People new to Medicare, especially those who are accustomed to medical insurance through an employer, may be disconcerted to learn the Original Medicare parameters for benefits and liability for out-of-pocket costs. However, be assured there are optional plans designed to supplement the Original Medicare program.
Medicare Supplement Options
Currently on the market are 10 supplemental plans. Though they are sold by private insurance companies, the plans must adhere to federal and state laws developed for your protection. Additionally, it is mandated that they be identified as Medicare Supplement Insurance. This insurance is also known as Medigap. Enrollment in Original Medicare Parts A and B is a prerequisite. The cost of supplemental insurance is in addition to the premium you pay Medicare for Part B. Prescription drug coverage is also available through a separate stand-alone Prescription Drug Plan.
The plans are labeled as A, B, C, D, F, G, K, L, M and N. Compare plans to find the coverage and costs that fit into your budget and meet your healthcare coverage needs. Stay up-to-date on changes to Medicare Supplement plans each year. For instance, Plan F covers the Part B deductible. That feature and those plans will not be available to newly eligible enrollees as of January 1, 2020.
Look across all supplemental plans to compare coverage for co-insurance and co-payments, hospice, skilled nursing facilities, Part A deductible and out-of-pocket limits. If you travel extensively, note that some of these plans cover emergency medical care outside the U.S. during international travel, which is not typically covered under Original Medicare with few exceptions.
Guaranteed Issue Right
In certain scenarios, insurance providers are required to furnish Medicare Supplement policies. This protection is known as a guaranteed issue right. In these cases, the company is required to sell the applicant a policy, cover all pre-existing conditions, and charge no more than they would charge someone without pre-existing or current health conditions.
When you turn 65 and are enrolled in Part B, you will have a 6-month initial enrollment period during which you’ll have a guaranteed issue right to purchase any Medicare Supplement plan sold in your state without being subject to medical underwriting. You cannot be charged more or turned down for a policy.
Determining Factors in Plan Selection
To identify the plan that meets your needs, scan the range of benefits across all plans, and do a personal cost/benefit analysis. Assign weightings to your priorities. For some retirees, it comes down to the affordability of premiums as well as a level of comfort with the benefits included.