The pocketbook is almost always the bottom line, especially in your retirement years. With so many aspects of Medicare, it’s impossible to keep straight on what’s covered, what’s not, and how much it’ll end up costing you in the end. Medicare supplement insurance is available to fill the gaps left behind from Medicare. Within these supplement plans, there are a myriad of options to choose from, so how do you know what’s right for you? Our Medicare advisors will break it down and make it simple so you get what you need without overpaying.
What is a Medicare Supplement Plan?
Medicare supplement plans are also referred to as “Medigap” or “Medsup” policies. Many Medicare eligible individuals choose to add a supplement plan to their Original Medicare plan to help offset their out of pocket costs for copayments, coinsurance, and deductibles.
Unlike Original Medicare, which is provided by the government, Medicare supplement insurance is provided by private insurance companies. This can make individual plan costs and coverage vary from company to company in Louisville, KY.
There are ten standard Medicare supplement insurance plans currently available: A, B, C, D, F, G, K, L, M, N. Because Medicare is a state-issued program, not all plans are available in every state, however residents of Kentucky are fortunate to have access to all ten options. The plans are lettered for convenience, but the letters have no relationship to the letters of Medicare Part A, B, C, and D.
Who is eligible for Medicare supplement plans?
To be eligible for a Medicare supplement insurance, you first have to be enrolled in Original Medicare Part A and Part B and a citizen of the United States or permanent legal resident for at least five continuous years. In addition, you must meet at least one of the following requirements:
- Age 65 and older
- Diagnosed with end stage renal disease (ESRD – permanent kidney failure requiring dialysis or transplant)
- Receiving disability benefits from the Social Security Administration or the Railroad Retirement Board
- Diagnosed with Lou Gehrig’s disease (ALS)
What is the difference between Medicare Advantage and Medicare Supplement?
Medicare Advantage and Medicare supplements are both ways you can enhance your Original Medicare coverage through private insurance companies. That’s where the similarities end. They are very different in their costs, coverage, and function.
You cannot enroll in both Medicare Advantage and Medicare supplement insurance. This is why it’s important to know the difference and make the best choice for you.
Medicare Advantage completely replaces Original Medicare with more thorough coverage. It is still part of the Medicare program, but it is provided through private insurance companies, not the government. It includes all of your medical and hospital costs as well as additional benefits such as dental, vision and hearing. However, Medicare Advantage does not provide coverage for hospice care (while Original Medicare does).
Medicare Advantage insurance plans typically require a monthly premium payment, annual deductible, coinsurance, and copayments. To enroll in Medicare Advantage, you must first sign up for Original Medicare Part A and Part B and then switch during the Disenrollment Period.
Medicare Supplement Policies
Medicare Supplement insurance complements Original Medicare, it is not comprehensive medical coverage. It is often referred to as Medigap insurance, and is designed as a secondary insurance to your coinsurance, copayment, and deductible costs.
There are 10 standard plan types, and each one offers different benefits. Some may offer international insurance coverage, others may offer coverage specifically for blood transfusions, or specifically for skilled nursing facility care. Every Medigap plan covers up to one year of Medicare Part A coinsurance and hospital costs after Medicare benefits are used up.
While benefits are standardized across the ten plans, the costs are not, meaning they could fluctuate depending on the private insurance company offering the plan and the state you live in.
You can choose Medicare Supplement insurance or Medicare Advantage, but you can’t have both. This is why it’s important to research all of your options carefully before deciding which is the best option for your health needs and budget.
The best way to decide is to talk to a licensed Medicare insurance agent. The independent Medicare agents at Braden Insurance Agency are always available to give free, unbiased Medicare advice. Give us a call today to set up your Medicare consultation.
What does Medicare Supplement Cover?
While all Medicare supplement plans provide an additional 365 days of hospital care during your lifetime, each of the 10 options is unique and cover a different aspect of your healthcare.
All supplemental plans provide coverage across the United States, regardless of the state you live or the state where you purchased the plan. However, only a specific international supplement will provide coverage outside of the United States.
The 10 options for supplemental plan coverage include the following:
- Part A deductibles
- Part B deductibles
- Coinsurance and providers’ excess charges
- Cost of blood transfusions
- Cost of additional hospital days after you have used up your Part A benefits
- Hospital and skilled nursing facility coinsurance
- Some preventive care benefits
- Foreign emergency medical benefits
- Some drugs the provider must give you
- Out-of-pocket limit
For a specific list of what each plan covers, read our article about Medicare Supplement Plans.
What Medicare Supplement Doesn’t Cover
In general, Medicare Supplement insurance is a cost-sharing program, and does not provide additional medical conditions. It is designed to help you pay for the coverage provided by Medicare, not to add additional coverage. Medicare Supplement insurance does not cover any of the following:
- long term care (like nursing home care)
- routine vision
- dental care (unless incurred during hospitalization)
- hearing care
- hearing aids
How much do Medicare supplement plans cost?
Medicare Supplement insurance is offered through private companies. This means the costs can vary depending on your location within Louisville, KY and the company. Each of the Medigap Insurance plans will have a different monthly premium.
To give you a ballpark of what you could be paying monthly, here is a chart of the average monthly prices for each plan.
|Medigap Plan||Average Monthly Premium|
If you would like a more comprehensive price breakdown of each plans’ cost, schedule a Medicare supplement consultation with one of the independent agents at Braden Insurance Agency. We provide free, unbiased advice so you get the best plan for you.
When Can I Sign Up for a Medicare Supplement Plan?
You can enroll in Medicare Supplement insurance during the Medicare Supplement Open Enrollment Period. This begins the first month that you are age 65 or older and enrolled in Medicare Part B. The Supplement Open Enrollment Period lasts for 6 months and guarantees your right to buy a plan during this time. The insurer cannot deny you coverage based on your medical history or current health if you apply during this period.
If you miss the open enrollment period, you may still apply for Medicare supplement insurance but if it’s outside of the Open Enrollment Period you could be denied coverage or charged a higher premium based on your health history.
We are Your Medicare Supplement Experts
We know deciding on a Medicare Supplement insurance policy can be daunting. Don’t let it scare you. The independent agents at Braden Insurance Agency in Louisville, KY represent several different insurance companies to ensure you understand your options and get the coverage you need. Some of these companies include…
- United Healthcare
- and more!
Call us today to schedule a no-pressure consultation where you will get free, unbiased advice. We are here for you.