What is Medicare Supplemental Insurance, Medigap?

Once you have enrolled in both parts of Original Medicare, Part A and B, you will be eligible to purchase insurance that supplements your health insurance coverage that fills insurance gaps left by Part A and Part B.  The supplemental insurance plans are known as Medigap or Medicare Supplemental Insurance.

Why do you need Medicare Supplemental Insurance Plans?

There are a couple of reasons you may need to purchase Medigap including filling in the gaps left from what Medicare Part A and Part B don’t cover and for assistance with costs that are not covered by Medicare.

How does Medicare Supplemental Insurance Plans work?

There are ten different supplemental plans that are regulated by Medicare and our federal government.  Medigap plans are labeled Plan A through Plan N alphabetically.  Only certain plans are available depending on where you live in the United States.  The plans are all standardized and offer the same benefits no matter where they are purchased, meaning Plan A in Michigan offers the same coverage as Plan A in Texas.  There are changes however in the premiums paid and the insurance companies that are permitted to sell them.

Things you should know about Medicare Supplemental Insurance:

Qualify:  If you are over 65 years of age, are enrolled in Medicare Part A and Part B, are 6 months from the first day of the month you apply for Medigap your acceptance in Medigap is guaranteed.  If you enroll in Medigap during this period, open enrollment, of time then there is no need to have a medical examination to obtain coverage.

Coverage: Original Medicare Part A, Part B, and Medigap coverage applies to only one person.  Your spouse will need to have their own policy, separate from yours.

Purchase: Medigap participants may purchase plans from any private insurance company that is licensed in your state.

Payment: The monthly premium that you pay for Medigap is paid directly to the private insurance company.  The payment is in addition to any premium that you are required to pay for Medicare part B.  The payment for Medicare part B is paid directly to Medicare.

Not Covered: There are certain things that Medigap doesn’t cover such as: long-term care, vision, dental care, hearing aids, eyeglasses, or private-duty nursing.

Return Policy: You have the right to cancel your Medigap insurance policy without penalty within 30 days of purchase.

Renewable Plans:  Medigap insurance policies are guaranteed even if you have health problems during the period in which you were covered.  This means insurance companies are not able to terminate your Medigap policy as long as you continue to make the monthly payment for the premium.

Preventative Maintenance:  Medicare pays for the entire proposed medical service if it is deemed it will help avoid future health issues.  If the doctor you are seeing accepts the amount that Medicare approves for the service, you will not have to pay a penny for the preventive services.

Prescription Drug Coverage:  Up until 2006 many Medigap plans covered prescriptions however, as of January 1, 2006 Medigap plans are no longer allowed to offer prescription drug coverage.  If you want prescription drug coverage you will need to purchase Medigap Part D, which offers this coverage at an additional premium.

The experts at eMedicare Supplemental Insurance, powered by Omega, have all the answers you are looking for when it comes to your Medicare Supplemental Insurance needs.  More information can be found at http://emedicare-supplemental-insurance.com/.

Three months before you turn 65 you should receive a packet of information that tells you exactly what you need to do during Medicare open enrollment to insure coverage.  Open enrollment only lasts for three months before the month you are set to turn 65 and for three months after.  If you choose to enroll in Medicare outside this period, you will be subject to a late enrollment penalty.

Late Enrollment Penalty

There are four different parts of Medicare which each have their own penalty for late enrollment.  These four parts are: Medicare Part A, Medicare Part B, Medicare Advantage, and Medicare Plan D.  There are penalties for each separate part of Medicare if you choose to enroll late.

Medicare Part A

Most likely you will automatically qualify for Medicare Part A when you turn 65.  If you do automatically qualify, often there is not premium.   Automatic coverage occurs for recipients who have, or who have a spouse who has, worked at least forty quarters in the United States.  This equates to ten years of employment in the U.S.

If you have not met this qualification, then when eligible you will be required to pay for premium for Medicare Part A.  If you choose not to at the time, waiting until a later date, your premium will increase monthly by 10%.  The increased premium will need to be paid for double the number of years you could have had Medicare Part A but did not choose to sign up.

Medicare Part B

Medicare Part B is like Medicare Part A in that your enrollment in benefits are automatic.  Like Medicare Part A, if you are not enrolled automatically you will need to enroll in Medicare Part B when you become eligible.  If you choose not to enroll in Part B when you are first eligible you will be charged a late enrollment penalty for the entirety of your coverage. The penalty has the potential to increase by 10% for every year you did not sign up but were eligible to do so.

Medicare Plan D

Medicare Plan D, also known as prescription drug coverage, is one plan that you will not automatically be enrolled in.  It is encouraged that you enroll in prescription drug coverage with in the enrollment period.  If you do not and you are not enrolled in any other prescription coverage the penalty you pay multiplies 1% of the “national base beneficiary premium” times the number of months that you have not had prescription drug coverage.   The premium is rounded to the nearest ten cents.

Exceptions

If you qualify for a Special Enrollment Period, you may avoid the late penalty for Medicare Part A and B.  This special enrollment period occurs when seniors are still working at 65 and delay enrolling in coverage.  The same is true as well if you are covered under your spouse’s medical insurance.

The experts at eMedicare Supplemental Insurance, powered by Omega, have all the answers you are looking for when it comes to your Medicare Supplemental Insurance needs.  More information can be found at http://emedicare-supplemental-insurance.com/.