Posts Tagged ‘medigap plans’

Medicare Supplement Insurance

Friday, February 24th, 2012

Medicare supplement insurance, also known as Medigap insurance, is insurance coverage designed to fill in the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover, like copayments, coinsurance, and deductibles. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay its share of covered health care costs. Medigap insurance is different from Medicare Advantage because it only supplements the Original Medicare Plan. If you opted for a Medicare Advantage health plan, you cannot also buy a Medigap policy. Although you do have out-of-pocket expenses with Medicare Advantage, they are typically not as great as with Original Medicare.

Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium ($96.40 in 2011 for most beneficiaries). In addition, you will have to pay a premium to the Medigap insurance company. As long as you pay your premium, your Medigap policy is guaranteed renewable. This means it is automatically renewed each year. Your coverage will continue year after year as long as you pay your premium.

Insurance companies can only sell you a “standardized” Medigap policy. Eleven standard Medigap policies are available in most states. Each lettered plan — A through G and K through N — offers a different set of benefits, filling different gaps in Medicare Parts A and B coverage. All Medigap plans with the same letter provide the same benefits. Only the premiums and the sponsors of the plans vary. Insurance companies that sell Medigap policies don’t have to offer every Medigap plan. However, they must offer Medigap Plan A if they offer any other Medigap policy.

It’s important to compare Medigap policies, because costs can vary. The standardized Medigap policies that insurance companies offer must provide the same benefits. Generally, the only difference between Medigap policies sold by different insurance companies is the cost.

You and your spouse must buy separate Medigap policies. Your Medigap policy won’t cover any health care costs for your spouse.

Generally, standard Medigap policies cover some or all of the cost of:

  • Your Part A deductible and coinsurance (i.e. the 20% that Medicare doesn’t cover) for hospital stays
  • Your portion of your doctor’s bills for Part B services
  • The first three pints of blood annually, if needed
  • Hospice care coinsurance

Medigap plans do not cover:

  • Long-term care to help you bathe, dress, eat or use the bathroom
  • Vision care, eyeglasses, hearing aids or dental care
  • Private-duty nursing
  • Prescription drugs, or any out-of-pocket costs for Part D plans

(AARP Medigap: Your Supplemental Insurance)

 

Sources used:

  1. http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/medicare-benefits-overview.aspx
  2. http://www.medicare.org/
  3. http://www.aarp.org/health/medicare-insurance/
  4. http://www.kff.org/medicare/
  5. http://www.aarp.org/health/medicare-insurance/info-01-2011/understanding_medicare_medigap.html

Using Pennsylvania Medicare Supplement Insurance

Monday, September 19th, 2011

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.

Pennsylvania Medicare Supplement Insurance

Monday, September 12th, 2011

If you are lucky, you have not found yourself in need of assistance only to learn that the type of coverage you thought you had is non-existent. These things happen, and in a larger number than many of us imagine. Pennsylvania Medicare supplement insurance helps in such cases. The problem is misinformation about insurance quotes, which may or may not be a result of negligence by the insurance companies. However, playing the blame game on the thousands of elderly folk out there without proper cover in these times of information overload does not help at all.

Many of us find ourselves tied up in the wrong coverage plan or find that our particular needs are not catered to. At such times, we will want to modify or upgrade our package, but not everyone knows how to go about it.

Supplemental insurance works by giving you full Pennsylvania coverage, which is affordable. Outpatient and hospitalization insurance has a lot of gaps and this necessitates the use of Pennsylvania Medicare supplement insurance plans, which work by filling all the gaps in the 10 insurance plans offered in Pennsylvania. For instance, the Pennsylvania Medicare part D coverage covers high risk areas which are excluded by Medicare. The fact is, Medicare coverage offers less expensive coverage when compared to other covers like Pennsylvania Medigap plans, but in the end, you will find a lot of gaps in the coverage and will probably need to do away with it all together. All of this can be avoided if you purchase Pennsylvania coverage.

Cheap is not the best way to go when it comes to insurance and this is what a lot of people are beginning to learn after going through unnecessary trauma. Comprehensive Pennsylvania Medigap insurance coverage, which reflects your needs is available for you should you need it. There are complexities in insurance coverage generally, but Pennsylvania Medicare supplemental insurance is standardized, so the quotes in any particular plan will be the same. For instance, if we purchase a coverage plan D from one insurance company and purchase the same D plan from a different company, the details in coverage will be the same.

Depending on your particular coverage and income, you may wish to reduce your premium by omitting any coverage, which is unnecessary for you; this is what a lot of people do with Medicare Supplemental Plan D. They do not need the part B Deductible coverage so they do away with it. It is a good way to cut down on your premium.   

