How to Avoid Medicare “Gaps”

Medicare helps to pay for a wide variety of health services, from flu shots to hospital stays, and from preventive health screenings to hospice care.

But it doesn’t cover everything. And it doesn’t cover all your out-of-pocket costs. Many services covered by Medicare require co-payments, coinsurance, and deductibles. You can purchase supplemental insurance to cover these “gaps” in Medicare. Such coverage is called Medicare Supplement Insurance, or Medigap.

If you have Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health services. Then your Medigap policy pays its share.

You have to pay for Medigap yourself, and it’s sold through private insurance companies. You can buy it only if you have Original Medicare, not Medicare Advantage, which is managed care provided by private insurers.

Every Medigap policy has to follow federal and state laws designed to protect you. Medigap insurance companies can sell you only a “standardized” Medigap policy identified in most states by the letters A through N. Each standardized policy must offer the same basic benefits, no matter which company sells it.

So beware when you’re shopping for a Medigap policy: Cost is usually the only difference between Medigap policies with the same letter sold by different companies. And there can be significant differences in how much various insurers charge for exactly the same coverage.

Here are some of the costs that Medigap policies often cover:

Medicare Part A (hospital) coinsurance and hospital costs for up to 365 days after Medicare benefits run out;

Medicare Part B (medical) coinsurance or co-pays;

Blood (first three pints);

Part A hospice care coinsurance or co-pays;

Skilled nursing facility coinsurance;

Part A and Part B deductibles.

Medigap policies generally don’t cover long-term care (like care in a nursing home), vision or dental, hearing aids, eyeglasses, and private‑duty nursing.

The best time to buy a Medigap policy is during your six-month Medigap open enrollment period, because you can buy any Medigap policy sold in your state, even if you have health problems, for the same price as people with good health. Medigap open enrollment period starts in the first month that you’re enrolled in Medicare Part B and you’re 65 or older.

Once this period is over, you can’t get it again. If you apply for Medigap coverage after your open enrollment period, there’s no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements.

Some other points to keep in mind: You must have Medicare Part A and Part B to buy a Medigap policy; a Medigap policy only covers one person. If you and your spouse both want Medigap coverage, you must each buy a separate policy; you pay the private insurer a monthly premium for your Medigap policy, in addition to the monthly Part B premium that you pay to Medicare; any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can’t cancel your Medigap policy as long as you pay the premium.

If you have a Medicare Advantage plan (like an HMO or PPO) but are planning to return to Original Medicare, you can apply for a Medigap policy before your coverage ends. The Medigap insurer can sell it to you as long as you’re leaving the Advantage plan. Ask that the new Medigap policy start when your Medicare Advantage plan enrollment ends, so you’ll have continuous coverage.

Original Source:

Orignal Author: Greg Dill

Original Date: March 16 2018

5 Steps to Take When Comparing Medicare Supplemental Insurance Plans

Medicare supplemental insurance plans are also known as ‘Medigap’. It is a procedural setup devised to benefit patients with waved off expenditures including coinsurance, copayments, and deductibles. These insurance plans are formulated and offered by private companies. Other Medicare supplemental insurance plans also sometimes apply to patients traveling outside their country.

A difference between a Medigap policy and a Medicare Advantage Plan needs to be made clear is that the latter is directed towards gaining medical benefits. On the other hand, the prior is attributed and functions primarily on increasing the already existing Original Medicare benefits.

To choose the right Medicare supplemental insurance plan takes a certain amount of assessments, comparisons, and trials. For your convenience here are five important steps to keep in mind when choosing a Medigap insurance plan:

Devise your HealthCare Costs

First and foremost, you should calculate the amount of money you spend on your healthcare products yearly or monthly. In doing so, you should also keep in mind the costs of services provided and covered by Medigap plans. Once you’ve gone through the Medigap plans and chosen your fix i.e. the one that fulfills your criteria of benefits required then move onto the next step.

Choice of Insurance Company

Once you’ve chosen your Medicare supplemental insurance plan, then you need to decide and scrutinize which insurance company offers your preferred choice of the Medigap plan. The vast range of companies should not overwhelm you, rather you should take ample time to decide which one you want to proceed with.

Comparing the costs of Medigap plans

Comparing the required premium costs, the insurance company would charge you on your choice of Medigap plan will help you exclude those companies that exceed your range for a premium charge. Also, some companies have ranging methods that might increase from what you paid in the beginning.

