So you’re turning 65 and need to purchase your Medigap policy also known as Medicare Supplement OR maybe it’s open enrollment and you’re interested in making some changes. Don’t worry, you’ve come to the right place.
Oklahoma Medicare Supplement or even Medicare Advantage can be confusing at best. It’s important to have a knowledgeable agent that can point you on the right path for your life.
Do I need a Medicare Supplement policy?
Can you afford not to? Original Medicare also known as Part A and Part B can leave you vulnerable to high health care expenses.
A Medicare Supplement provides financial security and additional health coverage for people with Medicare. The plan pays for some of the healthcare costs that Original Medicare doesn’t cover. These include out-of-pocket costs like co-pays, coinsurance, and deductibles).
A Medicare supplement is also known as a Medigap plan because it helps to fill the gaps in healthcare costs.
This type of coverage can go by multiple names, which adds to some of the confusion. If you hear: Medicare Supplement, Medicare Supplemental insurance, Medigap, Medigap plan or Medigap policy, it’s all referring to the same thing.
First, What is Medicare?
Medicare is a federal health insurance program for people in the U.S. who are 65 and older as well as some younger people with disabilities. Medicare is a different program than Medicaid, which offers health and other services to eligible low-income people of all ages.
In order to enroll in any Oklahoma Medicare Supplement/Oklahoma Medigap policy or even Medicare Advantage you must be enrolled in Original Medicare.
What is Medicare Supplement?
Medigap aka Medicare Supplement is private health coverage that is optional. The purpose of this policy is to fill in the gaps that Medicare does NOT cover such as if your hospital stay extends 60 days or you need more time in skilled nursing care than the 20 days that Medicare pays for.
- Plans help pay for healthcare expenses beyond what Original Medicare (Part A & Part B) covers.
- Depending on the policy, they’ll cover copayments, coinsurance, deductibles, and emergency care when traveling outside the U.S.
- Unless specified by the private insurer, Medigap plans pay 100% of covered expenses after Original Medicare pays its share.
Buying a Medicare Supplement plan can be a smart decision for both your health and your finances; however, finding and choosing a policy can be overwhelming so let’s walk through it.
How Do I Know All Plans are Equal?
Unlike Original Medicare (Medicare Part A & Part B) which is provided by the federal government, Medicare Supplement plans are sold by private companies which means you have plenty of options.
Medicare Supplement plans are standardized, which means that all the plans cover the same benefits. This makes it easier to compare options and lets you focus on choosing a company that has good financial strength and customer service.
Plans are labeled “A” through “N”. Additional benefits are provided under each of these plans. These additional benefits are also standardized. For example, all Plan A policies must provide the same additional benefits – the only difference between Plan A policies is the insurer and the price.
Is This Included in my Medicare premium?
No. Because this is through private insurance this is a separate premium that is billed monthly.
Does This Include My Prescriptions?
While that would make things a little easier, Medicare Supplement does not cover your prescription if your plan was purchased after January 1, 2006. You would need to purchase Medicare Part D for your drug card.
So, Then What Does Medigap Cover?
Good questions. Oklahoma Medicare supplement covers basic Medicare benefits (including Part A coinsurance, Part B coinsurance & copayment, hospital costs, hospice care, and
preventative care). Additional benefits may apply depending on the plan.
It does not cover Long-term care, dental, vision, hearing aid or other types of lifestyle bills typically are not covered. Those can be purchased separately.
Can I see any Doctor?
With Medicare Supplement, you can choose to see any doctor or healthcare provider that accepts Medicare. This is very different from Medicare Advantage plans which have networks of healthcare providers (doctors, hospitals, and facilities) that you’re limited to.
The good news is that the billing for Medicare Original and your supplement for covered Medicare services and products is automatically coordinated between Medicare and the insurance company. You will not have to file separate claims.
When Can I Buy an Oklahoma Medicare Supplement Policy?
If you buy Medicare Supplement insurance during your 6-month Open Enrollment Period which begins the 3 months before your 65th birthday and the 3 months after your 65 birthday, then it automatically begins when you enroll in Medicare Part B for the first time. For many retirees, this is often when they turn 65. However, if you work past age 65, the clock starts whenever you elect to start your Part B coverage. The best part about enrolling with your Initial Open Enrollment period is that there is no chance that coverage can be denied. Despite preexisting conditions or any health concerns, you will be approved. This is not always the case.
If you buy Medicare supplement insurance outside your Open Enrollment Period, you will be subject to “underwriting”. That means you can be denied coverage or charged more due to preexisting health conditions or due to your health history.
Once you have a standardized Medicare Supplement plan, it is guaranteed renewable, even if you have health problems. As long as you pay the premium, your policy cannot be cancelled.
If you wish to change your plan during the Medicare Open enrollment, which begins October 15 and goes through December 7, you must qualify. This means that insurance companies will underwrite you and can possibly deny coverage based on health conditions.
What Is the Difference In Plans?
The easiest way is just to show you.
(Image Source: 65medicare.org)
Both Plan F and Plan C are going away in 2020. However, these Medicare changes in 2020 won’t affect everyone. People eligible for Medicare Part A prior to 2020 will continue to have options to enroll in Plans C and F later on.
There are different levels of care depending on budget and desire. Plan A is the least robust, but the most budget conscious, while Plan F is the most comprehensive in coverage, but it is also the most expensive.
What Does It Cost?
Since all plans are standardized, you don’t have to worry about coverage differing, just the company and the rate they provide. Prices are going to vary company to company. Plans with less comprehensive coverage generally cost less; those with more comprehensive coverage will cost more. Out-of-pocket costs are typically lower for Medigap plans with more comprehensive coverage and higher for plans with less comprehensive coverage.
Where To Buy Oklahoma Medicare Supplement
You buy Medicare Supplement insurance plans (Medigap plans) through a health insurance agent, broker or directly from an insurance company. Unlike Original Medicare (Medicare Parts A & B), you do not buy it from the government.
ECI Insurance an independent insurance agency that can help you with multiple options and walk you through the complicated process of purchasing Medigap coverage and along with your Medicare Part D drug card. Contact us today!