If you’re 65 years old and enrolled in Medicare Parts A and B, you can apply for Medicare Supplement insurance. Even though Medicare beneficiaries can enroll in a Medicare Supplement plan at any time of the year, the best time to do so is during an open enrollment period that occurs within 6 months of your 65th birthday. That is when you can apply for a Medicare Supplement policy without having to answer health questions and can lock in the best rate.
Medicare Supplement insurance, a.k.a., Medigap, is supplemental health insurance meant to fill gaps between what’s paid by original Medicare and the overall cost of health care treatments. It also helps with charges like copays, deductibles, and coinsurance.
Deciding on Medicare Supplement Insurance:
Determining whether you need supplemental insurance with Medicare is a personal decision, and we at Lehigh Partners Senior Benefits are here to support you in making the right choice for yourself and your family. Medicare Part A and Part B, also known as Original Medicare, come with deductibles and copayments. If you prefer not to be concerned about these out-of-pocket costs, it might be worth considering the addition of a Medicare Supplement policy to cover such expenses.
Tailored Plans to Meet Your Requirements
In addition to lowering out-of-pocket costs, A Medicare Supplement insurance plan offers benefits that can be flexible and work for your specific situation.
- Plan choices: Choose from competitive solutions that best fit your needs and budget.
- Guaranteed renewable: Your coverage will never be canceled, even if your health changes
- No pre-existing condition waiting period: Prior medical conditions are covered as soon as your policy is effective.
- Freedom to choose: You can select any doctor or hospital that accepts Medicare, so you don’t need to worry about finding network providers or getting referrals to see specialists.
Comparing Medicare Advantage and Medicare Supplement:
Medicare Advantage, often referred to as "Part C," is offered by private insurance companies. If you enroll in a Medicare Advantage plan, you remain a part of the overall "Medicare" system. However, rather than receiving your Medicare benefits from the federal government program, you receive them from the Medicare Advantage insurance provider. These plans typically have more limited provider networks - you must stay within these networks to avoid additional out-of-pocket expenses.
Medicare Supplement insurance, on the other hand, is designed to cover the remaining costs, such as deductibles and copays, that arise from Original Medicare Part A and Part B. The provider network generally includes Medicare-approved providers and offers foreign travel emergency health care coverage when traveling outside the United States.
It is not possible to use both a Medicare Supplement policy and a Medicare Advantage plan simultaneously.
Medicare Supplement Plans:
Medicare Supplement plans are available in various options: A, B, C, D, F, G, K, L, M, and N. Each plan offers different levels of costs and coverage, depending on the deductible level and specific plan. The primary differentiating factor between these plans is the cost. It is important to note that all Medicare Supplement plans offered by private insurance companies must adhere to federal and state laws specifically designed to protect you.
To choose a Medicare Supplement insurance plan, the U.S. Centers for Medicare and Medicaid Services suggests following these four steps:
- Determine the benefits you require and find out which of the Medicare Supplement plans A-N align with your needs.
- Explore the insurance companies that offer Medicare Supplement policies within your state.
- Research the insurance companies offering the policies you are interested in and compare their costs.
- Purchase the Medicare Supplement policy that meets your requirements.
Choosing a Medicare Supplement Plan:
You have the flexibility to choose a Medicare Supplement plan at any time, but the optimal window to make your selection is during the 6-month open enrollment period. This enrollment period starts on the first day of the month you turn 65 or when you enroll in Medicare Part B. During this period, which spans your birthday month and the following 6 months, you can enroll in any of the 12 standard plans without the need for medical underwriting, and you will be charged the regular rate. Moreover, you cannot be subjected to higher premiums or denied coverage based on pre-existing health conditions.
If you decide to choose or change your plan outside of this timeframe, you still have the option to do so. However, keep in mind that it may require medical underwriting, result in higher premiums, and acceptance is not guaranteed.