Premium Charges

Furthermore, some companies automatically file your Medicare supplemental insurance plans. If they do it, it saves a lot of your time and headspace for a little extra charge of course. After comparison investigate how stable the insurance being offered by the company is in the long run. Seek assistance from Medicare Supplemental Insurance brokers to help compare prices between carriers.

One Person Policy

Keep in mind that one Medicare supplemental insurance plan is only applicable for a single person to whom it is initially made for. Your spouse or any other family member will require a separate insurance made for them. On that note, it is also illegal to sell your Medigap policy to someone else.

As previously mentioned, Medicare Advantage Plans are not Medigap plans. In a similar way, Veterans’ benefits, Medicare Prescription drug plans, Medicaid, Long-Term Care insurance policies aren’t either. The Medicare supplemental insurance plans take a lot of reading into and rightfully so. To have a better grip at the medical, procedural and legality jargons, one must take ample time to digest every piece of information and then devise. The idea is to choose the best offering available that helps and doesn’t exceed your premium charge limit.

Learn more about Medicare Supplemental Insurance plans, rates and more at  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 877-202-9248 today!

Medicare Glossary: a Guide to Terminology

Medicare Advantage Plan? Annual notice of change? Here’s what it all means.

There’s a lot to know about Medicare, including many terms associated with the insurance program that you’ll need to understand when signing up for and using your Medicare benefits. Here, a glossary of some of Medicare’s most common terms.


Medicare is the federal health insurance program for people ages 65 and older. It also covers people younger than 65 who have disabilities, plus those with end-stage renal disease, requiring dialysis or a kidney transplant, or amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease).

Original Medicare

Original Medicare is the insurance program managed by the federal government. This type of coverage generally includes Medicare Part A and Part B. Under Original Medicare, the government pays hospitals and doctors directly.

Medicare Part A

Medicare Part A is essentially hospital insurance. It covers different types of inpatient care, including inpatient hospital stays, care received in skilled nursing facilities, hospice care and some home health care.

Medicare Part B (Medical Insurance)

Medicare Part B covers services that are delivered on an outpatient basis, including doctors’ visits, laboratory and imaging tests, medical supplies and preventive services.

Medicare Advantage Plan (Part C)

Medicare Advantage plans, also called Medicare Part C, include coverage for both Medicare Parts A and B through a private health insurer that’s been approved by Medicare. These plans cover hospitalization, outpatient care and often prescription-drug coverage under one policy.

Medicare vs. Medicare Advantage

Should you opt for Original Medicare or Medicare Advantage (Part C)?

Medicare Prescription Drug Plan (Part D)

Part D plans are private insurance policies that add prescription drug coverage to Original Medicare, some Medicare Cost Plans, Medicare Private-Fee-for-Service Plans and Medicare Medical Savings Account Plans.

Medigap Policy

Medigap is supplemental insurance sold by private insurance companies to fill “gaps” in Original Medicare coverage. These policies help pay for copayments, deductibles and health care when traveling outside the U.S. that Original Medicare does not.

Medigap Open Enrollment Period

The open enrollment period for Medigap plans is a six-month window that starts the first month you become age 65 (or are older) and are covered by Medicare Part B. Coverage is guaranteed during this period. In addition, you cannot be charged more for coverage because of current or past health problems.


Advance Coverage Decision

A notice you get from a Medicare Advantage Plan letting you know in advance whether it will cover a particular service.

Annual Enrollment Period

Each year between Oct. 15 and Dec. 7, you can change your Medicare Advantage or Part D prescription drug plans for the following year. You can also switch from Original Medicare to Medicare Advantage or from Medicare Advantage back to Original Medicare.

Annual Notice of Change

A notice your Medicare plan sends each fall to alert you to any changes in coverage, costs or service area your plan is making that will take effect in January.

Benefit period

A benefit period is the way Original Medicare measures your use of hospital and skilled nursing facility, or SNF, services. A benefit period starts the day you’re admitted as an inpatient in a hospital or SNF. It ends after 60 consecutive days without receiving care. Medicare’s inpatient hospital deductible is paid at the start of each benefit period. A new benefit period begins when you are admitted to a hospital or SNF after one benefit period has ended. There is no limit to the number of benefit periods.


