What You Need to Know about MediGap, a.k.a. Medicare Supplements

A Medicare Supplemental Plan – typically referred to as a Medigap plan – is a type of health insurance plan offered by Private Insurance Companies to help cover the “gaps” of Original Medicare. Normally, Medicare Part A and Part B, which together make up what is called Original Medicare, pass on the costs of deductibles, coinsurance, and co-payments to you, the consumer. Investing in a Medicare Supplement helps cover these expenses. With a supplement, Medicare pays for its share of your medical expenses first. Then the supplement policy pays its share; depending on the type of supplement, this could be the remainder of your bill.

Medicare Supplemental Plans: Open Enrollment

You can purchase Medicare Supplements year-round though it is advised to purchase a supplement when first enrolled in Part B. During this six-month window of time, a Medicare Supplement company cannot ask you any medical questions. In other words, they cannot turn you down for any health conditions. Not only can they not refuse you a policy, but they can also not charge you any additional amount because of your pre-existing health conditions.

After the six months pass, then insurance companies are free to accept or decline your application based on health. Therefore, if you’re interested in purchasing a supplement, you should do so during your initial enrollment period.

Please note: The Annual Election Period (AEP) that occurs from October 15 to December 7 is not connected to Medicare Supplements. Many people mistakenly think that this is the time to change supplements with no health questions. AEP exclusively pertains to Medicare Part D and Medicare Advantage.

Medicare Supplemental Plans: Guaranteed Issue

Because people often have coverage through an employer, they wait to enroll in a supplement. Then when they retire or lose their group health coverage, they have 63 days following the loss of coverage to purchase six of the ten supplement plan types. This 63-day window is a guaranteed issue enrollment period; it’s essentially a special enrollment period. Much like the initial open enrollment period people have when enroll in Part B, the insurance company won’t deny coverage because of medical history.

There are other instances in which a guaranteed issue enrollment window occurs. For instance, losing Medicare Advantage coverage when moving out of state. If this is the case, then you need to keep notices from your previous carrier for proof of your creditable coverage for guaranteed issues. Doing so ensures you don’t incur a penalty for a Part D late enrollment.

Medicare Supplemental Plans: Underwriting

Even if your initial open enrollment and guaranteed issue has passed, you can still get a Medicare Supplement. The one exception is that you will now be required to answer health-related questions on your application. Based on your answers, the insurance company can accept or decline your application. Similarly, changing Medicare Supplement carriers will usually require underwriting. And once again, AEP is not a time that you can change your supplement without underwriting.

Medicare Supplemental Plans: 10 Types

There are 10 different Medicare Supplemental Plans to choose from and are identifiable by letters: Plan A, B, C, D, F, G, K, L, M, and N. Every plan is required to follow the guidelines set by Medicare when it standardized the plans in 1990. Furthermore, each letter category offers its own set of benefits. In other words, an insurance company cannot offer a benefit for a Plan G that is not available with another company. The benefits remain the same from company to company. The only difference between insurance companies for certain plan types is the monthly premium. Since the monthly cost is the only difference, companies incentivize their supplement plans with wellness programs like Silver Sneakers or telemedicine.

Contact a Licensed Agent Today!

Ultimately, you need to consider the benefits you need not only today but also in the future. There are many aspects of your health, life, and personal preferences to take into consideration when choosing a supplement. To make the decision process easier, contact a licensed agent to help you explain your options. Not only can an agent help you understand the 10 different supplement plans, but they will also be able to provide information on the insurance company. They can ascertain if the premiums for each of the companies are competitive. Additionally, they know the stability of a company and their history of premium increases. So don’t delay! Call an agent today to discuss your Medicare options!

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