A good medical insurance plan provides extra protection; it covers the things that otherwise bring a toll on your pocket, and later on in your retirement years, it matters the most when your health needs a plan that covers more than just basic health issues.
But if you don't have a good health insurance plan, it's easy to find one which suits you best and covers more than the basic health plans. Medicare plans are one of those plans which cover all most every aspect of medical care.
Medicare plans consist of two parts, Part A and Part B. Part A mainly focuses on Hospital related facilities, which includes hospital care, hospice cost or fees, and skilled nursing facility, this part of the Medicare plan is premium free. Part B provides coverage for your medical and preventive services and equipment, for which you must pay a premium, mostly deducted from your social security.
Understanding Medical Supplement Plan
Certain services are not covered in Medicare health Plans, both in Part A and Part B; therefore, people choose medical supplement plan to cover these services.
Definition
Medical supplement plans, often called Medigap plans, cover the gap or services left or not offered in your Medicare plan Part A and Part B. To get covered by a Medicare Supplement Plan, you must have Original Medicare Plan Part A and B. Almost all the Medigap plans cover the 20% of services not covered by Part A and B.
Private insurance companies sell Medicare Supplement plans; their premiums vary from provider to provider. It is a requirement by Centres of Medicare and Medical Services (CMS) to have a plan that covers and provides benefits nationally. It must be noted that these plans and policies cover individually; you and your spouse need to purchase separate Medicare Supplement Plans to get full coverage and avail of the services.
Medicare Supplement Plan Covers
Following is the list of services and facilities that a Medicare supplement plan covers; the range and cost may vary depending on the service providers.
- It provides cover for additional 365 days after your Medicare benefits are exhausted, along with Medicare Plan Part A (coinsurance) and hospital costs.
- Similarly, it covers your Medicare Plan Part B (coinsurance) or (copayment)
- The first three blood bags
- Hospice coinsurance or copayment
- Provision of care under a qualified nursing facility that is not covered by Plans A and B
- Medicare Health Plan Part A (deductible) is not covered by Plan A
- Medicare Health Plan Part B (deductible)
- Excessive charge of Medicare Part b covered by Medigap plans F and G
- Foreign Travel Exchange, but it's not available in Medigap Plans A, K, B, and L
- If you reach the maximum limit, Medicare Supplement Plans K and L covers 100% of services for the remaining part of the year and pay your Medicare Part B deductible.
There are 10 standardized Medicare Supplement Plans that different insurance companies and service providers cover; they start from alphabet A to N; you can visit a service provider's official site to check the plans they are providing. Apart from these plans, there are certain services that supplement plans don't cover, like:
- Vision
- Eyeglasses
- Dental
- Long-term health care
- Personal Duty Nursing
- Hearing Aids
How much an Average Medicare Supplement Plan Cost
Two main factors govern the cost of your Medicare Supplement Plan; first is your resident state, insurance company, and your age factor. For example, an insurance plan at the age of 65 might look expensive, but if you do the same for the age of 85, it is even costlier. Understanding is better
There are three ways insurance companies determine their prices:
Community-Rated: Any individual with a Medigap policy pays the same monthly premium irrespective of age.
Issue Age-Rated: In this particular category, your Medigap policy premium prices depend on your age; the younger you are at the time of getting the Medigap policy, the lower the premium is; similarly, in this case, the prices are premium don't go up due to age factor, but are impacted by other factors like inflation, etc.
Attained Age-Rated: The premium in this category is based on your existing age and increases as you age; initially, you get all the services by paying a lower premium, but over time it increases and potentially reaches its highest. Outside factors like inflation etc., also impact the premium prices in this category.
You must search and look up Medigap Plans while exploring different insurance companies; not all companies offer all Medigap Plans, and their rates may vary depending on the company; some plans are also offered with high deductible options.
Eligibility for Medicare Supplement Plan:
People 65 years of age and already enrolled in Medicare Part B are eligible to buy a Medicare Supplement Plan. Still, persons with qualifying disabilities can also apply for Medigap Plans before age 65.
Who should buy Medicare Supplement Plan?
Per the insurance experts, anyone concerned about out-of-pocket costs should consider buying a Medical Supplement plan. Medicare plans have cost-sharing in the form of deductibles and coinsurance. One must consider the following while purchasing Medicare Supplement Plan.
- Enrolling in an Original Medicare plan Part A and B is a must.
- The Medicare Supplement plan and Medicare Advantage plan are not the same; the medical advantage plan provides Medicare benefits following the Medicare rules and typically offers drug coverage, whereas the Medicare Supplement Plan fills the gaps in your original Medicare plan.
- One plan only covers one person; you must buy a separate plan for your spouse.
- Plans premiums may vary from state to state, but the benefits remain national.
- A standard plan is subject to renewable even if the medical condition changes.
Final Thoughts:
The Medicare Supplement plan is a good way to cover any gaps or services not covered in your original Medicare plan. Still, it would be best if you considered a few things: eligibility, services covered, premium prices, and selection of good insurance companies with the right Medicare Supplement Plans.