The portion of covered medical services you are responsible for after meeting deductibles, usually paid as a percentage of the total cost.

Coordination of benefits

A way to determine which health plan pays a medical claim first when you’re covered by more than one insurance policy.


A set dollar amount you’re required to pay for medical services or supplies, such as $10 for a prescription or doctor’s visit.

Coverage gap

Most Medicare Prescription Drug plans have a gap in coverage, which is also called the “donut hole.” It’s a temporary limit on what your drug plan will cover that begins after you and your plan have spent a certain amount on covered drugs. Once you reach the coverage gap, you qualify for savings on both brand-name and generic drugs.

Creditable prescription drug coverage

A health plan with prescription drug coverage that is likely to pay at least as much as Medicare’s standard prescription drug coverage is considered creditable. To avoid paying a penalty for signing up late for a Part D drug plan, you must have alternate insurance that is considered creditable when you become eligible for Medicare.


The amount you must pay for health care services before your Medicare plan begins to pay and help cover your costs.

Extra Help

A Medicare program to help people with limited income and resources pay for the premiums, deductibles and coinsurance associated with their Medicare prescription drug plan.


A list of prescription medications covered by your Part D prescription drug plan or another insurance policy with drug benefits, like Medicare Advantage Prescription Drug plan.

General Enrollment Period

People who don’t sign up for Medicare Part A and/or Part B when they are first eligible can do so during the General Enrollment Period. GEP runs each year between Jan. 1 and March 31.

Medicare Savings Program

A program that helps people with limited income and assets pay some or all of their Medicare premiums, deductibles and coinsurance.

Medicare Summary Notice

MSNs are notices you receive after your doctor or medical supply vendor submits a claim to Medicare for services you received. The Medicare Summary Notice explains what your health care provider or supplier billed Medicare, the Medicare-approved amount, how much Medicare paid and what you must pay.

Network Pharmacies

Medicare drug plans contract with pharmacies that agree to provide members with services and supplies at a discounted price. Some Medicare plans will not cover your medicines unless you get them filled at a participating network pharmacy.

Preferred pharmacy

Preferred pharmacies are part of a Medicare drug plan’s network. Your out-of-pocket costs for prescription drugs may be lower if you get them filled at a preferred pharmacy.

Mail-order programs

Some prescription drug plans and Medicare Advantage Prescription Drug plans offer mail-order programs that allow you to fill a 90-day supply of your covered medications and have them delivered to your home.

Late Enrollment Penalty

An amount added to your monthly premium for Part B or Medicare prescription drug plan (Part D) if you don’t join when you’re first eligible. With few exceptions, you pay this higher amount as long as you have Medicare.

Prior authorization

Medicare prescription drug plans require that you get approval before you fill your prescription for certain prescription drugs in order for them to be covered by the plan.

State Health Insurance Assistance Program

These state programs offer free local health insurance counseling for people with Medicare coverage and their families or caregivers. You can find your SHIP at or by calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.


Medicare Supplemental Insurance Coverage: Is It for You?

Medicare was not established to be a one size fits all type of insurance plan.  It was never intended to cover all medical expenses for all enrollees.  This is one of the many reasons that Medicare Supplemental Insurance Plans were created; to cover the gaps in medical expenses and Medicare coverage.  There are currently twelve different Medicare Supplemental plans of coverage to choose from which are effectively managed by the federal government.  Management by the government ensures that they have a parallel coverage regardless of the insurance agency from which you acquire it.

Choosing the Perfect Medicare Supplemental Insurance Coverage

Before choosing a Medicare Supplemental Plan it is important to understand the coverage that you need.  Evaluate where Medicare Part A and Medicare Part B are lacking in medical coverage for your specific needs and compare supplemental insurance plans to determine which one addresses the best combination of medical needs for you at a budget that is affordable.  It is crucial to understand that no matter where you choose to purchase insurance from the plans will remain the same.  Medicare Supplemental Insurance Plan G through Blue Cross Blue Shield is the same as Plan G through United Health Care. The only difference being the service you receive and the premiums you pay.

Because there are only a dozen plans to choose from this process is a lot simpler than searching for local insurance coverage.  There is no difference between the plans regardless of the private insurance organization you choose to purchase it from.

