Medicare is a federal health insurance program that allows certain groups of people to get healthcare coverage without purchasing individual insurance plans or enrolling in a group health plan, such as an employer's health plan.
Depending on the type and amount of coverage you have through the Medicare program, and your specific needs, you may need to add on one or more Medicare supplement plans to manage the “gaps” in your coverage.
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Medicare Supplemental Insurance Plans
- Medicare supplement plans, also known as “Medigap” plans, cover the costs that are not covered by original Medicare.
- There are 10 Medicare supplement plans: A, B, C, D, F, G, K, L, M and N.
- Plans E, H, I and J, which covered various Medicare gaps, are legacy plans that are still in force for some people, but were discontinued in 2010.
- If you join a Medicare Advantage Plan, you cannot buy Medigap supplemental plans.
What Is a Medicare Supplement Plan?
When you qualify for Medicare, you will be asked about which, if any, supplemental insurance plans you wish to purchase. This leads many to ask, “What is a Medicare Supplement Plan?”
Medicare supplemental insurance, or Medigap policies, are designed to cover what original Medicare does not. These plans close the "gaps" in coverage and help seniors and those with disabilities to manage the costs of their care.
The 10 Medicare supplemental insurance policies, known as Medigap plans, each cover a range of healthcare costs, in differing amounts.
Benefits included in all of these plans are:
- 100% coverage for Part A coinsurance and hospitalization costs, up to 365 days beyond what Medicare covers
- 75% to 100% coverage for Part B coinsurance and copayments
- 50% to 100% coverage for the first three pints of blood during a hospital stay
- 75% to 100% coverage of Part A hospice care coinsurance or co-payment
Additionally, some plans include the following benefits:
- 50% to 100% coverage for skilled nursing facility coinsurance
- 50% to 100% of Medicare Part A deductible
- 100% of Medicare Part B excess charges
The percentage of coverage for each of the covered costs varies depending upon which supplemental Medigap plan you choose, so it is important that you compare a variety of Medicare supplement insurance quotes before making a selection.
How to Qualify for Medicare Supplement Plans
If you live in the US and are a citizen, you will automatically qualify for Medicare when you turn 65. At that time, you will have a six-month open enrollment window during which you can enroll in any Medigap plan of your choosing, without having to go through an application or underwriting process.
To supplement your Medicare plan with additional coverage outside of your open enrollment period (for example, if you qualify for Medicare due to a disability), you will need to have Medicare Part A and Part B in place, and you will need to go through an application process to qualify.
Which Medicare Supplemental Insurance Plan Is Right for You?
Each of the different supplemental Medicare health insurance plans has its own costs and benefits. The benefits are regulated by the Medicare program and will be the same anywhere you go, but the costs will vary from one insurance company to another.
How do you go about deciding whether one of Medigap plans makes sense for you? How can you compare Medicare supplement insurance quotes?
With all of the choices available to you, you may need the guidance of a qualified agent to advise you about which Medicare supplement plans are right for your particular situation.
Independent insurance agents can help you navigate through your various options and can make sure you go with a company that is both highly rated and competitively priced. Contact an agent near you to learn more and to start comparing Medicare supplement insurance quotes.