medicare supplement plans
Many people confuse the term “Medicare Supplement Plans” with “Medigap Plans”. It should be noted that Medicare supplement plans fill in some gaps in coverage in original Medicare which is known as “Medigap”.
There are 10 standardized Medigap plans available for senior citizens, each marked with the letters A to N. And these plans are only available through private insurance companies, and it is not necessary for the insurance companies to sell all the 10 Medicare supplement plans. Every insurance company selling Medicare Supplement policy have to offer at least Plan A and if they offer any other policy than they must also offer either Plan C or Plan F.
Please note that Medicare Supplement plans can be used only to pay Original Medicare expenses. These plans can be used to cover expenses that you may have in Part C Medicare. If you enroll in Medicare Advantage plan, you can keep your Medigap plan as long as you keep paying the monthly fee, but you will not be allowed to enjoy Medigap plans on the cost of Medicare advantage plans. There are few things that you need to keep in mind before going for Medigap plans.
First and foremost, the beneficiaries must be enrolled in Medicare Plan A and Plan B. Secondly, if the beneficiary has a Medicare advantage plan than they can apply for Medicare policy and you will have to leave Medicare Advantage plan before you can enroll in Medigap. These Medigap policies are only able to cover one person. If anyone from your family want to avail then they will have to enroll themselves.
Monthly premiums will have to be paid to private insurance companies in addition to monthly Plan B premium. You are not bound by any insurance company, you can select any insurance company you like that is licensed in your state. Each standardized Medigap policy is guaranteed renewable, even when suffering from health problems. This means that the company cannot cancel Medicare Supplement insurance contracts as long as you pay the premiums. Medicare supplement plans allow you to use any provider that can accept Medicare. Among all the states of America, Arizona is considered as one of the best places to live after retirement. Arizona provides the best Medicare and Medigap help to senior citizens.
There are two specific Medigap plans (Plan k and Plan L) which are capable of covering out of pocket limits, because once your basic health care costs reaches the limit, your Medigap plan will cover 100% of all the expenses for the rest of your year. It is worth mentioning that original Medicare don’t have the ability to include a yearly out of pocket limit. Remember, Medicare supplement plan is meant to work side by side with your original Medicare coverage. You only need to remain enrolled in original Medicare to take the benefits of Medigap.
Although private insurers are required to offer the same benefits for each Medicare plan, these companies can change the costs of premiums they charge for this coverage. So if you are looking for Medigap coverage, you must contact different insurance companies to find a Medicare Supplement plan that is appropriate for your medical and financial needs. Remember that insurance companies use different methods to price their Medigap plans. Pricing method that company uses may affect the amount of premium you pay when you first enroll in a Medicare Supplement plan, as well as your long-term costs.
Medigap can be used only by people enrolled in traditional Medicare only. It is not a Government-run program but you can buy private insurance to cover some or most of your expenses in traditional Medicare. Medicare advantage plans consist of variety of private health plans for every type of needs. HMOs and PPOs are the most commonly used among the beneficiaries. Most of the plans include drug prescription coverage at no extra cost. Some plans are capable of covering routine hearing and vision services but not all. By law, all plans have annual limits for out-of-pocket costs.
Another difference from the traditional program is that most plans require you to go to the doctors and hospitals within their network and if you want to go out of the network, you will have to pay extra.
If you enroll in Medicare Advantage health plan, you can’t use a Medigap policy to cover your expenses, and it is illegal to sell insurance Medigap policy if you are enrolled in a Medicare Advantage plan. If you want to stay in traditional Medicare, you will need a separate Part D plan to get prescription drug coverage and pay an extra premium for it. A Medigap does not cover drugs outputs of- pocket.
