What is a Medigap Plan?
It is the generic term for a group of supplemental private health insurance policies sold to those over 65 who are enrolled in Medicare, or who have other disability coverage from a private insurer.
Insurance companies coined it to help them sell the policies, but it has stuck. It comes from combining the words Medicare and supplemental insurance.
Difference between Attained Age vs Issue Age vs Community-Rated
1. Attained Age.
It is the age at which you are entitled to Medicare. If you are a man and signed up for Social Security at age 65, your attained Age is 65 years. If you are a woman getting Social Security benefits based on your husband’s work record, your attained Age is the age at which he enrolled in Social Security or later.
2. Issue age.
The issue age is the Age you are when the policy is issued. It can vary depending on the plan. But policies are usually issued between 65 and 72. You will pay higher premiums for a policy earlier than your issue age. But if you issue policies later than your issue age, you will pay lower premiums;
3. Community rated.
These plans do not base their rates on your health or pre-existing conditions you may have had in the past. They charge a standard premium rate each month of the year for all subscribers of a given plan regardless of their age or health status. All individuals within that community are charged the same amount for coverage.
What happens if I get sick? Who’s eligible for them?
It does not cover all medical expenses, so a person on Medicare will require insurance to fill in any gaps. Medigap plans can fill these gaps in coverage that may occur depending on a person’s health and financial situation.
Types of Medigap plans:
Part B – This plan covers hospital and skilled nursing facilities, hospice care, and home health care services.
Part C – This plan covers hospital and skilled nursing facilities, hospice care, and home health care services.
Plan D is similar to the Part D prescription drug plan, except Medicare does not run it. Those with this plan must pay the premiums themselves. It is similar to private prescription drug plans.
Part E . Helps pay for out-of-pocket costs not already covered by Parts A and B. It includes skilled nursing facilities, hospice care, home health care services, private duty nursing, and other non-hospital out-patient services.
What Are My Rights Concerning The Plans?
You have a right to choose your Medigap plan. You can choose a high-deductible health plan and pay the premium upfront. Or you can choose a low-deductible plan that provides you with some coverage, at least in the short term, at little or no risk.
1. You can purchase a high-deductible health plan. Deductibles are the amount you pay before it pays for your medical services.
2. You have the right under federal law to choose which medicare drug coverage plan you want to be part of. It is called Part D drug coverage.
3. You have the right to appeal decisions that result in Medigap plan coverage denials or claim payments not being made.
4. The federal government requires health insurance providers to let you know what their enrollees are saying about them and let everyone know how health providers perform on customer service, value, satisfaction, and complaints.
5. Part D prescription drug coverage, if you choose to enroll in one, will be based on your income level and the cost of your medications. The higher the cost of your medications, the higher the premium you will pay for your Part D plan
How Much Does A Medicare Supplemental Plan Cost?
The premium will vary according to the benefits provided by the plan i.e., low-deductible vs. high-deductible, financial situation, i.e., retired or working, and the chosen plan in each state. It is necessary to use a formula based on a person’s income, Age, health status, and additional factors such as geographic location.
The price varies with the state in which you live. Your premium will be higher if your plan covers home healthcare benefits, as this option is generally more expensive than other types of benefits.
If you qualify for Medicare but don’t know where to start, we have licensed insurance agents ready to answer your questions and help you enroll in Medicare Advantage, Medicare Supplement Insurance, and Prescription Part D plans.
Many seniors now depend on supplemental Medicare health insurance policies as part of their health care budget. It is essential to have a Medigap plan if you decide to enroll, and it is also essential to have the best coverage available at reasonable costs. The medicare supplement plan F helps with the high cost of prescription drugs.
How to Compare Medigap Policies (Medicare.gov)
Medigap (Medicare Supplement Health Insurance) (CMS.gov)