Facts You Should Know About Medicare Supplemental Insurance Coverage

Price Variability

Even though these plans are identical, the cost of acquiring Medicare Supplemental Insurance Coverage may vary from carrier to another. This is due to the additional services and premium features attached to it. Therefore, try to shop many companies and compare their packages before you buy. Single insurance carriers offer a different selection of plans. Hence, each insurance company will try to introduce you to the plans they sell which may be different from another.

Same Package Coverage

Regardless of who you buy your Medicare Supplemental Insurance Coverage from, the package is still the same as the gaps found in Medicare. There are several levels of benefits offered by this comprehensive 12-plan package, ranging from Plan A to plan L. More so, there are many private companies out there that offer one or more of them. However, regardless of where you buy these plans from, the coverage is the same and identical. Therefore, if a company should tell you their plan is different from others with some unique benefits, don’t believe them.

Only One Plan is Needed

According to the law, only one Medicare supplement insurance plan is needed. However, you easily cover the gap in your Medicare coverage by purchasing the Medigap insurance. What this implies is that if a plan covers your need, you don’t need any other supplemental plan. If otherwise, you can go for a Medigap insurance plan. Generally, buying more than one pan is considered “illegal” by the Federal Government.

Only You

You are the only one that can be covered by a Medicare insurance plan. Unlike the traditional insurance plans that oftentimes cover your family and loved ones, Medicare only covers you and no one else. Hence, married couples must purchase different plans for themselves. More so, if a private insurance company should tell you their insurance policy covers you and other people, they are not genuine, and you should rather consider other companies.

Bottom Line

Generally, it is a wise option to enroll in a Medicare Supplemental Insurance Plan. Likewise, it is essential to understand the basics before proceeding to purchase one. If you are yet to purchase one, there is still time for you to do so. Follow the above tips and facts for choosing a Medicare Supplemental Insurance Plan and be assured of the best choice.

Learn more about Medicare Supplemental Insurance plans, rates and more at  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 877-202-9248 today!

Fully Utilizing Medicare Supplement Insurance Plans

Medicare is meant to provide medical insurance to the seniors of this country. However, with all the added reliefs in the programs offered by Medicare, there are certain additional coverages that the government allow individuals like you to obtain from private insurance companies. These are summed up in a collective term known as Medigap. Before you could enroll in a Medicare Supplemental Insurance Plan, it is important for you to think deeply about your present health condition, family health history, and future prospects. This is because choosing a Medicare Supplemental Insurance Plan depends upon the factors mentioned. There’s no one-plan-fits-for-all.

When can you choose Medigap?

If you want to fully utilize the benefits of these supplement insurance policies, then you need to avail them in the time span of 6 months after you turn 65. However, it is important for every senior to have a Medicare Part A and Part B before enrolling in the Medigap.

Also, it is worth noting that those who have Medicare Advantage plan can also enroll in the program. But for that to happen, you would have to leave the plan.

How should you choose them?

It all depends on the factors mentioned above. Furthermore, every state in the U.S has a different set of rules and regulations regarding Medigap. Therefore, before you go on selecting the policies from A through N, you need to know about the criteria in your particular area. The coverage of the individual plans also depends on the private insurance provider. It can vary greatly from company to company. Although, there are certain plans such as Medigap Plan C that offer the same set of benefits throughout the market; however, certain additions and omissions might be experienced in the other plans.

What is the role of the monthly premium?

You wouldn’t be able to enjoy the benefits of Medigap plans if you do not pay the monthly premium set by the company. Therefore, to fully utilize them, you need to pay them dully on time. That way, you could stand eligible for renewing them without any major hassle.

Medigap plans can be beneficial in providing deductibles for Medicare Part A and Part B. However, with all that, it should be kept in mind that there are some things that the supplement plans cannot cover. For example, according to the website of Medicare, the supplement plans do not cover any dental and vision care, hearing aids, eyeglasses, any long-term care, or private nursing. These are all out-of-the-pocket costs. What else it doesn’t cover are the drug costs. You’d have to buy the Medicare Part D for that. Combined with Medigap plans, the Medicare Part D would serve the purpose, but it should be noted that you’d have to pay the monthly premium for this part separately. It wouldn’t be included in the Medigap premium.

Choosing a Medicare Supplemental Insurance Plan requires attention on your part. After all, enrolling in an unnecessary plan could only result in a waste of time and money. Therefore, enroll in a Medicare Supplemental Insurance Plan only when you know it’s best for you. Only then, you can fully utilize its benefits.

