What Is a Medicare Supplement Plan? (Medigap)
A Medicare Supplement plan also known as a Medigap policy, is designed to help pay for some of the costs that original Medicare does not cover. Medicare supplement plans are offered by private insurance companies and available to individuals who are eligible for Medicare. A Medicare supplement plan will help limit out-of-pocket medical expenses such as copayments, coinsurance and deductibles. Medicare supplement plans are secondary to Original Medicare while Medicare Advantage Plans are primary to Original Medicare.
For Medigap Policies sold on or after June 1, 2010, there are 11 standardized plans labeled Plan A through Plan N. Each one of these standardized Medigap policies provide the same benefits to the individual. Some of the Medigap plans can also offer additional benefits such as skilled nursing facility coinsurance and foreign travel emergency care.
Key Features of a Medicare Supplement Plan:
Doctor Choice – Individuals can select their preferred doctors and hospitals, (so long as they accept Medicare patients).
Access to Specialists – Individuals can see specialists without needing a referral.
Convenience – Virtually no claim forms to file.
Freedom – Coverage that travels with you anywhere in the U.S.
Guaranteed Renewals – Medicare supplement plans are automatically renewed, so long as individuals continue to pay their premium on time, without misstating one or more material facts upon initial enrollment.
How do I get a Medicare Supplement Plan?
In order to get a Medicare Supplement Plan you must have Medicare A and B. You must continue to pay your monthly Part B premium in addition to your monthly Supplement plan premium.
You can obtain this plan during your Medigap Open Enrollment Period, which is the six-month period starting in the first month you are 65 years or older. During this period, you cannot be denied coverage on account of a past or current health issue.
In some states such as New York, the law requires that private insurance companies who underwrite these Medigap insurance policies, must accept the enrollees application for coverage at any time throughout the year.
What Does a Supplement Plan Not Cover?
Any plan sold in 2006 or later does not include prescription drug coverage. Individuals will need to purchase a stand-alone Part D plan in addition to their supplement plan to get prescription drug coverage.
In addition, the core supplement plan will not cover things like: long term care, dental coverage, cosmetic surgery, vision care, eyeglasses, hearing aids and acupuncture.
However, some companies will offer optional supplemental benefits such as: fitness programs (also known as Silversneakers), dental and vision plans. Click here to find out which companies offer this today.
About Plan Medicare
Located in Melville, New York, Plan Medicare is a consulting agency formed to aid in understanding the many facets of Medicare. Plan Medicare helps determine eligibility, clarify options and assist in the enrollment process. Representatives are available 365 days a year to answer questions on payments, billing, policy, updates and changes and enrolling in new plans and policies. The health care landscape is constantly changing, it can be confusing and frustrating to try to figure out what kind of plan will work best. Assistance is available, however. We make Medicare easy.