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HOW DO I CHOOSE MEDICARE SUPPLEMENTAL INSURANCE
Medicare supplement or Medigap is a standardized plan sold by private healthcare insurance companies designed to offer special benefits that original Medicare does not cover.
Medicare Supplement insurance policy can help pay for some of the healthcare costs not covered for by the Original Medicare such as copayments, coinsurance, and deductibles.
Medicare supplement helps with other costs such as Medicare Part B excess charges or emergency medical coverage when you’re traveling outside the country. Medicare supplements generally don’t cover long term care, vision or dental care, hearing aids, and private duty nursing.
Medicare Supplement Insurance Policy gives beneficiaries the freedom to choose any hospital, caregiver, or doctor that accepts Medicare without undue restrictions and such coverage is guaranteed renewable for life.
Medigap policies do not offer coverage for costs incurred by a beneficiary under other types of health coverage, including Medicare Advantage plans (such as HMOs and PPOs), stand-alone Medicare Prescription Drug plans, employer/union group health coverage, Medicaid, or TRICARE.
Also, insurance companies do not sell Medigap Policy to a beneficiary that has coverage
With rising cost of out-of-pocket payments for healthcare beneficiaries, Medicare Supplement can help set an individual’s mind at ease.
THINGS TO KNOW ABOUT MEDICARE SUPPLEMENT (MEDIGAP) PLAN
- Beneficiaries must be subscribed to Medicare part A and Part B
- A Medigap policy is different from a Medicare Advantage plan. Medicare Advantage plan helps you to get Medicare benefits and coverage for other additional benefits while a Medigap policy only supplements your Original Medicare.
- A monthly premium is paid to a private insurance company to get Medicare Supplement. This is in addition to the monthly Part B premium paid to Medicare.
- Unlike Medicare Advantage plans, Medigap policy only covers one person. If a beneficiary wants Medigap coverage for their spouse, they’ll each have to buy separate Insurance/
- Medicare Supplement can be purchased from health insurance companies licensed to sell one in particular locations.
- Any standardized Medigap policy is subject to renewal even if you do not have health problems. This means the insurance cannot cancel your Medigap policy as long as you pay the premium.
- It is considered illegal to purchase Medigap policy if you’re already on a Medicare Advantage lean if you’re unless you’re switching back to Original Medicare.
- Medigap policies are not allowed to include prescription drug coverage. Anyone who requires prescription drug coverage will have to join a Medicare advantage Prescription drug Part D plan.
WHAT DOES A MEDICARE SUPPLEMENT PLAN COVER?
Medicare Supplement plans are designed to pay for the costs that a beneficiary would normally pay out-of-pocket, but this will depend specifically on which Medicare Supplement plan one selects.
All Medicare Supplement insurance plans cover Medicare Part A coinsurance and hospital costs at 100%. Outside this, the plans differ in terms of the extent to which they cover certain benefits and what benefits they cover. For instance, only Medicare Supplement insurance plans C & F cover Part B deductible.
All plans offer coverage for Blood, but plan K offers 50% coverage and plan L covers it at 75% while the other 8 plans offer 100% coverage.
Those who were not eligible for Medicare before 1st January 2020 won’t be able to buy Medicare Supplement Plans C and F. These plans are gradually being phased out, but those who are already subscribed to it can keep it.
For those faced with hospitalization, a Medicare Supplement Insurance plan could save them the burden of excess cost. Hospitalization coinsurance costs for 61 – 90 days are $352 per day. Days 91 and beyond cost $704 per day until a lifetime reserve is met and subscribers must pay all costs.
These amounts are for 2020, and all standardized Medicare supplement insurance generally cover these cost for up to a year after Medicare benefits are exhausted.
However, before a beneficiary receives Medicare Part A benefits, payments for Part A deductibles have to be made. The current cost for each benefit period is about $1400.
HOW DOES A MEDICARE SUPPLEMENT INSURANCE PLAN WORK?
For beneficiaries with Medicare Part A and Part B, there are up to 10 standardized Medicare Supplement Insurance plans labeled A, B, C, D, F, G, K, L, M, and N, and may cover between 4 and 9 of the following 9 benefits:
- Medicare Part A coinsurance for hospital costs
- Medicare Part B coinsurance for copayments
- The first 3 pints of blood for a medical procedure
- Part A hospice care coinsurance or copayment
- Skilled facility care coinsurance
- Part A deductible
- Part B excess charges
- Foreign travel emergencies
Generally, Medicare supplement insurance plans do not cover routine vision or dental care. They also do not cover hearing aids, eyeglasses, private duty nursing, or long term care such as nursing home care.
For these categories of care, subscribers may be able to buy additional insurance from a private insurance company or take responsibility for the full cost.
Until recently, most people who bought Medigap policies chose plan F, which gave the most comprehensive coverage, including paying for Medicare Part B deductibles.
Plan D and Plan G have similar benefits to Plan C and Plan F, except for not covering the Part B deductible. people who signed up or became eligible for Medicare before 2020 can purchase or continue plans C or F, though prices may rise and it may be a better deal to switch to a plan that doesn’t cover the deductible.