Learn more about Medicare Supplemental Insurance plans, rates and more at  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 877-202-9248 today!

The ABCs of picking a Medicare supplemental policy

Dear Savvy Senior,

Can you provide any advice on choosing a Medicare supplemental policy to help cover things outside of Medicare? I’ll be 65 in a few months and could use some assistance.

— Looking for Help

Dear Looking,

If you plan to enroll in original Medicare, getting a supplemental policy (also known as Medigap insurance), too, is a smart idea because it will help pay for things that aren’t covered by Medicare like co-payments, co-insurance and deductibles. Here are some tips to help you choose an appropriate plan.

Medigap plans

In all but three states (Massachusetts, Minnesota and Wisconsin), Medigap plans, which are sold by private health insurers, come in 10 standardized benefit packages labeled with the letters A, B, C, D, F, G, K, L, M and N.

For more information on the different types of plans and the coverage they provide, including Medigap options in Massachusetts, Minnesota and Wisconsin, see Medicare’s “Choosing a Medigap Policy” guide at, or call 800-MEDICARE and ask them to mail you a copy.

How to choose

To pick a Medigap policy that works best for you, consider your health, family medical history and your budget. The differences among plans can be small and rather confusing.

To help you choose, go to, and click on “Supplements & Other Insurance” at the top of the page, then on “Find a Medigap policy” and type in your ZIP code. This will give you a list of the plans available in your area, their price ranges and the names, and contact information of companies that sell them. But it’s up to you to contact the carriers directly to get their specific pricing information.

You can also compare Medigap prices on most state insurance department websites (see for links), or you can order a personalized report from Weiss Ratings for $99 at

Since all Medigap policies with the same letter must cover the exact same benefits (it’s required by law), you should shop for the cheapest policy.

You’ll get the best price if you sign up within six months after enrolling in Medicare Part B. During this open-enrollment period, an insurer cannot refuse to sell you a policy or charge you more because of your health.

You also need to be aware of the pricing methods, which will affect your costs. Medigap policies are usually sold as either: “community-rated” where everyone in an area is charged the same premium regardless of age; “issue-age-rated” that is based on your age when you buy the policy, but will only increase due to inflation, not age; and “attained-age-rated,” that starts premiums low but increases as you age. Community-rate and issue-age-rated policies are the best options because they will save you money in the long run.

You can buy the plan directly from an insurance company, or you can work with a reputable local insurance broker.

Drug coverage

You also need to know that Medigap policies do not cover prescription drugs, so if you don’t have drug coverage, you need to consider buying a separate Medicare Part D drug plan too. Go to to compare plans. Also note that Medigap plans do not cover vision, dental care, hearing aids or long-term care either.

Alternative option

Instead of getting original Medicare, plus a Medigap policy and a separate Part D drug plan, you could sign up for a Medicare Advantage plan that provides all-in-one coverage. These plans, which are sold by insurance companies, are generally available through HMOs and PPOs. To find and compare Advantage plans, go to

Original Source:


BBB warns Medicare recipients to not fall victim to latest scams

The Better Business Bureau is warning Medicare recipients to not fall victim to scammers. Beginning in April 2018, Medicare will begin mailing new cards to everyone who gets Medicare benefits. In Wisconsin, cards will begin to be mailed out after June.

A spokesman for the BBB stated, instead of having your Social Security Number on the card, the new cards will have a unique Medicare number. Cards will be mailed to the address you have on file with the Social Security Administration. This will happen automatically and you don’t need to do anything or pay anyone to get your new card.

While Medicare cards are undergoing this big change to make them more secure, scammers are taking advantage of confusion around the launch.

How the Scam Works
You receive a call from a person claiming to work with Medicare. They are allegedly calling about the new Medicare cards, which will be mailed this spring. The cards will be more secure because they use a “Medicare Beneficiary Identifier” instead of a Social Security number.

The scammer claims that there’s a problem with your card. The con artist may say your new card was lost or someone tried to use your ID number. To resolve the situation, the scammer just needs your Social Security number.

In another version, the scammer claims you must pay money to receive your new Medicare card. They may ask you for payment information, so they can “complete the process” for you. They may even ask you to mail them your old card.

