Using Pennsylvania Medicare Supplement Insurance

It seems Medicare beneficiaries deal with more and more complicated issues on a daily basis.  There are hundreds of choices for plans which compliment basic Medicare coverage, and for those living in the state of Pennsylvania, several Pennsylvania Medicare supplement insurance choices are available.  Most beneficiaries already have a supplementary plan, but may not understand the proper use of these plans.

Most Pennsylvania Medicare supplement insurance plans work with your Medicare benefits to provide extra coverage for expenses.  The problem is, not all of these plans work the same way and not all plans will provide 100% coverage.  It is important that beneficiaries understand their coverage and which insurance plans are available to them before incurring medical expenses.  A full understanding of your Pennsylvania Medigap insurance coverage will help you avoid surprise expenses after visiting a doctor or obtaining medical supplies.

To learn about your plan, read through your policy materials, or call the customer service line for your Pennsylvania Medicare supplemental insurance plan.  Ask the following questions regarding the policy:

– Does the plan cover 100% of any copay after Medicare pays?  If it doesn’t, you will have to pay some of the expenses, so find out what it does cover.  A common set up is for the Pennsylvania Medigap plans to cover 80% of charges after Medicare.  So, if the charge was $100, Medicare might pay $80 and put $20 toward a copayment.  The supplemental insurance would pay %80 of the $20.  This means they pay $16 and you pay $4.  This doesn’t sound like much, but the expenses can mount quickly if you are not aware of them.

-Does the plan cover deductibles.  Medicare has an annual deductible of $110 for its Part B benefit.  This is the benefit that covers visits to the doctor, some supplies and other outpatient procedures.  If the plan does not cover deductibles, you will have to pay this amount each year before your insurance kicks in.

-Does the plan pay for items that are non-covered under Medicare’s Part B benefit?  Some services and supplies are not covered at all under Medicare.  A very good supplement insurance will also pick up some charges for these supplies, although the majority of these plans will only follow after what Medicare actually pays for.

-Does the plan offer a Pennsylvania Medicare Part D Coverage?  You should always know if you have a drug benefit associated with your insurance, because it can save you a great deal of money at the pharmacy!  Standard medical insurance policies hardly ever cover prescriptions, so ask about this benefit before purchasing insurance.

-What providers can you use under the plan?  Generally, most supplemental insurances will pay for services provided by any Medicare eligible provider.  However, there are some plans which operate under a managed care environment, and providers must contract with them.  Make sure your doctor is contracted with the plan, if that is the case.

Once you fully understand your Pennsylvania Medicare supplement insurance, you can avoid extra expenses and surprise bills.

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