The Basics of Medicare Supplement Plans

A Medicare Supplement Insurance Plan, also known as Medigap, is different from a Medicare Advantage plan. Instead of offering coverage like HMO, PPO, and MSAs, it helps you pay for the costs that Original Medicare cannot cover.

Medigap plans have different requirements than Medicare Advantage plans. These plans also have varying options that may or may not cover the costs of the care you need. If you have any questions about Medigap policies, call one of our professional health agents today at 888-218-4543.

Medicare Supplement Insurance Requirements and Application

Medicare Supplement Insurance helps cover what Original Medicare doesn't

Medicare supplement insurance plans are sold by insurance companies licensed to sell them. Before you buy a Medigap plan, you must have both Medicare Part A and Part B. Medigap plans only cover one person, so spouses must purchase separate plans. Once purchased, you pay the insurance company a monthly premium as well as the Part B monthly premium.

Insurance companies are not required to sell Medigap policies to people under 65, although some companies may offer them. The availability of Medigap for people under 65 may also depend on your state. The enrollment period opens the month that you are 65, so if you turn 65 in September, the period would open in October. The period is open for 6 months after you turn 65. If you miss the enrollment period, you may lose important benefits or be charged higher premiums.

What Does Medigap Cover?

Medicare Supplement Insurance plans do not pay for coverage like other health insurance plans. Instead, these plans supplement Original Medicare coverage so that copayments, coinsurance, and deductibles are covered.

Medigap coverage is offered in lettered plans, which may be confused with Medicare Part A and Part B. However, Medigap plans are different. When you’re looking to buy a Medigap plan, know that insurance companies may not offer all of the different plans. However, companies are required to offer Plan A at the very least.

Standardized Medigap plans must cover basic benefits such as: 

  • Copayments or coinsurance costs for Medicare Part A for up to a year after Medicare benefits run out. 
  • Medicare Part A hospice care copayments or coinsurance costs
  • Medicare Part B copayments or coinsurance costs

Additionally, if you need blood during a medical procedure, the first three pints should also be covered.

The best time to apply for Medigap is the month after you turn 65
Medicare Supplement Insurance (Medigap) has some limits, but standardized Medigap plans must cover a few basic benefits.

What Does Medigap Not Cover?

In the past, there were some Medigap policies that covered prescription drugs. However, plans could not cover prescription drugs after January 1, 2006. Also, Medigap coverage does not include vision, dental, or long-term care. Hearing aids or private-duty nursing are not usually covered as well. If you need prescription drug coverage, you will need a separate Medicare Part D plan.

Note that Medicare Supplement plan options are different in Massachusetts, Minnesota, and Wisconsin than in the rest of the country.

If you’re thinking about dropping a current Medicare Supplement plan, make sure you time it right. If too much time passes, or there is a lapse in care, late enrollment fees may apply.

Let Us Help You Find The Right Plan

At Buffalo Health Advisors, we believe in providing solutions to individuals as they transition to Medicare plans. Not only can Medicare Advantage work to protect your health, choosing the right plan can go a long way toward protecting your wealth. This plan is critical if you are going to be living on a fixed income during your retirement years.

It will cost you nothing to learn more about the options available to you. Call or stop by our Nashville, TN office to discuss your Medicare plan options with one of our experienced agents.

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Medicare and insurance don’t need to be complicated. Talk to a Buffalo Health Insurance Benefits Advisor and let’s figure this out together. When you think Medicare, think Buffalo.

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