The world of Medicare Supplement Plans, or Medigap Insurance Plans, can be one confusing roller coaster. There are so many options, combinations, and companies to sift through.
To make the process of applying for Medigap Plans in just a bit easier, we have compiled the twelve questions we receive from our Louisville, KY clients the most often and put them into this one, easy to read article.
After you are finished reading, be sure to schedule your free, unbiased consultation. Our independent agents can help you find and apply for one of the Medigap Insurance Plans that is perfect for you.
Question #1 - What is a Medicare Supplement Plan?
A Medicare Supplement Plan is a type of Medicare health insurance that helps pay for, or supplement, some of the costs that Original Medicare Part A and Part B do not cover. These costs include things like copayments, coinsurance, and deductibles.
There are ten standardized Supplement Plans, also referred to as Medigap Insurance Plans, that can be purchased by those who already have Original Medicare Part A and Part B. Not all Medigap Plans are available in every state, but those Medicare recipients in Louisville, KY and throughout Kentucky have access to all ten plans.
The ten plans are...
Each of these plans helps fill in the cost gaps for things like…
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance or copayment
- First 3 pints of blood that may be needed during an operation
- Part A hospice care coinsurance or copayment
- Coinsurance for skilled nursing facility
- Medicare Part A deductible
- Medicare Part B deductible
- Medicare Part B excess charges
- 80% of foreign travel emergency care; if you are traveling abroad and need medical attention, some plans will cover 80% of your bills.
Medigap Insurance Plans are offered through private Medicare Supplement Insurance companies and while the coverage for each plan does not differ from company to company, the cost of each plan could vary.
Question #2 - Am I eligible to apply for a Medigap Insurance Plan?
All Medicare eligible recipients who are already enrolled in Original Medicare Part A and Part B are eligible to apply for any of the ten standardized Medigap Insurance Plans.
When you turn 65 and enroll in Original Medicare Part B, you have a guaranteed right to buy a Medicare supplement policy for six months starting from the first day of your birth month that you turn 65. During this time, you can not be refused application for any reason.
If you miss this window, you can apply later at any time, but run the risk of being denied coverage altogether or charged a higher premium than if you had applied during the Medicare Supplement Open Enrollment Period.
Question #3 - Does a Medigap Insurance Plan replace Medicare Parts A and B?
No. All Medigap Insurance Plans are intended to be used in conjunction with the benefits you are already receiving by having Original Medicare Part A and Part B. These plans are just meant to help supplement the costs associated with Original Medicare.
Medigap Plans also do not replace Medicare Advantage Part C. You can have Original Medicare Part A and Part B with a Medigap Insurance Plan OR Medicare Advantage Part C, but not both.
Question #4 - Do I have to use certain doctors?
One of the many benefits of having Original Medicare Part A and Part B with one of the Medigap Insurance Plans is you have the ability to see any doctor or go to any hospital who accepts Medicare and is taking on new Medicare patients.
To find out if a doctor accepts Medicare, you can either call the office and ask or simply go online to find the nearest Medicare doctor who can help you with your health concerns.
Question #5 - How do I know which Medigap Insurance Plan is right for me?
Trying to pick the best plan out of the ten Medigap Insurance Plans for your health needs and budget would give anyone a headache. Each plan offers different coverage options and different insurance companies have different prices for each plan.
The best course of action would be to set up a completely free, unbiased consultation with the independent agents at Braden Insurance Agency. We have the ability to sell Medigap Plans from several different Medicare insurance companies so you can be sure you are getting the best plan for your health needs and pocketbook. Give us a call today to schedule your free consultation!
Question #6 - Do Medigap Insurance Plans provide nursing home coverage?
Basically, nursing home coverage is very limited. Medicare only covers specific situations where a nursing home is needed. For example, Medicare will only cover the costs of Skilled Nursing Facility Care after you became ill or injured, was admitted to the hospital for at least three days, and then was later moved to a nursing home for thirty days of continuing recovery and rehabilitation.
Generally, patients in nursing homes receive either intermediate or custodial care, which includes services like bathing, eating, dressing, toileting, transferring from bed to wheelchair or wheelchair to bed and moving around. These types of care services are not covered under Medicare or any of the Medigap Insurance Plans.
Question #7 - Can I shop around for a different Supplemental Insurance plan?
Yes. In fact, we encourage it. Medicare eligible recipients are not required to purchase specific Medigap Insurance Plans from a certain private insurance company. It is best to purchase the one that best fits your health needs and pocketbook.
The ten standardized plans have the same coverage no matter who you purchase from, but different companies have different premiums for their plans. So be sure to talk to an independent Medigap Insurance Plan agent who can help you compare all your options.
Question #8 - Can Medigap Insurance Plans be terminated?
No. The private insurance company in Louisville, KY that you purchase your Medigap Insurance Plan from can only cancel your plan if one or more of the following situations happen…
- You fail to make your premium payment
- Material omission or misrepresentation on your application
- The insurance company you purchased from goes out of business
Question #9 - How long does it take to apply for Medigap Insurance Plans?
The hardest part of applying for Medigap Insurance Plans is deciding which of the ten plans is best for you. After that, the process is quick and painless. The actual act of applying can be completed in under 20 minutes. Once everything is submitted, the approval process can take up to 3 weeks.
Question #10 - Do I have to take a physical exam?
Most likely, no. Since several private companies offer Medigap Insurance Plans and each company has their own way of handling supplement plans, there is a small chance you may have to complete a physical exam. Talk to one of the independent agents at Braden Insurance Agency to find out which companies require physical exams.
Question #11 - What if I have a pre-existing condition? Will the plan accept me?
First of all, pre-existing conditions are very common and are defined as health conditions that existed prior to the application of a Medigap Insurance Plan. Some examples include cancer, heart disease, diabetes, and asthma.
Medigap Plans are sold by private insurance companies who are allowed to make judgments based on an applicant’s health history. They are NOT allowed to make such judgments during the Medicare Supplement Open Enrollment Period, which lasts six months from the first day of your birth month in which you turn 65 and enrolled in Original Medicare Part B.
During this window, you can not be denied a Medigap Insurance Plan based on your pre-existing condition. If you apply for a Medigap Insurance Plan after this six-month window, you could be denied coverage or charged a higher premium based on your pre-existing condition.
Question #12 - After enrolling, can I switch from one plan to another?
You can switch your plans anytime during the year and all you have to do is submit a new application.
The best time to switch from one plan to another is during the Medicare Supplement Open Enrollment Period. During this time you can not be denied coverage based on your medical history or charged a higher premium than someone else. Once this window has passed, if you want to change your Medigap Insurance Plan, you may have to answer medical history questions that could prevent you from changing or force you to pay a higher premium on the new plan.
Know What Is Best For You
We hope you feel a little more relaxed about signing up for Medigap Insurance Plans after reading through these helpful answers.
Is there a question you have that we didn’t answer?
We do not want to leave any stone unturned. If you have more questions, please do not hesitate to give us a call to schedule a free consultation with one of our independent agents. We want to make sure you are 100% confident in your decision.
At Braden Insurance Agency, we are your Medigap Insurance Plans experts.