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Is Your Policy Covering All of Your Needs?
When you’re enrolling in Medicare, you might find that these federal policies don’t quite meet all of your needs. Rather than go without the coverage and help that you deserve, you can work with an independent Medicare insurance agent like Allen and Associates to find the ideal supplement insurance plans.
Instead of covering your health benefits, these supplement plans cover the costs associated with Original Medicare. Unlike Medicare, supplement plans are purchased through a private insurance provider. This can make it challenging to find the right plans without proper guidance. Reach out to our insurance agents today to see how we can help!
Allen and Associates is Your Top Rated National® Insurance Company
- You’ll find Allen and Associates insurance agents in more than 15 states, serving the entire United States.
- We specialize in Medicare and Medigap policies, helping you find the right level of coverage for your current and future needs.
- Our insurance agency is invested in your success and will take the time you need to explore and explain each policy and how it benefits you.
- Thanks to our experience and network of providers, we can connect you with the federal and private insurance plans that make the most sense for you.
- Allen and Associates have been helping individuals like you for more than two decades. We’re ready to leverage our experience to help you get the most out of your supplemental plans.
While Medicare covers most of your needs, it might meet all of them. In moments like these, you’ll want to find a plan that makes up for any gaps in coverage. But even before you signed up for Medicare, figuring out which insurance plan was best for you was challenging. The best way to make informed decisions is by empowering yourself with knowledge. The independent insurance agents at Allen and Associates have outlined the basics of Medicare supplement plans below.
WHAT ARE SUPPLEMENT PLANS?
When you enroll in Medicare Parts A and B, you’ll find that this program covers most of your health-related expenses, but you’ll also find that it misses out on a few things. When you need a policy to provide for these gaps in coverage, you and your insurance agent will look for supplement plans. These plans are also commonly called “Medigap” and help to pay for the health care costs that Medicare doesn’t address. Your supplement plans work on out-of-pocket expenses like copays, coinsurance, and your deductibles.
With the rising costs of healthcare and increasing out-of-pocket expenses, a supplement plan is a great way to maximize the potential of your Medicare policies.
Who’s Eligible For Medicare Supplement Plans?
Eligibility for a Medigap plan is similar to that of Medicare itself. You’ll need to be age 65 or over, and before you can enroll in a supplement plan, it’s important that you have already enrolled in Medicare Parts A and B. If you have enrolled in Medicare C, or the Medicare Advantage plan, you are not eligible to enroll in a Medicare supplement plan.
Generally, you’ll enroll in a Medicare supplement plan during the six month open enrollment period for Medicare. This enrollment period begins on the first day of the month you turn 65. During the enrollment period, you’ll be able to purchase any plan an insurance company offers without the risk of being denied or charged more for pre-existing conditions. If you apply for a Medigap plan outside of this enrollment period, a medical underwriter may deny your eligibility for a policy or increase your rates.
With any Medicare supplemental health insurance policy, you will pay a monthly premium to maintain coverage.
What’s the Difference Between Medigap and Medicare Advantage?
When it comes to understanding the differences between Medigap and Medicare Advantage, the similarity between the names can lead to confusion. Ultimately, both approaches are achieving the same end goal: helping to cover your healthcare costs and needs. However, each does so in a distinct manner.
Medicare Advantage
Medicare Advantage is part C of Original Medicare. Similar to a Medigap plan, Part C is offered through private insurance companies, but unlike Medigap, Part C offers plans that are equivalent to Parts A and B of Original Medicare. In some cases, these companies may even offer coverage similar to Part D of Original Medicare. Like Medigap, you’ll have to enroll in Parts A and B and pay any premiums from Part B, but you’ll sign your plan with a private insurance company.
Typically, Medicare Advantage plans are offered as a preferred provider organization (PPO) or a health maintenance organization (HMO). Through a PPO, your insurance company will offer a selection of providers and healthcare centers that you can choose from, all without the need for a referral. Using an HMO, you’ll choose a primary care provider who will then help you create a structured treatment program and connect you with the appropriate referrals. In either case, you will pay a premium to see a provider outside of your network.
Medigap
Like Part C, Medigap plans are purchased through a private insurance company. But unlike Part C, it only covers what Parts A and B do not. Medigap does not replace your Original Medicare coverage like Medicare Advantage does.
Which is Better?
Depending on your needs and your available options, either plan could be a better choice for you. It’s also important to remember that you cannot have both Medigap and Medicare Advantage.
Generally, Medigap plans incur a higher monthly premium but may have lower out-of-pocket expenses than an Advantage plan. That said, Medicare Advantage usually costs less and covers more options, which might work better for your budget. You’ll need to work with an independent Medicare insurance agent to determine which approach is best for you.
WHAT DOES MEDIGAP COVER?
A supplemental Medicare insurance plan is designed to help pay for the healthcare costs that your Original Medicare plan doesn’t cover. Typically, this includes your copayments, your coinsurance, and your deductible. It can also cover some services that Original Medicare does not offer. This includes medical care while traveling outside of the United States.
What Standardized Medicare Supplement Insurance Plans are Available?
To best protect you, every Medigap policy has to fall within federal and state laws and guidelines. These plans must be identified as “Medicare Supplement Insurance,” and are distinguished by letters. All of the Medigap policies offer the same basic benefits, but some offer more benefits than others. In states like Massachusetts, Minnesota, and Wisconsin, Medigap plans and policies use different standards.
