Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage. provides decent health insurance coverage for your major medical, but it doesn’t cover everything. However, you have the option to fill most of the coverage gaps by purchasing a Medicare supplement plan, also known as Medigap.
While it might initially seem complicated, if you follow our five-step plan, you’ll be well on your way to secure the coverage you need. Here are the essential steps to finding the right supplemental Medicare plan for your situation.
Assess Your Situation: Is a Medicare Supplement Plan the Best Option?
Medigap plans help fill the coverage gaps in Original Medicare. All plans help with your hospital coverage, and most plans help with your medical copaysA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service., as well. However, before looking at what each plan offers, we find it beneficial to first assess both your personal health and your financial needs. Here’s why.
We each have different health and financial situations. So, a plan that’s best for you isn’t necessarily going to work for your best friend. It’s easy to say that everyone should have a Medicare Plan FMedicare Supplement Plan F is the most comprehensive Medicare supplement plan available. This plan covers all Original Medicare deductibles, coinsurance, and copayments, leaving you with no out-of-pocket costs on all Medicare-approved services. or Plan G because they offer the most coverage, but not everyone can afford one of these plans in retirement. Likewise, while a Medicare Plan NMedicare Supplemental Plan N is one of the ten standardized Medigap plans. Although it is one of the newest plans available, Medicare Plan N is quickly becoming a favorite with Baby Boomers aging into their... can save you money, it could end up costing some people a lot more because it does not cover excess chargesA Medicare Part B excess charge is the difference between a health care provider’s actual charge and Medicare’s approved amount for payment..
Assessing your situation means taking an honest look at your situation. Are you super healthy and active, or do you have a chronic condition or two that may worsen as you age? Answering this question will help you decide if you need the most coverage possible or if you can take a little risk.
Also, if several hundred dollars per month out of your retirement income when you’re in your 70s and beyond isn’t an issue for you, then, by all means, get the best coverage available. However, if your budget is a little tighter, it might be necessary to think creatively.
Explore Your Medicare Supplement Plan Options
One of the best things Medicare did from the very beginning is to lay out a simple, standardized system for gap coverage. Currently, there are 10 standardized plans on the market, identified by the letters A through N. The benefit, and what makes Medicare supplement so easy, is that Plan A from Aetna is exactly the same as Plan A from Humana, or any other carrier.
The lettered plan system makes shopping super simple. As a consumer, all you have to do is figure out the coverage you need, then go price shopping. This simplicity is nowhere to be found in Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B)., which truly take an expert to figure out.
By using the following Medicare Supplement Plan Comparison Chart, you can visually see what’s covered by each plan. It couldn’t be any easier.
If you live in Massachusetts, Minnesota or Wisconsin, your plan options are slightly different. Each of these three states follows its own rules for Medigap coverage.
Please note that Medigap Plan F and Plan C are no longer be available to new enrollees. As of 1 January 2020 Congress no longer allows Medicare supplement insuranceMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. to cover the Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share., which Plans F and C cover. Beneficiaries already enrolled in one of these plans are grandfathered in, so long as they keep their current policy.
Understand How Medicare Supplement Plans are Rated for Price Increased
When you have matched your needs with a plan you can start shopping. You’ll see the monthly premiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. first, but don’t immediately latch on to a policy with the lowest rate. There’s another factor to consider.
Ask your agent to show you rate increases on all of the policies presented. When you do, you’ll clearly see that companies don’t all raise their rates at the same time or at the same pace. This is important. Here’s why.
Medicare supplement insurance carriers use three common methods to determine rates and rate increases. They include:
- Attained-age rated
- Community-rated
- Issue-age rated
Most experts agree that you should ask your agent to explain the pricing system of each policy they present. You have a right to know if your rates will increase as you age.
Also, don’t be shy about picking up the phone to get help. By law, insurance agents and brokers can’t increase rates, so you’ll pay the exact same premium going through an agent or broker as you will going direct. However, if you go direct, you’ll only see rates from the insurance company you call.
If you don’t already have an agent, call 1-855-728-0510 (TTY 711) and speak with a licensed HealthCompare insurance agent. There’s no obligation, and they offer more plan options than any other national agency.
Don’t Delay… You Have Time-Sensitive Guaranteed Issue Rights
When you enroll in Medicare or turn age 65, you have a one-time personal enrollment period that comes with guaranteed issue rightsGuaranteed-issue is a right granted to Medicare beneficiaries and applies to Medicare Supplement insurance (aka, Medigap plans). All states and the federal government enforce this essential right, which protects Medicare beneficiaries from medical underwriting.. And once the clock runs out, so does your opportunity to get Medigap coverage without going through medical underwriting.
You see, unlike Obamacare, which guarantees everyone coverage, supplemental Medicare insurance is not really health insurance. And it does not have to follow the same rules. However, the federal government does insist that all new Medicare beneficiaries be allowed the coverage of their choice without question. But, you only have a six-month window of time with these guaranteed issue rights.
Once the clock expires on your personal enrollment period, insurance companies can and will ask you to answer health questions and go through their medical underwriting process. And, they can and will deny you coverage, or charge you more, or force you into a policy with lesser coverage. However, when you exercise your guaranteed issue rights, they can’t ask you questions about your health and they can’t deny you coverage or charge you more because of your health. Period.
17 Ways to Boost Your Medicare & Social Security Benefits in Retirement
On this page, we’ve explored four easy steps you can take to get into the best Medicare supplement plan for your personal needs. Now it’s time to check out all of the steps you can take to get the most benefits possible in retirement. Check out the 17 ways you can maximize Medicare and Social Security in retirement.