Medicare Supplement
Insurance or Medigap
Medicare Supplement Insurance or Medigap
First a quick refresher
Medicare Part A- Inpatient Hospital Coverage typically no monthly premium because you paid payroll taxes.
Medicare Part B- Outpatient Medical
Coverage, it does have a monthly premium that you pay along with a Medicare Supplement Premium.
Medicare Part D- Prescription Drug Coverage, it also has a monthly premium.
Where does Medicare Supplement Insurance (Medigap) fit in
Original Medicare, Part A has a big “benefit period” deductible, at least $1,400.
Part B typically only covers 80% of costs with no cap, leaving you with 20% to pay.
In a bad year you can hit the Part A benefit period deductible a few times.
The Part B 20% can unfortunately turn into a big number if it’s a round of chemotherapy or heart surgery.
Medicare Supplement Insurance, Medigap, pays most of what A and B does not pay!
Depending on the plan you pick (and we’d recommend a plan that covers 100% of the A and B cost) Med Sup will cover the Part A deductibles and the Part B 20%.
In Maryland there are 10 Standardized plans which are identified by a letter.
Some popular plans are Plan G, Plan C, Plan F, and the only difference in a Medicare Supplement Plan G sold by XZY Insurance and a Plan G sold by ABC Insurance is the monthly premium.
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So, let’s take a quick look at a plan, Supplement Plan G, as an example, what do you get for your monthly premium dollars.
Plan G will cover 100% of
Medicare Part A Coinsurance and Hospital Costs, Medicare Part B Coinsurance and Copayments, Blood (first 2 pints), Part A Hospice Care coinsurance and copay, Skilled Nursing facility coinsurance, Part A and B deductible, Medicare excess Charges.
When to Enroll
First you have to be enrolled in Medicare Parts A and B.
Once you are enrolled in Part B you can enroll in a Medicare Supplement Plan.
Once you are enrolled in Part B you can enroll in a Medicare Supplement Plan.
You will then have 6 months to enroll before you would no longer be Guaranteed-Issue (GI).
GI Means if you miss the 6 month window, say you wait until your 66 or 67, you would be subject to underwriting and a lot of questions about your health which could mean you are denied.
If you want to switch your Medicare Supplement plan, let’s say you buy a Plan K, that only covers 50% of your Original Medicare Plan B coinsurance, and then you decide you want to switch to Plan G, you would not be GI and would be subject to underwriting.
Reasons why most people pick a Medicare Supplement Plan
I’m kind of burying the lead here, you can go to any doctor, anywhere, that accepts Medicare, no referral necessary.
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So your plan travels with you, you have freedom.
Let’s say you move or spend your summers in Maryland and Winters in Florida, unlike a Medicare Advantage plan with a network you are tied to, a Med Sup (Medigap) plan allows you to go to Florida, see any doctor, get that knee replacement and not have
anything more than a small deductible (203.00 in 2021) to worry about.
There are no copayments, no coinsurance, you will not be hit with a $350 dollar a day hospitalization co-pay, it’s great coverage!!
The downside of a Medicare Supplement Plan
Since a Medicare Supplement plan only covers what Original Medicare covers, supplemental benefits like dental, vision, hearing are NOT covered.
These benefits are covered in a Medicare Advantage plan, to a degree.
You can purchase additional insurance for these benefits at a reasonable rate, but it is not included under one card like a MA plan.
Miscellaneous Stuff
There are household discounts available Your Medicare Supplement plan will get your Medicare Part B claim directly from Medicare and then pay your doctor directly.
There are a few payment options, deducted from Social Security check, electronic funds
transfer from bank, bill mailed to home.
The Maryland Insurance Administration (MIA) regulates Med Sup insurance companies.
Once a year a Med Sup insurance company can file for a rate increase and the MIA is
who decides how much to allow.
That also means we can see on the MIA website the
rates for every carrier, MIA Medicare Rate Guide, very transparent.
So, based on the fact it’s free to work with us please give us a call
Jim Mauro (301) 767-7239
or
email jmauro@soinsbkgrp.com