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How to Know if You Need a Medicare Supplement Plan

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Need a Medicare Supplement Plan: When you reach or approach age 65, you may consider your options when it comes to Medicare enrollment. In the standard coverage plans, the beneficiaries receive Medicare Part A and Part B which are known as Original Medicare.

Part A covers hospitals, palliative care, and qualified care facilities, while Part B covers doctor visits, outpatient therapy, medical equipment, and ambulance. They both have deductibles and coinsurance. So, it depends on your health needs, it may be worth seeking Medicare supplemental insurance (also called Medigap) to pay for these out-of-pocket expenses. 

How to Know if You Need a Medicare Supplement Plan

How to Figure out if You Need a Medicare Supplement Plan

Here are four things to be considered when you decide if the Medicare Supplement is right for you. 

Do You Receive Medical Treatment Often?

If you see a family doctor or specialist  (i.e. weekly or monthly), you usually pay coinsurance or partial B compensation for each visit and that can be costly over time. Not to mention the daily Part A coinsurance when you need medical treatment in a hospital for more than 60 days. For example, you pay $335 per day (in 2018) for each benefit period on days 61-90 of your hospital stay. But when you enroll in Medigap, the plan helps you cover these costs out of pocket after Medicare pays its share. 

Do You Want to have the Freedom to Choose Your Providers?

You have the freedom to choose any hospital or doctor in the country that accepts Medicare because Medicare Supplement Plans don’t have networks. This can be very useful if you live in a different state during certain months of the year or are traveling out of state to visit loved ones. Plans are also standardized in most states, meaning you get the same benefits no matter where you buy a policy. The only exceptions are Minnesota, Wisconsin, and Massachusetts, which have different rules. 

Do You Have Any Pre-Existing Health Issues?

During your Medigap Open Enrollment Period (Medigap OEP), which is a one-time period of 6 months, which usually begins the first month you’re enrolled in Part B when you are 65 or older, you are eligible to purchase an available plan regardless of your medical history records. And because of a preexisting medical condition, you cannot be charged a higher premium.

You’ll also get these protections if you have a “guaranteed issue right” to buy Medigap. Guaranteed issue rights usually are applied when your Medicare insurance changes or when you lose insurance coverage. If you have a right guaranteed issue, you can enroll in Medigap after your OEP ends, but no later than 63 calendar days after your health insurance ends, and continue to be covered for all your existing medical conditions without paying more. However, you might have a 6-month “pre-existing condition waiting period” in which the Medicare Supplement Plan may not cover the costs of pre-existing medical conditions. 

Are You Planning to Travel Internationally?

If you travel abroad a lot, this will be another reason to consider a Medicare Supplement plan. In the event, an unforeseen injury, accident, or sickness occurs while you’re not inside the United States, most Medicare Supplement plans will provide insurance coverage for medically necessary emergency care. With Original Medicare Parts A and Part B, you don’t get insurance coverage for health care you receive in a foreign country.

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Buying a Medicare Supplement (Medigap) Plan

When you buy Medicare supplement insurance, remember that the plan does not replace your original Medicare coverage. These plans are typically used to help you to pay out-of-pocket expenses that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.

You must be enrolled in Medicare Parts A and B to purchase a policy because Medigap only works with original Medicare. Private insurance companies sell Medigap plans. However, companies don’t have to sell every plan. That’s why it’s very helpful to work with a licensed insurance agent to compare Medicare Supplement plans from different insurance companies to find the right and best one for you. An agent can also give you great help in choosing Medicare Part D prescription drug coverage that is not covered in a Medicare Supplement plan.

If you’re about to reach Medicare eligibility, Now is the time to consider your coverage options. Original Medicare offers reliable benefits, but it doesn’t cover everything. If you’re looking for a health insurance plan that offers national coverage and the flexibility to manage your medical expenses that are out of your pocket, Medicare Supplement Insurance could be the best plan you’re looking for you. 

Abby’s Consulting | +1 (973) 590-2695

Choosing the right health plan through Medicare can be overwhelming and stressful. The Senior Healthcare team is a national resource that provides free guidance and support to seniors and helps them choose the most appropriate insurance plan that fits their specific needs and budget. Our goal is to empower and empower our customers to make the best decisions about their health care and eliminate the confusion about Medicare. At the baby consulting Team, we’re not part of an insurance company. We are loyal to our customers and our mission is to provide them with the best health options at the lowest cost. 

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