Medicare, in itself, offers pretty much the most important matters when it comes to medical insurance. However, it does not cover everything, and there are probably a lot more areas to be covered if one would like to have a comprehensive health insurance coverage. This is where Medicare supplemental insurance in 2018 comes in. It fills in where Medicare falls short on.
Also known as, Medigap, it may be availed through private insurance providers licensed to sell in your respective states and comes with a monthly premium.
To better understand what Medicare supplemental insurance covers, let us first take a look at what your original Medicare plan covers.
Basically, Medicare coverage provides health insurance to Americans aged 65 years old and above who have contributed to the system through their payroll tax. Additionally, younger people with specific disability, as determined by the Social Security Administration, as well as those people with the end-stage renal disease and amyotrophic lateral sclerosis are also provided with health insurance under Medicare.
It is divided into two parts namely Parts A and B. Part A covers hospital care, nursing facility care, hospice, and home health services while Part B covers services which are necessary to treat a disease or medical condition such as laboratory tests, surgeries, and doctor visits as well as supplies such as wheelchairs or walkers. Also, Part B also provides health care to prevent illnesses detected at an early stage.
Medicare supplemental insurance is available for those who already have health insurance coverage under Parts A and B. However, those who are currently covered under Medicare Advantage plan cannot avail of a Medigap plan.
A Medigap policy can only cover an individual person. Monthly premiums paid for Medigap are on top of the monthly premium paid for Part B of Medicare. As long as you are paying the monthly premium, your Medigap policy is renewable, and the insurance agency cannot cancel it for reason of your health status.
The open enrollment period for a Medigap plan is within six months after you signed up for Medicare Part B. You may also enroll for one six months from the first day of your birth month during your 65th birthday but you have to make sure that you have already signed up for Medicare Part B. During this period, you will be paying regular rates for the Medigap plans. Signing up beyond this prescribed period will give you higher prices, if an insurance company agrees to provide you coverage, after all.
However, if you do have a pre-existing health condition, you might only be able to enjoy the coverage of your Medigap plan six months after you signed up for it. Your insurance provider might not pay for out-of-pocket expenses you incur for your pre-existing health condition. But if you do have a continuous creditable coverage under your health insurance before you bought a Medigap policy during the open enrollment period, your Medigap policy may cover your pre-existing condition.
Benefits of Medicare Supplemental Insurance in 2018
Medicare supplemental insurance plans vary depending on the levels of health insurance coverage it offers. The premium payment depends on the health insurance providers, but the coverage is standardized across all insurance companies and all states with the exceptions of Massachusetts, Michigan, and Wisconsin. However, different insurance providers also have different rules when it comes to eligibility, so it is essential to shop around and compare policies from different providers before buying one.
The cost is also dependent on the type of plan you want to avail, your location, and your age. Though the coverage is pretty much standard across different companies, plans which are priced higher affords extra benefits and higher coverage which will mean lower out-of-pocket expenses for you.
The variety of Medicare supplemental insurance plans is labeled Plans A to N though Plans E, H, I, and J are no longer available and are only enjoyed by those who availed of it before 2010. Medigap plans C, D, E, F, and G have the same package of essential benefits while the remaining plans have a different set of benefits offered.
All Medigap plans cover Medicare Part A coinsurance and hospital costs for an additional 365 days after Medicare benefits have been used up.
Plans A, B, C, D, F, G, M, and N pay for the Medicare Part B co-insurance, where specific rules are to be observed for Plan N. Fifty percent (50%) of the Part B co-insurance is covered under Plan K while 75% is covered under Plan L.
The same plan coverages apply for the first three pints of blood and Medicare Part B copayment.
Skilled Nursing Facility (SNF) coinsurance is covered under Plans C, D, F, G, M, and N. Plan K covers for the 50% while Plan L pays for 75% of the expenses. However, Plans A and B do not include SNF coinsurance.
Medicare Part A deductible is covered under Plans B, C, D, F, G, and N. Plans K and M comprise 50% of the deductible while Plan L provides for 75%. Plan A, on the other hand, does not offer coverage for Medicare Part A deductible.
Meanwhile, Part B deductible is covered only under Plans C, and F whilst Part B excess charge is covered just by Plans F and G.
Eighty percent coverage up to individual plan limits on foreign travel emergency is provided under Plans C, D, F, G, M, and N. The rest of the plans do not cover this.
Medigap plans A, B, C, D, F, G, M, and N will pay for the Medicare-covered cost once you have reached the annual out-of-pocket spending limit on your Medicare Part B deductible.
It is essential to keep in mind that any Medicare supplement insurance policies will not cover long-term care, vision or dental care and supplies such as eyeglasses and hearing aids.
Getting a Medicare supplemental insurance in 2018 is a good idea to enhance further the health insurance coverage provided by Medicare. With its variety of plans to choose from, you have the option to avail of the package that better suits your needs, financial capacity, and most importantly, your health status.