Medicare Supplement Insurance
Today’s senior citizens are faced with many options when it comes to health care after age 65. Most seniors will need supplemental insurance to pay on expenses not covered by Medicare. Supplement insurance is available from many different sources and we have listed some of the options below. Neither Medicare nor Medicare supplement policies cover most long-term care expenses.
Original Medicare Plan
The Original Medicare plan is run by the federal government. It is a traditional pay-per-visit health plan that lets you go to any doctor, hospital, or other health care provider who accepts Medicare. You pay the deductible. Medicare pays its share of the Medicare-approved amount, and you pay your share. The Original Medicare Plan has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).
- Part A (Medicare)
Hospital insurance that covers hospice care, home health care, skilled nursing facilities, and inpatient hospital stays. - Part B (Medicare)
Medical insurance that helps pay for doctors’ services, outpatient hospital care, durable medical equipment, and some medical services that are not covered by Part A. - Cost
You pay the $93.50 Part B monthly premium in 2007, the Part A and Part B deductibles, and the coinsurance.
Supplemental Insurance
Medicare supplement insurance policies being sold today must be approved by the Department of Insurance in your state and there are no "bad" policies. However, not all companies are the same and there are currently hundreds of companies marketing policies. This makes the task of shopping for insurance even more cumbersome.
To avoid the underwriting process for Medicare, utilize the open enrollment periods that occur at the same time each year. The open enrollment period for Medicare is always between November 15 and May 15th of the following year. Your coverage starts the day after your enrollment during this open enrollment period. If you miss this opportunity, you still have the option of enrolling after May 15th of that year (which may involve a penalty), or waiting until the next open enrollment period starts that November 15th again.
Contact us for a quote on Medicare supplemental insurance.
Eligibility for Medicare Supplemental Insurance
You are automatically accepted for coverage and no health questions are required to be answered if:
- You are applying three calendar months before you enroll in Medicare Part B.
- You are applying in the calendar month in which you enroll in Medicare Part B.
- You are applying within six calendar months immediately following the month you enroll in Medicare Part B.
- You are applying within six calendar months beginning with the month of your 65th birthday if you’re currently enrolled in Medicare Part B.
- You are eligible for guaranteed issue. Guaranteed issue applies when you lose or terminate health coverage under certain circumstances, providing you apply within 63 days of the termination date of your prior health plan. You must provide a copy of the termination notice you received from your prior plan along with your application. This notice must verify the circumstances of your prior plan’s termination.
There are many types of private health insurance/coverage that you can buy to supplement, or fill the gaps, in your Medicare coverage. This supplemental insurance will pay for some or all of your health care costs that are not covered by Medicare. These types of private health insurance/coverage include:
- Employee or Retiree Coverage
(from your employer or union) - Medigap Insurance
(from a private company or group)
People often refer to all of these types of private health insurance/coverage as "supplemental insurance." However, "Medicare Supplemental" or "Medigap" insurance is a specific type of private insurance that is subject to Federal and State laws.
Medigap
Medicare supplemental insurance policies that are sold by private insurance companies to Medicare beneficiaries to fill the "gaps" in Original Medicare Plan coverage. There are ten standardized policies, labeled Plan A through Plan J. Your State decides which of the 10 policies can be sold in your State. Medigap policies only work with the Original Medicare Plan.
Part D Prescription Drug Coverage
Who can get Medicare prescription drug coverage?
Everyone with Medicare is eligible for this coverage, regardless of income and resources, health status, or current prescription expenses.
When can I get Medicare prescription drug coverage?
To avoid the underwriting process for Medicare, utilize the open enrollment periods that occur at the same time each year. The open enrollment period for Medicare is always between November 15 and May 15th of the following year. Your coverage starts the day after your enrollment during this open enrollment period. If you miss this opportunity, you still have the option of enrolling after May 15th of that year (which may involve a penalty), or waiting until the next open enrollment period starts that November 15th again.
How does Medicare prescription drug coverage work?
Your decision about Medicare prescription drug coverage depends on the kind of health care coverage you have now. There are two ways to get Medicare prescription drug coverage. You can join a Medicare prescription drug plan or you can join a Medicare Advantage Plan or other Medicare Health Plans that offer drug coverage.
Whatever plan you choose, Medicare drug coverage will help you by covering brand-name and generic drugs at pharmacies that are convenient for you.
Like other insurance, if you join, you will pay a monthly premium, which varies by plan, and a yearly deductible. You will also pay a part of the cost of your prescriptions, including a copayment or coinsurance. Costs will vary depending on which drug plan you choose. Some plans may offer more coverage and additional drugs for a higher monthly premium. You should note: Depending on the cost of your prescriptions, there is a maximum that will then place you within a window where you are responsible for 100% of your prescription costs. Once you reach the maximum stop-gap, the co-pays for prescriptions drugs are reduced significantly. If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible. Contact us for more information about Medicare and how it applies to your health coverage plan.
Why should I get Medicare prescription drug coverage?
Medicare prescription drug coverage provides greater peace of mind by protecting you from unexpected drug expenses. Even if you don’t use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy. For most people, joining now means protecting yourself from unexpected prescription drug bills in the future.