Medicare is a federal health insurance program that was initially established for the purpose of paying for various health care expenses for those who are age 65 and over, as well as certain other individuals.
While this program can cover a lot for its enrollees, the truth is that there are also a great deal of out-of-pocket expenses that Medicare participants can be left with each year. Because of that, many Medicare enrollees need a way to help in covering this “gap”.
What is Medicare Supplement Insurance?
Medicare Supplement insurance is a type of insurance coverage that is designed to fill in the “gaps” in Medicare’s coverage, such as the deductibles and co-payments that enrollees must pay out-of-pocket. This is why Medicare Supplement is often referred to as “Medigap.”
These plans are not offered by Medicare directly, but rather by private insurance companies. Each Medicare Supplement plan is named after a letter of the alphabet, starting with Medicare Supplement Plan A. Plan A offers the most basic set of benefits – and most of the other Medigap plans such as Plan N must include this “core” set of benefits, along with the additional coverage that they provide. If you have a current plan such as Plan J and have questions, we can help you find the answers you are looking for.
Yet, while each of these plans must offer the very same set of benefits, regardless of which insurer is offering it, the premium price that is charged can differ – sometimes substantially – from one insurance carrier to another.
This means that a Medicare Supplement Plan A that is offered by one insurance carrier can be quite a bit more expensive than a Plan A that is offered by another insurance carrier. With that in mind, it is important to shop and compare before making your final decision on a Medicare Supplement insurance plan.
How Medicare and Medicare Expenses Work
Today’s Medicare program essentially consists of four components. These include:
- Medicare Part A – Hospital Coverage: Medicare Part A provides coverage for hospitalization. This includes inpatient hospital care, as well as some forms of home health care following a hospital stay. Medicare Part A also provides coverage for some hospice care services.
- Medicare Part B – Doctors’ Coverage: Part B of Medicare is medical insurance. This can help in covering services that are needed for the diagnosing and treating of medical conditions such as doctors’ visits, outpatient care, emergency department care, and equipment that is needed in a patient’s home. Also, Medicare Part B may cover some types of preventive health care such as flu and pneumonia vaccinations. Medicare Part A and B are known as Original Medicare.
- Medicare Part C – Medicare Advantage: Medicare Advantage is also referred to as Medicare Advantage. This form of Medicare coverage can take on a managed care approach to delivering Medicare-covered services, such as an HMO or PPO. Those who are eligible for Medicare Parts A and B can choose to instead receive all of their health care services via a Medicare Advantage provider organization under Medicare Part C.
- Medicare Part D – Prescription Drug Coverage: Medicare Part D provides coverage for prescription drug costs. This type of Medicare coverage is also offered through private insurance companies. Those who are eligible for Medicare Part A and Part B are also able to enroll in a Medicare Part D plan. Those who are in a Medicare Part C / Medicare Advantage Plan may have Medicare Part D prescription drug benefits already contained within their plan.
How Does Medicare Supplement Insurance Work?
Unlike HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations), Medicare Supplement plans are considered to be fee-for-service plans. This means that they offer a set of benefits that can help the insured to pay for certain types of care – regardless of the health care provider that is selected.
It is important to note, though, that Medigap benefits will only be supplemental to what Medicare covers. This means that if a Medicare enrollee has costs that are not covered in the first place by Medicare, such as non-essential plastic surgery, then a Medicare Supplement policy will not pay for the deductible or the co-insurance either.
Typically, Medicare Supplement insurance will not cover long-term care or custodial care either. Nor will they cover items such as dental care, vision care, the cost of eyeglasses or hearing aids, or private duty nursing care.
What is Covered in Medicare Supplement Plan A?
Medicare Supplement Insurance Plan A is the most basic of all the Medigap plans. This plan is considered to offer the primary, or core, benefits – and these benefits are offered in most of the other Medicare Supplement insurance plans.
Any insurance company that offers any Medicare Supplement insurance plan must offer at least Plan A as an option although they do not have to offer all of the Medigap plan options. They must also offer Medicare Supplement Plan F or Plan C if they offer any plan.
The benefits that are offered in Medicare Supplement Plan A (in 2016) include the following:
- Medicare Part A co-insurance for hospital costs, up to an additional 365 days after Medicare benefits are exhausted;
- Medicare Part B copayment or coinsurance coverage;
- First three pints of blood;
- Medicare Part A hospice care coinsurance or copayment.
*It is important to note that Medicare Supplement plans work differently in the states of Minnesota, Massachusetts, and Wisconsin.
Why Consider Medicare Supplement Plan A Versus Other Medigap Plans?
There are several reasons why a Medicare Supplement Plan A may be a good option for many people. For many, the core benefits that are offered by this particular plan are enough – especially given that the premium for a more comprehensive Medigap plan will typically rise due to the wider array of benefits.