Some states even offer Medigap plans for beneficiaries under 65 years of age who are eligible for Medicare because of disability or under certain conditions. Federal law doesn’t allow states to sell Medicare Supplement insurance for under 65 years, but depending on where you live, some states offer Medigap coverage for beneficiaries under 65 years of age. Every state can have its own eligibility criteria and terms. If you are a Medicare beneficiary under 65 years of age and interested in purchasing a Medicare Supplement insurance, contact your state insurance department to find out if you qualify for Medigap coverage in your state or not.
- July 30, 2016
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As you get older, health insurance becomes an undeniable necessity, regardless of current health status. Medicare, the national health coverage system managed by the US federal government primarily addresses the insurance needs of senior citizens and the disabled. Its coverage however is limited, hence many Medicare beneficiaries opt for some form of additional health insurance. If you are looking for a plan that addresses your health insurance needs more comprehensively, consider the different Medicare supplements in Phoenix AZ.
What is Medicare?
Medicare is a nationwide health coverage program available to US citizens 65 and older, people receiving disability insurance and people suffering from specific conditions (end-stage kidney disease and Lou Gehrig’s disease).
Medicare is a four-part program. Parts A and B are referred to as Original Medicare. Part A covers costs of inpatient care in hospitals, skilled nursing or rehab facilities, whereas Part B covers outpatient and preventive care, doctor visits, ambulance services etc.
Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare. To join, you must have Medicare A and B. Medicare Part D is available as a standalone plan and covers prescription drug costs. Parts C and D are optional and are offered by private companies.
What is not covered by Original Medicare?
Original Medicare doesn’t cover cosmetic surgery, health care outside the US, hearing aids, long-term care, most types of eye and dental care, non-emergency transportation and prescription drugs (with the exception of immunosuppressants and oral anticancer drugs). Also, policyholders need to pay the deductibles, copays and coinsurance required by Medicare.
To cover medical expenses not included in Medicare, a majority of Medicare users have some kind of supplemental health insurance, including employer or military-based coverage, Medicaid (government insurance for low-income families) or some of the different private options – Supplemental Insurance for Original Medicare (known as Medigap) and Medicare Advantage.
Choosing Medicare supplements in Phoenix AZ
When it comes to supplemental health coverage, people tend to confuse Medigap and Medicare Advantage, despite their significant differences. Medicare Advantage (Medicare Part C) replaces your Original Medicare. It is supplied by private insurance companies, which provide the full range of Part A and B benefits, under contract with Medicare.
To join Medicare Advantage, you must have Medicare Part A and be eligible for Medicare Part B. Medicare Advantage comprises several plans with different benefits. Most of them cover prescription drug expenses.
How does Medigap work?
Unlike Medicare Advantage, Medigap complements Original Medicare. As the name suggests, Medigap is designed to fill in the coverage gaps in Original Medicare. This includes copays, coinsurance, deductibles, health care abroad and hospice expenses (palliative care for the seriously ill).
To buy Medigap, you must have Medicare Parts A and B. You can’t buy Medigap if you already have Medicare Advantage, but you can drop the latter and apply for a Medigap plan before your Medicare Advantage coverage expires. Medigap plans don’t cover long-term care, eye or dental care, hearing aids, eyeglasses, or private nursing care.
When to buy a plan
The best time to buy a plan is during the open enrollment period. This term describes a six-month period that starts the first day of the month you turn 65, during which insurance companies are obligated to sell you any of the 10 Medigap plans, irrespective of your current health status or past medical history.
If you miss this opportunity, you may still buy a Medigap plan, but the insurance company has the discretion to reject you on health grounds through a so-called medical underwriting process. This is a process where the insurance company uses your health information to decide whether or not to sell you a policy.
You can cancel your Medigap by asking your provider to terminate your plan and send you a confirmation. However, your provider cannot cancel your policy as long as you pay your premiums on time, regardless of changes to your health. This is known as guaranteed insurability.
As of January 1, 2006, Medigap policies do not offer prescription drug coverage. For this purpose, you can buy Medicare Part D (Prescription Drug Plan) available through private insurers.
