Medicare supplement health insurance (also known as a Medigap policy) is offered by private health insurance companies – they are not federal government plans like standard Medicare. The advantage of a Medicare supplement plan is that it can help relieve some of the financial burden of medical costs like deductibles and coinsurance.
Even if you are healthy at age 65, one accident or illness can put medical bills far past what standard Medicare covers. It’s important to know that coverage is guaranteed if an individual enrolls in a Medicare supplement plan during the Medicare supplement open enrollment period. This enrollment period begins the first day of the month in which you turn 65 and have enrolled in Medicare Part A and B.
Some Medicare supplement plans also offer coverage for services that standard Medicare doesn’t cover, like emergency medical care when traveling away from the United States, which is a great option for the adventurous traveler. Other benefits include skilled nursing facility coinsurance coverage and hospice coinsurance or copayment charges.
Say you have a car accident and your pelvis is crushed in the smash-up. You need surgery, and require a long hospital stay to recover and receive therapy.
Standard Medicare will pay:
- Ambulance transportation
- You are responsible for your Medicare deductible and 20%
- Inpatient hospital care and surgery
- Medicare deductible: $1,260
Depending on the Medicare supplemental health insurance plan you purchase (we’ll use the most popular Plan F for this example), your supplemental insurance will pay:
- Your Part A deductible
- Your Part B deductible
- Your Part A coinsurance and copayments
- Your Part B coinsurance and copayments
Top Tips About Having a Medicare Supplement Plan
- You are required to have standard Medicare Part A and Part B.
- You have to make two payments. Your monthly premium for your Medicare supplement plan is paid to the private insurance company, and your monthly standard Medicare premium is paid to the federal government.
- You have to remain single, even if you are married. Medicare supplement only covers one person per policy – there is no joint coverage. If you and your spouse both want Medicare supplement coverage, you will need to buy individual insurance plans.
- You can only buy a Medicare supplement policy from any insurance company that’s licensed in your state to sell plans. If you haven’t heard of the company trying to sell you Medicare supplement, do your research on their customer service record and verify they are eligible to sell in your state of residence.
- Your Medicare supplement plan is guaranteed renewable, even if health problems occur while you’re covered. Your insurance company cannot cancel your Medicare supplement policy as long as the monthly premium is up to date.
- A vital consideration for seniors – Medicare supplement plans do not include prescription drug coverage. You must enroll in Medicare Part D to obtain prescription drug assistance.
- Finally, if you have a Medicare Medical Savings Account plan, you cannot purchase a Medicare supplement plan. It’s not allowed.
What Medicare Supplement Policies Don’t Cover
Another important consideration for seniors is what Medicare supplement doesn’t cover. If you are in need of assistance to help pay for long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing, you will have to pay these expenses out of your own pocket.
There’s no reason to wait on purchasing a Medicare supplement health insurance plan.