How to Avoid Medicare Scams
• Know how the Medicare card switch works. Understand that Medicare isn’t calling consumers about the card switch. Also, the new Medicare cards are being provided free of charge.
• Never provide personal information to a stranger. Don’t share personal details with anyone who calls you unsolicited. Do not confirm or give out your full name, address, Social Security number or any other personal information.

Original Source:

By WSAW Staff |

Improve Your Medicare Coverage with a Medicare Supplemental Insurance Plan

Medicare covers the basic healthcare needs of seniors in America.  However, a Medicare supplemental insurance plan can be purchased as additional protection to avoid financial ruin if you should become injured or sick.  Medicare supplemental insurance plans are also known as Medigap.

Supplemental insurance plans provide additional coverage that pays costs that Medicare doesn’t.

These costs may include copayments, coinsurance, and deductibles. It may also cover insurance for travel outside of the USA. If you wish to enroll in a Medicare supplemental insurance plan it’s important to know that you are obtaining insurance coverage from a private company.

Enrollees are often curious as to how Medigap insurance works when they are already enrolled in Original Medicare. Medicare will first pay its share of the Medicare-approved amount of your healthcare costs and then whatever it not covered, depending on the supplemental plan you choose, a portion or all will be paid by your Medigap policy.

It’s important to know that your Medigap policy is different from the Medicare Advantage Plan. The MAP provides Medicare benefits, while Medigap basically supplements your original Medicare benefits. If you wish to improve your Medicare coverage and enroll in a Medicare supplemental insurance plan, you must first have Medicare Part A and Medicare Part B.

But if you have the Medicare Advantage Plan you will not be able to get Medigap. However, you can choose to leave the Medicare Advantage Plan and then enroll in Medigap, but you must do it before your Medigap policy starts. You will not qualify for a Medigap plan if you already have a Medicare Medical Savings Account (MSA) Plan either.

After you choose a Medicare supplemental insurance plan you must pay a private insurance company a monthly premium to enroll in the program. You must pay it every month to stay in good standing, and it’s in addition to your regular Medicare premiums.  A Medigap policy from a private insurance company will only cover one person. If you need your spouse or children covered, you’ll also need to purchase separate policies.

You should also know that you need to purchase from a private insurance provider who has been licensed to sell in your state. One great benefit of the Medigap policy is that you’ll always be covered, and that it’s guaranteed renewable, even if you have health problems. If you pay the premium, the insurance company won’t be able to cancel the policy.

After January 2006, Medigap policies haven’t been able to include prescription drug coverage. If that’s something you’re interested in, you can search for information on Medicare Prescription Drug Plan (Part D).

Before choosing a Medicare supplemental insurance plan you should know that the Medigap policies don’t cover everything. Some of these items may be long-term care, private duty nursing, dental care, eyeglasses, vision care, or hearing aids. Don’t mix up Medicare supplement insurance plans with other types of medical insurance plans. Before you enroll in a Medicare supplemental insurance plan, carefully review your options and make the right choice of plan for you and your family.

Learn more about Medicare Supplemental Insurance plans, rates and more at  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 877-202-9248 today!


Ten Important Facts about Medicare Supplemental Insurance Plans

Are you a senior on Medicare? You probably know that the plan does not cover all the health insurance benefits you need. This is exactly where a Medical supplemental insurance plan becomes important. Also referred to as Medicare gap or Medigap coverage, it has a variety of benefits that supplements the costs that Medicare does not cover. Here are ten important facts about Medicare supplemental insurance plans.

Medicare supplemental plans are standardized

Medicare supplemental plans are standardized. This means that each plan that begins with the same letter (with designated letters A to N) must have the same basic benefits, irrespective of the insurance company you purchase the plan from. However, different insurance companies determine their pricing independently.

Medicare supplemental insurance plans cannot be combined with certain health insurance types

Medicare supplemental plans were designed to work with Original Medicare (parts A and B). If you have another type of insurance, purchasing a supplement plan from a supplement plan from an insurance company may be illegal.

Medicare Supplement plans do not cover all medical benefits

Benefits such as Part A and B deductible, Part B excess charges, skilled nursing facility care coinsurance, and foreign travel emergency are covered up to 50% by some Medicare supplement plans. On the other hand, benefits such as Medicare part A coinsurance, part A hospice care copayment or coinsurance, part B coinsurance or copayment, and the first three pints of blood are covered by supplement plans to at least 50% and it could be up 100%.