Medigap plans at a glance
Medigap comprises 10 standardized plans, offering different levels of coverage. Standardized means that regardless of the insurance provider or the location, the benefits offered by the 10 plans will be the same. In accordance with federal law, all Medigap plans have to be labeled “Medicare Supplement Insurance”. Each of the 10 standardized plans is designated by a letter (A, B, C, D, F, G, K, L, M, and N).
However, although the plans offered by different providers are standardized, the costs are not. This means that different insurance companies charge different premiums for the same policy, so make sure you do some research before making a decision. In Arizona, people can choose from all 10 Medigap plans. More than half of policyholders opt for Plan F, followed (albeit not closely) by Plans C, B and D.
Despite coming at the highest cost, Medicare Supplement Plan F is the most popular choice, due to its comprehensive coverage. Plan F covers 15% in excess of the Medicare-approved costs, leaving the policyholder with zero additional costs after Medicare has paid its share.
Plan C is the second most comprehensive plan. This plan doesn’t cover Medicare Part B excess costs. Both F and C don’t cover post-discharge expenses i.e. home recovery costs (drugs, rehab, medical supplies etc.).
No matter which option you choose, supplemental health coverage will significantly lower your medical expenses not covered by the traditional Medicare policy. Just keep in mind that after you choose your plan, you will also need to carefully choose the insurance company, since providers differ in the packages, premiums and coverage they offer.
Also, remember that the least expensive policy is not necessarily the best choice. Your health can change considerably in the future, actually making your currently affordable policy the most expensive one tomorrow. In any case, both Medigap and Medicare Advantage have annual memberships, which gives you the opportunity to change your mind and your plan once a year.
If you have Medicare, you know that there are a lot of things it does not cover. Beneficiaries who want to get additional coverage to their Part A and Part B insurance plans, can do so through the various Medicare supplements in Phoenix AZ. All of these are part of what’s known as “Medigap”.
In essence, there are “gaps” in your original Medicare coverage. This is where Medigap comes in, as the different Medigap plans cover health costs that are not covered by original Medicare. Medigap “fills in the gaps”. Medigap insurance plans are only available for participants who have both Medicare Part A and Medicare Part B coverage.
Choosing a Medigap policy is crucial for every health insurance beneficiary. Since your original Medicare coverage might not include certain expenses, you may have to face numerous out-of-pocket costs. These costs include coinsurance, copayments and so on.
Medicare supplements in Phoenix AZ include twelve standardized service plans. These Medigap plans are labeled with letters, from A through L. They all offer an extensive set of covered services for the beneficiaries who already have a Medigap A or B policy. The Medigap A policy is the basic coverage policy. The Medigap B policy covers everything that Medigap A policy offers, plus additional benefits.
When choosing a Medigap policy, you need to compare the various Medicare supplements. Comparing these supplements may be challenging for most Arizona residents. So, instead of making a choice on your own, you are welcome to rely on our expertise and knowledge. We can help you compare these supplement plans and choose the one that fits your needs.
Medicare Advantage vs. Medigap plan
When speaking of Medicare Advantage plans and Medigap plans, many people confuse the two. Some people believe they are similar, but there are major differences between these two options. What you need to know is that Medigap policies are only available to people who have Medicare Part A and Medicare Part B. Beneficiaries who have a Medicare Advantage plan cannot get Medigap.
Medigap can only be used by beneficiaries of traditional Medicare. This is private insurance that you can buy in order to cover some out-of-pocket expenses which are not covered by your traditional Medicare plan. These may include some Part B costs, Part A deductibles, medical emergency costs made abroad and so on. The coverage depends on which kind of policy you have.
The costs of your Medigap policy
The costs of Medigap plans are influenced by various factors. They depend on the type of Medigap plan, your age, health, and location. Once you choose your Medigap plan, you are obliged to pay a monthly premium. Most Medigap plans can help you pay for your Medicare co-payments, as well as the co-insurance for a hospital stay.