There are also many more insurance carriers that will offer Medicare Supplement Plan A. This is because any insurer that offers Medicare Supplement coverage must offer Plan A. Because of the wider array of choices, it is likely that there will also be more competition in terms of pricing – and this may help to keep the premium costs down. With this in mind, be sure to compare several different Medicare Supplement Plan A options before making your final coverage choice.
Factors to Consider When Choosing Your Medicare Supplement Insurance Plan
Prior to enrolling in any Medicare Supplement insurance plan, it is important to consider certain factors. These criteria can help you in determining the best choice of coverage for you. These include:
- Determining your specific health care needs, as well as the services that may be the most important to you (and to your spouse, if applicable);
- Considering how much you can afford to pay in premiums, as well as the out-of-pocket expenses that you can expect to pay – depending on which plan that you choose;
- Considering the insurance company that you purchase the Medigap coverage through – regarding its financial strength, stability, and reputation for paying out its policyholder claims. Typically, insurance carriers that have ratings of at least an A or better can make for a good choice.
In some cases, it may also help to visit Medicare’s website at www.Medicare.gov to view any updates in Medicare’s coverage and / or premiums, as well as co-payments and deductibles as they pertain to Medicare Part A and Part B.
Who is Eligible for Medicare Supplement Insurance Coverage?
While you may be covered by Original Medicare or Medicare Advantage benefits, not everyone is eligible for Medicare Supplement insurance coverage. In fact, it is only those who are enrolled in Original Medicare (that is Medicare Part A and Part B) that can apply for Medicare Supplement insurance.
This is because those who get their Medicare benefits through a Medicare Advantage plan may already be getting some similar coverages through their existing plan. Therefore, Medicare Advantage enrollees are not allowed to apply for Medicare Supplement insurance.
When Can You Purchase a Medicare Supplement Insurance Policy?
The best time to purchase a Medicare Supplement insurance plan is during what is referred to as your “open enrollment” period. This is the six-month period that starts the day in which you turn age 65, and you are also enrolled in Medicare Part B. This is because, during this time period, you will qualify for a Medicare Supplement insurance policy – even if you have an adverse health condition.
If, however, you wait until your open enrollment period has ended to apply for Medigap coverage, it is possible that an insurance company could charge you a higher rate for your coverage – or even deny you for a policy altogether – if you do not meet the medical underwriting criteria.
If you do wait to apply for Medigap until after your open enrollment period has expired, you may still be able to qualify for coverage, provided that your health is good. If you do have a pre-existing health condition, the coverage for a pre-existing condition can only be excluded if the condition was treated or diagnosed within six months before the start of the coverage under the Medicare Supplement insurance policy. This is what is referred to as the look-back period.
Once the six months have expired, the Medigap policy will cover the condition that had been excluded. And, in this case, your Original Medicare coverage (Part A and / or B) would still cover services for this condition – but you would just be responsible for the copayment, coinsurance, and / or deductible that is associated with such services.
If, however, you health is such that you do not qualify for Medicare Supplement coverage at all, you could end up without a plan. In this case, it would have been best to have applied during your open enrollment period.
How and Where to Find the Best Premium Quotes on Medigap Plan A
When looking for the best premium quotes on Medigap Plan A, it is important to shop and compare. This is because, while all insurance companies that offer this type of coverage must offer plans with identical benefits, the premiums that are charged can differ – sometimes a great deal – from one insurance carrier to another.
Therefore, when searching for your Medicare Supplement Plan A, it is often best to work with either an agency or a company that has access to more than just one Medicare Supplement carrier. That way, you will be able to compare several different policies in an unbiased manner and from there, you can determine which will be the best for you.
If you are in the market for Medigap insurance, then we can help. We work with many of the top Medicare Supplement insurance companies in the marketplace today, and we can assist you in obtaining all of the Plan A quotes that you are seeking. We can do so for you quickly and easily – all from your home computer – and without having to meet in person with an insurance agent. When you are ready to move forward, just simply <Click Here Now>.
Should you find that you still have any questions regarding Medicare Supplement Plan A – or even if, you just have a general question about Medigap – our experts are happy to assist you. We can be reached directly via phone, toll-free, by dialing <XXX-XXX-XXXX>.
We understand that the purchase of a Medicare Supplement plan can seem a bit overwhelming. There is a lot of information to go over – and there are many different policies and carriers to consider.
But if you are considering this type of coverage – and especially if you are within your Medicare Supplement Open Enrollment period – then there is not much time to waste, and it is important that you get your Plan application submitted so that the insurer cannot charge more – or possibly even deny your application for coverage in the future. So, if you need help in understanding Medigap Plan A, please feel free to contact us today – we’re here to help.