Medicare Supplemental Insurance or Medigap insurance?
What Is It and Is It Right For You?First, the terms “Medicare Supplemental Insurance” and “Medigap Insurance” are essentially the same thing. The insurance industry typically uses “Supplement,” and the government typically uses “Medigap.” But what are they? They are insurance plans that you can purchase to cover the expenses that Medicare Parts A & B do not. Medicare is your primary payor with the plan being secondary. Medicare covers many expenses, but not all. Because you are responsible for these “gaps” in coverage, the plans can be referred to as gap coverage. If you only have Medicare Parts A & B, these are the costs you would be responsible for (based on 2020):
- Part A Hospital Deductible of $1,556 per benefit period (days 1-60);
- Part A Hospitalization costs (days 61-90) of $389 per day;
- Part A Hospitalization costs (days 91 – 150) of $778 per day;
- Part B Annual Deductible of $233 per year; then 20% of the Medicare-approved amount for most outpatient services and medical supplies, with no cap on your potential expenses…;
- The cost of the first 3 pints of blood;
- Skilled Nursing Facility Care (rehab unit) $194.50 per day (days 21-100) and 100% of cost beyond day 100.
Purchasing Medicare Supplemental InsuranceTo cover some or all of these expenses, you can buy Medicare supplemental insurance coverage from private insurance companies. There are 11 different standardized plans, labeled A – D, F, high-deductible F&G, and K – N. Plans C & F are also available as Select plans. Plans C & F cover 100% the expenses that Medicare doesn’t, as long as they are Medicare-covered services (Now only avaliable for those with Part A. Effective dates prior to Jan 1,2020). The other plans offer different levels of coverage and usually satisfy everyone’s needs and budget. They allow you to see any doctor or hospital as long as they are set up in the Medicare system. Select plans C & F require you to use a hospital from the “select” list for non-emergency services. People like them because they are easy to use with virtually no paperwork. Also, they typically move with you if you are thinking of retiring in a different area. Even though Medicare typically doesn’t cover you outside the country, some plans will include a foreign travel emergency benefit. These plans are sold year-round, but some restrictions may apply. Medicare requires the insurance companies to accept you with no underwriting within six months of your 65th birthday. Because outpatient prescription drug coverage is not covered by a Medicare supplemental insurance plan, you will want to purchase a plan separately. Some people may be eligible for drug coverage through the VA.
Which is better: Medicare Supplemental Plan or Medicare Advantage Plan?
Different strokes for different folks.A Medicare Supplemental Insurance Plan can offer for ease of use because there are no network limitations other than verifying the doctor/facility are participating in Medicare, and you can use it in any of the 50 states without checking in with the plan. But all plans do have a monthly premium starting as low as $46/month and going up from there to about $250 or more. (Costs vary to plan, age, area, health & tobacco status) A Medicare Advantage Plan can be great for someone that doesn’t use many medical services as you only pay for the services you receive. Many plans can be had for as little as $0 monthly premium. However, all plans (with the exception of PFFS plans which are not very popular anymore) have networks, so to get the lowest costs, you will want to use in-network doctors/facilities. HMO’s always require you to use in-network providers, except in the case of a life-threatening medical emergency. Also, many services require prior authorization, and many HMO’s require referrals to see specialty doctors. But, they do come with extra benefits you don’t get from Medicare or a Supplement, like fitness club memberships, vision, hearing, etc. The good news is that you can try an Advantage plan for a one-year trial and if you don’t like it, Medicare will allow you to enroll in, or back into, a Medicare Supplement plan anytime during the one-year period – no questions asked. But it must be your first time on an Advantage plan, and there may be exceptions to this.
Contact Us For Your Medicare Advantage Insurance NeedsOur customer service doesn’t stop when your policy arrives in the mail. We’re there for you year after year because as your needs change, so too should your Medicare Supplemental Insurance Plans. We have met so many wonderful people in this community, and we look forward to meeting with you. Contact us today by completing our easy online request form. Give us the opportunity to work for you. You’ll be glad you did!
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18:35 01 Dec 21
I contacted Kathy Thousand today by email. She responded immediately and was able to schedule an appointment for me in a few days. I am so grateful for her.
16:42 08 Oct 21
I recommend anyone that has any questions about Medicare insurance to let Kathy and her team guide you through this process. There is nothing like sitting and talking to someone in person, who can answer all your questions. I also know that if I need help or have any questions in the future, I can always call her! Thank you so much for your help!
22:41 09 Apr 21
01:19 29 Mar 21
Kathy and her team did a awesome job helping my husband and I out picking our Medicare supplements. Kathy is very knowledgeable about what insurance is a good "fit" for your circumstances. I highly recommend this office for any of your insurance needs.
19:18 09 Mar 21
My husband and I were referred to Kathy Thousand by a neighbor while being inundated with emails and mail from everywhere. We promptly made an appointment and were extremely pleased with her thorough knowledge as we were having a hard time on our own.I highly recommend Insurance Options and especially Kathy who made for an easy transition in the retirement phase of our lives.Roland & Elaine Figueredo
21:56 02 Nov 20
Kathy was fantastic! She answered all our questions and helped us navigate a real mess with great ease. She overcame obstacles that we couldn't deal with and we now have a great Medicare plan!
15:47 23 Oct 20
Kathy is professional, thorough and personable, too. A delight to work with to take care of my needs. Highly recommended!
20:21 20 Oct 20
I spent almost 2 hours with Kathy Thousand reviewing all of the supplemental insurance plans that fit me. Well worth the time!! I just recently retired and started my Social Security. She was very thorough and answered all of my questions. She is very good at what she does. I would recommend her to my family and friends.
19:45 05 Aug 20
All of my questions were answered with patience and professionalism, my needs and requests were addressed too. The office was clean and welcoming with protection for the Covid 19. I look forward to continue doing business there.
15:33 10 Jul 20
12:47 01 May 20
20 years ago the Thousand's wrote our health insurance plan which I have kept all these years. I can't believe the time has come for a new chapter, Medicare! Once again I feel confident that Kathy has done a wonderful job of finding the coverage's right for this phase of our insurance needs as well. Thank you for easing my apprehension regarding these insurance changes as well!
18:35 30 May 19
15:37 28 Nov 18
Complex...made very simple. Kathy Thousand was/is the best in her advice regarding Medicare Supplemental plans. Normally, choosing a plan is very complex and confusing...in her case Kathy explained in simple terms what care is best for me.I would give her 10 stars if that was possible!
15:00 25 Sep 18
11:09 23 May 18
Thanks Kathy for all of your help and guidance. I was defiantly going in the wrong direction. I guess everyones situation is different. It pays to see a pro.😲
20:38 21 May 18
Kathy was great, very helpful and took the time to educate me on Medicare supplements. I highly recommended mm no here.
16:42 09 May 18
20:06 04 May 18
I can’t say enough about the assistance with Kathy Thousands from Insurance Options, Inc. My husband and I are newcomers to Florida and MEDICARE. Kathy took as much time as we needed to make a choice for which Medicare supplement to take. She is a wealth of knowledge and information about all insurance options. Several weeks later, after we make our choice, we had more questions and again, she took her time and reviewed our program to ensure we were comfortable with our supplement choice. If you need any guidance with Medicare supplements or other insurance, please give her a call.....you won’t regret it.Five Star company, and Customer Service.....
16:00 24 Apr 18