Medicare supplement plan is best bought when you are first eligible

Although Medicare supplement plan can be bought anytime, you could be subjected to medical underwriting which would allow insurance companies gather information about your medical history. This history – past or present – could be used as grounds to either charge you more for a plan or reject your application. The Medicare Supplement Open Enrollment Period is the best time for purchasing a supplement plan. During this time, you would not be subjected to a medical underwriting by insurance companies. This period lasts for six months beginning from when you are 65 or older.

You must leave your insurance plan to enjoy a Medicare Supplemental plan

If you already have another insurance plan such as a Medicare Advantage plan, you must leave the plan before the Medicare supplemental plan begins.

A Medicare supplement plan is for one person

If a holder has a spouse that qualifies for a Medicare supplement plan, he/she will have to purchase a separate policy.

Consumers pay a premium

Medicare supplemental insurance plan consumers pay the insurance company a monthly premium for the policy. This is in addition to the Part B premium that a policy holder must pay to Medicare.

Medicare Supplement plans no longer cover prescription drugs

In the past, Medicare supplemental plans had prescription drug coverage. However, since January 1, 2006, such coverage has been disallowed. For consumers who need such coverage, they can purchase the stand-alone Part D also referred to as Medicare Prescription Drug Plan.

It is illegal anyone with an MSA to sell a Medicare supplemental plan

If anyone has a Medicare Medical Savings Account (MSA) Plan, it is illegal to sell a Medicare supplemental plan to a consumer.

Medicare Supplemental Plans are guaranteed renewable

So long as a consumer continues to pay the premium, no insurance company can cancel a Medicare supplemental policy even if the consumer has medical issues.

Learn more about Medicare Supplemental Insurance plans, rates and more at  Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to an expert in Medicare coverage toll free 877-202-9248 today!

What older people should know about Medicare and Medicaid in an era of proposed reform

We have made Medicare and Medicaid so complex that the quality of our own understanding of the individual implications of enrollment as well as the debate over various reform proposals is degraded.
We have made Medicare and Medicaid so complex that the quality of our own understanding of the individual implications of enrollment as well as the debate over various reform proposals is degraded. File illustration


Not unlike both the 111th Congress that passed the Affordable Care Act and the 115th Congress that recently amended it with the new federal tax bill, we are often in the dark about our own health care and health insurance systems.

Whether you think this is a matter of being in good company or a national embarrassment, I can think of no problem greater among our citizenry than health insurance illiteracy in general, and about Medicare and Medicaid, in particular.

Many of us, for example, learn about the limits of our own individual health care coverage at the clinic check-in window or in the pharmacy check-out line. These are the wrong venues at which to ask questions and consider the implications of plan and coverage design.

Polling data reveals that the majority of Americans do not understand that Medicare offers only a limited long-term care benefit, for example. As citizens, we generalize about health care and health insurance in ways that may be profoundly inaccurate as well as personally disadvantageous, though they seem intuitive to us. When we do this, we bargain in the dark over both our own future and that of our fellow Americans.

Never miss a local story.

Older people are at a particular disadvantage in this “understanding your health insurance” game because older Medicare beneficiaries are often retired, remote from former employers’ human resource departments and they are often reluctant to burden adult children with the task of attempting to decipher coverage.

Government-funded health insurance beneficiaries are required to choose, choose and choose again in a system that requires them to make selections at every turn, even if they must be made in the near dark.

Traditional Medicare or Medicare Advantage? Medicare Part D coverage and, if so, what plan? Medicare Supplemental Insurance and, if so, at what level of coverage and cost?

We have made Medicare and Medicaid so complex that the quality of our own understanding of the individual implications of enrollment, and also the debate over various reform proposals are degraded. Is it a defect or a feature of these programs that ordinary intelligent citizens of good will have difficulty understanding both their own government-funded health insurance and the proposals to reform both Medicare and Medicaid throughout our society?

The UMKC Consortium for Aging in Community is hosting two public events on Medicare and Medicaid in March, in an effort to create a bridge between health care experts and the community’s need for information. It is our hope this series will enable all of us to be better health care beneficiaries, both more aware and more concerned about why the system is structured the way it is.

Ordinary intelligent people ought not be excluded from the current debates over the future of Medicare and Medicaid. Indeed, those very people ought to drive the debate, as they are the ones with the most at stake in any reform proposal.

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Original Date: March 4 2018