Author: United Integrity

WHAT IS MEDICARE SUPPLEMENT INSURANCE?

Medicare Supplement insurance, also known as Medigap, offers plans meant to cover the costs Medicare does not.

Consequently, it covers a wide array of payments:

• Deductibles
• Copayments
• Coinsurance
• International care

Medicare Supplement plans are offered by private insurance companies, and the benefits of the standardized plans are always the same. The only differences that occur are in the required premiums, as rates differ from insurance company to insurance company. Some states may have additional regulations concerning coverage.

Prices vary by location, age, sex and possibly current health conditions except for those turning 65, going on Medicare Part B for the first time, losing credible coverage, or qualifying for Medicare disability.

HOW DOES IT WORK?

Medicare pays for most medically necessary expenses. The remaining 20% is sent to Medicare who then forwards to your Medicare Supplement insurance company.

Like other insurance plans, Medicare Supplement plan policyholders must pay a monthly premium to receive services. This premium is paid in addition to premiums for Medicare Part B. (Most individuals do not pay for Medicare Part A, as it has previously been paid in payroll taxes during their working career.)

WHO SHOULD CONSIDER A MEDICARE SUPPLEMENT PLAN

To be eligible for a Medicare Supplement plan, individuals must meet the following criteria:

• An individual must be at least 65 years old, unless on Medicare Disability or has ESRD
• The applicant must have Medicare Part A and Part B.

ADVANTAGES

Medicare Supplement plans offer several benefits.

LESS PAPERWORK

Your Medicare Supplement plan sets up an automatic crossover with Medicare, so you do not have to file any claim paperwork. Your doctor simply sends the entire bill to Medicare, and Medicare forwards the remaining portion to your Medicare Supplement insurance company.

FREEDOM TO CHOOSE HOSPITALS AND DOCTORS

Insured individuals can go to any facility that accepts Original Medicare. Instead of being forced to pick from a list an insurance company provides, you’ll have more flexibility to choose the hospitals and doctors of your choice.

TRAVEL

If you travel between states or internationally, Original Medicare may not cover you in the event you would need care away from home. However, Medicare Supplement plans do provide additional coverage. As a result, vacations or business trips can be enjoyed fully.

COST

Medicare Supplement plans provide peace of mind knowing that most of your expenses will be paid by Medicare and the insurance company.

GUARANTEED RENEWABLE

Your Medicare Supplement plan cannot be canceled for any reason unless you do not pay premiums on time. Regardless of health or newly diagnosed conditions, your policy is guaranteed renewable.

PEACE OF MIND

If you’re retired or have low income, you have the freedom to choose your own hospitals and doctors without referrals and with limited out of pocket expenses.

Call today to speak with a licensed representative to find a plan to fit your financial goals and needs.

WHAT DOES A MEDICARE SUPPLEMENT PLAN COVER?

The out-of-pocket costs of a Medicare Supplement plan are typically lower in the long run because they offer more flexibility, more stability, and more coverage than most other plans.

A Medicare Supplement plan has no networks – that means that you can continue to see your own doctors and use your own hospitals of choice. A medical provider can not turn you away based on your Medicare Supplement insurer as long as they accept Original Medicare. Medicare Supplement plans offer low to no copays and low to no deductibles, thus you don’t have to come up with a large sum of money if you were to become sick or injured. Medicare Supplement plans give you the freedom to choose between 30 different drug plans (depending on your state), which makes it more likely that you can get the particular prescriptions you need at a price you can afford. Call today to find out which drug plan will save you the most money based on your current medications.

You have the ability to sign up for a Medicare Supplement plan 6 months before you turn 65 and 6 months after. You cannot be denied due to health or age. To discuss your options, call today to find the ideal plan for you.

WHAT DOES A MEDICARE ADVANTAGE PLAN COVER?

Many people don’t realize that a Medicare Advantage plan is not Original Medicare–by choosing a Medicare Advantage plan, you are opting out of Original Medicare and purchasing a private plan. The main draw for a Medicare Advantage plan is that it may save you some money in the short term because they typically offer lower monthly premiums than a Medicare Supplement plan, but they tend to cost more in the long run due to many more out-of-pocket costs. Our licensed representatives can help you determine what those costs might be and which plans are most appropriate for you.

A Medicare Advantage plan has networks, which means you may only see doctors that are covered under their plan, and you may have to find new doctors and hospitals when you sign up. Medicare Advantage plans also typically carry copays and deductibles that must be paid for out-of-pocket. Medicare Advantage plans often offer drug coverage but may not cover the particular medications that you take. The costs for a Medicare Advantage plan can go up as high as $6,700 maximum out-of-pocket but could be higher if you get treatment or services outside of your network. It’s important to call to determine what type of drug coverage will suit you best.

It’s important to know if you choose a Medicare Advantage plan and become sick, you may not easily switch to a Medicare Supplement or Medigap plan. At this point, you will have forfeited your Initial Election Period and must now go through the medical underwriting process. During medical underwriting, your age, health history and pre-existing conditions will be taken into consideration for your eligibility. Your illness or injury will now be considered a pre-existing condition, and your new carrier may deny coverage.

Under a Medicare Advantage plan, your copays, in-network doctors, and drug coverage can change from year to year, so it’s important to review the terms of your plan often. Medicare Advantage plans are typically catered to those with lower income, even though they can have higher costs in the long run.