurance. As a result, you can stay in the hospital as long as needed without worrying about the cost. Furthermore, Medigap Plans give you these benefits:

  • Freedom to choose your own doctors and hospitals
  • No referrals required to see a specialist
  • No claim paperwork – claims are automatically filed with your supplement company

 

 

Medicare Parts Vs. Medigap Plans

Although the names sound similar, Medicare Parts such as Part A and Part B is not the same as Medigap Plan A, Plan B, etc. To buy a supplement policy you must have Medicare Part A and Part B. Learn more about the 4 Parts of Medicare.

Medigap Plans only cover one person. So your spouse or other family member must have a separate supplement policy. When you enroll two or more people, you can get a household discount and save money on your monthly premiums. Non-smokers can get additional discounts, as well. Call Senior Healthcare Direct at 1-855-368-4717 and find out how much you can save.

Furthermore, Medigap Plans do not include drug coverage. So if you need prescription drugs, you can add a separate Part D drug plan.

More Common Questions about Medicare Supplements

What is the difference between Medicare Supplement and Medigap?

Medigap is another name for Medicare Supplement. Hence, both names refer to the same thing.

What if I already have Plan C or F?

Starting January 1, 2020, Medigap plans won’t be allowed to cover the Part B deductible ($203 in 2021). Therefore, Plans C and F will no longer be available for people new to Medicare starting January 1, 2020. If you already have either of these two plans (C or F), you can to keep your plan.

Can I buy Medigap if I lose my health coverage?

Yes, you may have a guaranteed issue right to buy a Medigap policy. It is most important you keep these documents: Copy of any letters, notices, emails, and/or claim denials with your name on them. This proves your coverage is terminated.

When is the best time to buy a Medigap Plan?

The best time to buy a Medigap policy is the 6-month period starting the first day you turn 65. For example, you turn 65 in March and enroll in Part B, then best time to buy a Medicare Supplement Plan is from March to August.

Does Medigap cover pre-existing conditions?

In some cases, the supplement insurance company can refuse to cover your out-of-pocket costs for pre-existing health problems for up to 6 months. This is called a “pre-existing condition waiting period.” After 6 months, the Medigap policy will cover the pre-existing condition.

What is a ‘Look Back’ Period?

A condition treated or diagnosed within 6 months before your Medigap coverage starts.

Medigap coverage is excluded for conditions in the ‘Look Back Period.’  Your original Medicare will still cover the condition, but you will be responsible for paying 20% co-insurance and copays.

Common questions about medicare

They are the same thing. Copy needed from Masthead here on this. Personally, I found this difference in language to be the most confusing thing about learning about Medicare.

Starting January 1, 2020, Medigap plans won’t be allowed to cover the Part B deductible ($203 in 2021). Therefore, Plans C and F will no longer be available for people new to Medicare starting January 1, 2020. If you already have either of these two plans (C or F), you will be able to keep your plan.

Yes, you may have a guaranteed issue right to buy a Medigap policy. It is most important you keep these documents: Copy of any letters, notices, emails, and/or claim denials with your name on them. This proves your coverage is terminated.

The best time to buy a Medigap policy is the 6-month period starting the first day you turn 65. For example, you turn 65 in March and enroll in Part B, then best time to buy a Medicare Supplement Plan is from March to August.

In some cases, the supplement insurance company can refuse to cover your out-of-pocket costs for pre-existing health problems for up to 6 months. This is called a “pre-existing condition waiting period.” After 6 months, the Medigap policy will cover the pre-existing condition.

A condition treated or diagnosed within 6 months before your Medigap coverage starts.

Medigap coverage is excluded for conditions in the ‘Look Back Period.’  Your original Medicare will still cover the condition, but you will be responsible for paying 20% co-insurance and copays.

medicare Supplement Guarantee issue

Guaranteed issue rights are rights you have in certain situations where Medicare supplement company must offer you certain Medigap policies when you are not in your Medigap open enrollment. Some common situations where you have guaranteed issue rights to apply for a Medigap policy include:

Medicare Advantage Plan is leaving Medicare or stops providing care in your area or you move out of the plan’s service area. You can apply as early as 60 days before your health coverage ends. Otherwise, you only have 63 days after your coverage ends.

When you have Original Medicare and your employer group health coverage is ending. Rights are guaranteed if you apply no later than 63 days after your group coverage ends.

When you have Medicare and Medicare Select policy and you moved out of the Medicare Select service area. You can apply as early as 60 days before Medicare Select coverage ends. Otherwise, you only have 63 days after Medicare Select coverage ends.

Within the first year of enrolling in Medicare Part A at age 65 you decide to switch from Medicare Advantage Plan or PACE. You can apply as early as 60 days before your coverage ends. Otherwise, you only have 63 days after your coverage ends.

You dropped a Medigap policy to join a Medicare Advantage Plan for the first time and within the first year. You can switch back to Medigap within 63 day after your coverage ends.

In general, guaranteed issue time period works just like open enrollment, except that it’s shorter time frame.

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