Since coverage is standard, there are no ratings of Medigap policies. Subscribers can confidently compare insurer’s prices for each letter plan and simply choose a better deal.
It is important to note that Medicare Supplement Insurance plans are not connected with or endorsed by the U.S. government or the Federal Medicare Program.
BEST MEDICARE SUPPLEMENT PLANS FOR 2021
From a research conducted by Health.com, 8 best Medicare supplement insurers were selected from about 19.
They were judged based on the following criteria: customer satisfaction, benefits offered, access, coverage, and add on. Below are the best Medicare Supplement Plans:
- AARP UNITEDHEALTHCARE: UnitedHealthCare makes customer satisfaction a top priority with about 95% satisfaction rate and coverage to 34% of all Medigap enrollees. With hearing, vision discounts, and multiple wellness benefits, UnitedHealthCareprovised customers with access to an extensive network of providers and pharmacies. The company also provides numerous plan options nationwide which makes it stand out as the most well-known health insurer option in the U.S.
- HUMANA: Humana is one of the largest health insurers in the country with the most (free) extra benefits offered and 24/7 phone access to registered nurses. Humana offers Medigap plans A – N, has comparatively low annual rate increases, provides multiple wellness rewards, and has nationwide coverage.
- MUTUAL OF OMAHA: Mutual of Omaha is owned by its policyholders and consistently has one of the highest customer satisfaction ratings, offering 98%payment of claims within 12 hours. Among the benefits offered to its policyholders are a complementary vision plan, household discounts, nationwide coverage, online quotes, and a free 30-day look period in which you can decide if to maintain the plan or make do with it.
- CIGNA: Cigna offers amazing online user experience, competitive rates, and a robust rewards program. They provide additional supplement insurance options such as coverage for catastrophic events like accident expenses, cancer, heart attack, and stroke. In addition, Cigna subscribers are given access to a discounted gym membership, yoga equipment, chiropractic treatments, and various health products through their healthy reward program. Cigna plans are, however, not available in all states and take a whole 14 business day turnaround for claims.
- AETNA: though Aetna does not offer as many extra benefits as the other insurers analyzed earlier, it still stands out with its good track record of maintaining competitive rates year after year. The company is committed to giving back to society through financial support and volunteer services. While Aetna offers a 12-month rate lock on 1st-year premiums and a 12% household discount, its plans are not available nationwide.
- BLUE CROSS BLUE SHIELD: Blue Cross Blue Shield is a conglomeration of 36 different health insurance companies, including Anthem, CareFirst, Horizon, Wellmark, and others. BCBS health insurance companies consistently offer competitive rates along with state-specific discounts based on certain criteria such as household enrollment, payment frequency, and payment method. BCBS also offers multiple plan options in many locations and has 95% and 96% of hospitals and healthcare providers respectively on its network.
- STATE FARM: state farm is a localized company committed to providing a personalized, local experience. They offer direct access to local agents, no high deductible plan, and no option to add Part D prescription drug coverage. State farm offers very limited plans and is only good when working with people at the grassroots.
- TRANSAMERICA: Transamerica offers coverage in every state of the U.S. They provide automatic payment discount, with low deductible plans.
DIFFERENCE BETWEEN ORIGINAL MEDICARE, MEDICARE ADVANTAGE, AND MEDICARE SUPPLEMENT
The original Medicare may appear similar to the Medicare advantage plan given that both plans gives you basically the same set of Medicare part A and Part B benefits, there however have certain differences that will make an intending subscriber choose one over the other.
The original Medicare was established as a government health insurance program to incorporate:
- Medicare Part A which is hospital insurance and generally covers care at skilled nursing facilities and nursing homes sometimes
- Medicare Part B is medical insurance designed to cover preventive care, doctor visits, lab tests, durable medical equipment, and more.
Conversely, Medicare advantage plans provide an additional way to get part A and B coverage. Private insurance companies approved by Medicare offer Medicare advantage plans which provide prescription drug coverage and other benefits such as routine vision and dental care.
Medicare Advantage is an alternative to the original Medicare that provides coverage of Parts A and B (hospital care and outpatient services), and often covers prescription drug coverage, dental vision, and hearing coverage as well as other additional perks such as fitness membership.
Most Medicare Advantage plans operate as health maintenance organizations or preferred provider organization insurance.
MEDICARE SUPPLEMENTS CONCLUSION
Medicare supplement also known as Medigap on its part provides coverage of healthcare which the original Medicare does not include. While Medicare advantage primarily pays for your healthcare bills, Medicare supplement further covers certain cost-sharing expenses required by Medicare. For example, copayments, coinsurance, and deductibles.
Also, Medicare supplement helps with other costs such as Medicare Part B excess charges or emergency medical coverage when you’re traveling outside the country. Medicare supplement (Medigap) generally doesn’t cover long term care, vision or dental care, hearing aids, and private duty nursing.