The benefits offered by a Medigap plan depend on the type of plan you choose. Less expensive plans offer less benefits and come with higher out-of-pocket costs. Meanwhile, more expensive plans include more benefits. These extra benefits may include coverage of routine checkups, at-home recovery costs, some Medicare deductibles, and so on.
It is crucial to decide which benefits are right for you, in order to discover what type of plan best fits your needs. That way, the cost of your Medigap policy will make sense and you can lower your out-of-pocket costs related to your health.
How to choose the right Medigap plan?
Choosing a health plan can be complicated. There are many factors to consider before you decide which plan is right for you and your family. Medicare supplements in Phoenix AZ offer you a variety of benefits to choose from.
If you’re wondering how to make the right choice, here are some essential questions to consider:
- Will your health plan cover all the services and medications you need?
- Will your health plan cover your regular visits to a doctor?
Compare all the options available and remember that your monthly premium isn’t the only factor to consider. Make sure you check all of the available cost-sharing elements such as copayments, coinsurance, and deductibles, which may be included in your plan.
If you need help with understanding all of these, it is wise to contact our professionals before you make a decision. In addition, here is what you need to know when choosing from the available Medicare supplements in Phoenix AZ.
1. What types of plans can I choose from?
We offer several supplement health plans and they are all different. Aetna Medicare Supplement Plans are health plans that we recommend in addition to Medicare Part A and Part B. These plans help you pay for additional healthcare costs, such as copayments and deductibles.
These Medicare supplement plans include benefits such as three pints of blood per year, and 365-day hospitalization coverage after the Medicare coverage ends. These plans also cover twenty percent of Medicare-approved expenses or copayments for outpatient services, among other things.
We also have experience with the Blue Cross Blue Shield Arizona (BCBSAZ) plan which covers expenses that are not covered by Medicare and Medicare Advantage. Moreover, we work with Mutual of Omaha Medigap insurance plans. These health plans help you reduce co-pays, premiums and deductibles for services covered by Medicare Part A and Medicare Part B insurance plans.
Another popular option we work with are the United Healthcare Supplement Plans. These plans may help you cover some expenses that are not included in Medicare Parts A and B such as deductibles, coinsurance, and copayments. United Healthcare supplements help you cover your annual out-of-pocket expenses and they don’t require a referral in case you need to see a specialist.
2. What does each health plan cover?
Are your current doctors in the plan’s structure? If the answer is no, it is wise to consider what fees your plan should cover. Additionally, you should check which hospitals your doctors are affiliated with, and if these hospitals are part of your plan’s structure.
One of the crucial elements that you should consider is whether your plan covers your spouse and children. Are any preventive services covered, such as checkups and blood pressure screenings?
3. What additional costs will I have to cover?
When choosing a Medigap policy, aside from the premium and deductible payments, you may also have to pay certain additional costs. These additional costs include copayments, coinsurance, your share of allowed charges, out-of-pocket maximum limits, and then limits on services and non-covered services, etc.
Choosing the right Medigap is a big decision. Before you decide, make sure you are well aware of what’s covered and what’s not. The health plan you choose will determine how you and your insurance will share the costs of your health care. Our experts can help you choose the best Medigap policy for you and your family.
The US Healthcare system is constantly changing and evolving, and so is medicare. It’s never too late (or too early) to start looking at and comparing Medicare supplement plans for 2015. Anyone wishing to get a head start would be wise to begin their research now. This includes anyone looking for Medicare supplements in Phoenix AZ, as well as anyone looking to leave their Medicare Advantage plan and return to original Medicare. People shopping for a supplement policy in 2015 need some simple reminders on how to choose the best coverage.
Which Plan Should You Choose?
Prior to enrolling in a supplement plan in 2015, there are several things that you need to consider. In order to determine the most suitable plan, it would be wise to consider your health status and family medical history. There are differences in the plans that may be small and confusing, so you’ll need to do your homework and see which plan works best for you.