Individual insurance companies determine which plans they will offer and sell, and state laws can influence which ones they are able to offer. Generally speaking, insurance companies do not have to offer every Medicare supplement insurance plan but must provide Medigap A if they offer any kind of policy, and must also offer Plan C and Plan F if they offer any plan.
Medicare Supplemental Insurance Policy Guide
When it comes to selecting the right supplemental plan for your Medicare policy, it’s important to understand your options. We’ve briefly outlined each of the plans available so you can see what each plan has to offer.
PLAN A
The most basic of all of the supplement plans, Plan A covers the 20% that Medicare doesn’t pay for outpatient treatments. All Medigap providers must offer Plan A, but some states may not offer it to those under age 65 who are on Medicare.
PLAN B
Medigap Plan B pays after Medicare pays. That means it covers everything Plan A does, but also picks up the hospital deductibles from Medicare Part A. Plan B is separate and different from Original Medicare Part B.
PLAN C*
This Medigap plan is one of the most comprehensive available. Plan C covers everything except for Medicare excess charges. Using Plan C, both deductibles and the 20% toward outpatient treatments are both covered. Plan C is separate and different from Original Medicare Part C.
*Starting in January of 2020, Plan C is no longer available for those who are eligible for coverage.
PLAN D
This is one of the least popular Medigap Plans. Plan D covers most expenses but does not cover the Part B deductible or any Medicare excess charges. Plan D is separate and different from Original Medicare Part D.
PLAN F*
Easily one of the most popular Medigap plans, Plan F covers all of the expenses and items that you would have to pay from MEdicare. This leaves you with no out-of-pocket expenses for your covered services. This is ideal for those who do not want to worry about copays after appointments and hospital visits.
*Starting in January of 2020, Plan F is no longer available for those who are eligible for coverage.
PLAN G
Like Plan F, Medigap Plan G covers everything except for your Medicare Part B deductible. The premiums for Plan G are very good, making it an affordable option for many. Plan G is usually considered a better value than Plan F in some states.
PLAN K
Medigap Plan K has a yearly out-of-pocket limit which can change from year-to-year. After the out-of-pocket expenses have reached their limit, your Medigap Plan K provider covers 100% of the Medicare costs for the rest of the year.
PLAN L
Medigap Plan L covers 100% of your costs related to your Medicare Part A coinsurance and hospital costs up to one year after your Original Medicare benefits are exhausted. It also covers 75% of the costs of your Part A hospice care coinsurance or copays, your Part A deductible, your Part B coinsurance or copays, and the first three pints of blood used in a medical procedure.
PLAN M
Medigap Plan M covers half of your Medicare Part A deductible, as well as your inpatient services. It also covers Part B coinsurance or copays, your Part A hospice care coinsurance or copays, and extras like emergency care while traveling internationally.
PLAN N
Created in 2010, Plan N offers low premiums, but you’ll pay for your copays for things like doctor appointments and emergency room visits. Plan N does not cover your Medicare excess charges.
Who Needs a Medigap Plan?
The unfortunate reality is that Medicare is not free and does not cover all of your medical expenses. Without a supplemental insurance plan, you’ll have to pay out-of-pocket for your deductibles and 20% of all of your outpatient coverage. Additionally, Original Medicare has no out-of-pocket maximum, meaning that some procedures or emergency medical visits could quickly get out of hand.
A Medigap plan is a simple way to protect yourself from these fees and expenses. No matter what happens to you and your health, a Medigap plan ensures that your financial freedom is unaffected.
SAVE TIME AND MONEY BY WORKING WITH A MEDICARE INSURANCE AGENT
While more than 60 million Americans are enrolled in Medicare, that doesn’t mean the process is always simple. The nuances of the Medicare system mean that many people go without the level of coverage they need to maintain their quality of life.
You can avoid these risks by working with an independent Medicare insurance agent. The team at Allen and Associates can help you build a customized Medicare plan that saves you time, money, and headache.
Get to Know Your Medigap Options
With so many options to choose from, selecting the right supplement Medicare health insurance plan can feel a little overwhelming, especially if you live in a state that offers specific plans. Our agents are trained in both federal and local Medicare policies and can connect you with the resources you need to make an informed decision.
ENROLL IN A MEDICARE SUPPLEMENTAL HEALTH INSURANCE PLAN TODAY
Choosing the right Medigap plan on your own can be frustrating. Don’t let the nuances of each plan keep you from getting the coverage you deserve. At Allen and Associates, you’ll find a team of highly qualified and professional independent insurance agents who put your best interests first. Together, we’ll explore your current and future health needs, and find policies and plans that are cost-effective. Of course, once you’ve selected a plan, we’ll continue to work with you to ensure that your coverage continues to meet your needs. Contact us today to get started!
WORK WITH ALLEN & ASSOCIATES TODAY
Struggling to find the right Medicare plan for you? Struggle no more. The team of insurance agents at Allen and Associates have more than 20 years of experience in this nuanced field and can help you make smart choices for all of your healthcare needs. Once we’ve helped you select a policy, we’ll continue to work with you to ensure that it always meets your needs.