Even though the industry is clearly changing and constantly welcoming new companies who are just entering the market, keep in mind that there are several things that remain constant when you are choosing your Medicare supplement plans. One of those constants is that every company still has identical coverage and benefits within each plan letter.
Considering the state of today’s economy, people are hoping to save as much money as possible. What this means is that you should do thorough research on all the top supplement plans in order to make sure that you choose the most suitable and affordable coverage for yourself.
Comparing rates from multiple companies for the particular plan you’ve set your eyes on is one of the most important things. Even though they all pretty much have the same benefits, their premiums are very different. If you fail to compare rates from several companies, you risk paying a substantially larger amount for the same coverage.
Many people in the past have enrolled in a Medicare supplement plan F because it offers 100% coverage, but an increasing number of people are looking at plans like G or N, mostly because these plans save you money in almost every scenario.
While there is no perfect option that suits your exact unique needs when it comes to choosing Medicare supplement plans, there are plans that suit most people. The plans that suit the most people are F, G, and Plan N.
Medical Supplement Plan F
Most Medigap carriers sell plan F, due to its popularity in the population. However, despite the fact that it offers expansive coverage, Medicare Supplement Plan F does not cover everything. With plan F, beneficiaries are still obliged to pay their monthly Medicare Part B premium payments. Plan F is an attractive option for people that require regular medical assistance.
What follows are the most obvious costs and benefits of choosing plan F:
- Covers any and all gaps left unfilled by Plans A and B
- Full coverage of all expenses approved by medicare
- The Highest premium out of all the different plans
- Allows you to visit any hospital or doctor that accepts Medicare
A high-deductible option on Medicare Supplement Plan F is also available. If you choose this option, you have to pay a deductible of $2,180 for 2015 before the plan pays anything. This amount can be increased each year. High-deductible plans are characterized by lower premiums. However, in case you get sick, you’ll end up with higher out-of-pocket costs.
Medicare Supplement Plan G
Medicare supplement plans in 2015 do not change in benefits. Regardless, more and more people will likely be looking at Medicare supplement plan G as their primary plan. This includes people who are just turning age 65 and entering the Medicare System. Furthermore, it includes those looking to switch their Medigap plan in order to save money.
High-rate increases from the current carrier are a common reason for switching plans. You should consider switching to plan G if you are currently tied to Medicare supplement plan F to see if it fits your needs.
The primary and only difference between plan G and plan F is who pays the Medicare part B annual deductible. Even though plan F takes care of the annual part B deductible for you, in exchange you are paying higher premiums for them to do so. With Plan G, you will have lower monthly premiums, and you will pay the part B annual deductible yourself.
Furthermore, you are also obliged to cover the deductible for Part B, out of pocket, before Medicare begins paying, the same as with Plan F.
Plan G is an attractive option for people who are willing to pay the Part B deductible out of their pockets and want some coverage for hospitalization.
Medicare Supplement Plan N
Medicare supplement plan N is another plan that many people might consider in 2015. Similarly to plan G, with Plan N you pay the annual part B deductible yourself. The difference is that with Plan N, after you pay this deductible, you might end up with $20.00 co-pay per doctor visit. Moreover, in case you visit the emergency room and you are not admitted, you are obliged to pay a $50.00 co-pay with plan N.
Additionally, Plan N does not cover Medicare part B excess charges. Finally, the premiums are lower for plan N in comparison with both plan F and plan G. Here are the costs and benefits of choosing plan N:
- You are obliged to pay the deductible for Part B
- $50 co-payment if you visit an emergency room and you are not admitted
- Up to a $20 co-payment for each doctor or specialist visit
- Will not cover any excess charges from Part B
Choosing a Medicare supplement plan can oftentimes be an overwhelming task. Whether you decide to go with Plan G, N, or F, you need to be certain that the plan you choose suits your needs, and your financial abilities. By following the advice in this article you can make an informed choice that will pay dividends for your health in the long run.