A few packages like the Medigap Plan F are rather comprehensive compared to the rest of the packages and they attempt to secure the needs of the individual to the maximum. You will notice this when looking at most of the angles in their health care. Pennsylvania Medicare supplement insurance makes coverage more comprehensive by covering many gaps in the middle. I would advise a thorough review of all the packages and quotes before purchasing coverage. If you are going to buy Medicare, make sure you know exactly what you are covered for. Pennsylvania Medicare supplemental insurance should be checked out.

Compare Medicare Supplement Plans

Saturday, June 12th, 2010

Medicare has really been of benefit to many individuals who need insurance coverage but were unable to afford it. It is run by the federal government and it covers individuals who have reached 65 years of age or individuals of any age who have end-stage renal failure. Even with this insurance, it can be difficult for you to afford the additional costs that may come up as a result of your regular doctor’s visits and hospital stays. These often come as a result of annual deductibles that need to be met, along with copayments that are attached to the Medicare policy. Some type of supplementary insurance policy may be necessary and you can compare Medicare supplement plans rather easily.

Medicare supplement plans are available in something that is known as Medigap. It is rather aptly named, as it helps to cover the gap that was left by the extra expenses through the Medicare policy. These supplementary programs are available through independent insurance agencies and they are not available through the federal government. That is why it may be necessary for you to do a little bit of comparison shopping in order to save money. What is not going to be necessary, however, is for you to compare policies because of differences that exist from agent to agent.

The reason why this is the case, is because the Medigap policies are standardized so you’re going to receive the same coverage, regardless of which insurance company you happened to go with. These policies are regulated by the states, so there is no variation at all. The reason why you would compare Medicare supplement plans, however, is because you have several to select from. Each of these plans is going to provide you with various types of coverage and it may benefit you to choose one over top of another.

Another reason why you might want to compare Medicare supplement plans is because of the fact that each individual in your family is going to have to have their own policy. If you and your spouse are both covered under Medicare part A and part B, you are still going to need your own Medigap policy. Although this may seem a little bit inconvenient, it can actually benefit you in many ways. One of the main reasons why this is the case is because you may need different coverages for your policy than what your spouse needs.

Demystifying the Popularity of Medigap Plan F

Thursday, May 13th, 2010

Over the years, the most popular Medicare supplement plans, better known as Medigap plans, have been Medigap Plan F and Medigap Plan J.  But with a new structure due to take effect on June 1, 2010, Medigap J will be eliminated (with three other plans) due to redundancy, leaving Medigap Plan F as the most popular choice if you’re turning 65 and planning to get supplemental medical coverage.  Plan F is also very popular with insurance vendors, and it is oftentimes the first plan (together with the soon-to-be-defunct Plan J) that they offer would-be customers.  But is it really worth all the extra money?  Is Medigap Plan F overrated, as some analysts believe?  It wouldn’t take long to analyze that Medigap Plan F isn’t all that it is cracked up to be.  Yes, it may be more complete than other Medigap plans, but in the long run, may not be necessary for a would-be insurance subscriber.

Compared to other Medigap plans, Plan F is considerably more expensive, oftentimes priced at about $20 to $30 more per month.  Those wanting to save money may settle on a Medigap Plan D or Plan G, and could stand to save quite a lot on a yearly basis.  That means you can save as much as $360, or even $400 yearly if you go onto one of the lower-tier Medigap plans!  Even with the $135 per year Medicare Part B deductible that is not covered in lower-tier plans, that’s still a lot of savings, comfortably in the $200 to $250 price range most of the time.  Remember, do not think of the roughly $20 per month – that really would not sound like much.  Think of the yearly savings and what you can use with the money you save by choosing a lower-tier Medigap plan.

A lot of consumers choose Medigap Plan F because it helps protect them in case doctors do not accept Medicare assignment.  Medicare assignment is the amount of money Medicare pays for certain medical procedures and services, resulting in what we call Part B excess charges.  However, take note that in most cases, doctors are more than happy to accept assignment, so would it really be worth it paying a higher monthly rate for this additional security that may not be needed after all?

Would-be Medigap Plan F subscribers need to weigh all factors before splurging on this particular supplement.  It may be what most seniors are going for these days, and it may be a tried-and-tested plan that a lot of subscribers had gone for in the past, but maybe it’s time to give some of the lower-tier plans a chance, and time to save some much-needed money on insurance.   Do not get us wrong, Medigap Plan F is a good plan, but those wanting to spend as little as possible and still get a lot of coverage can consider other options.

Introducing Medigap Plans M and N

Wednesday, May 12th, 2010

Since 1992, Medicare Supplement plans, better known as Medigap, have offered pretty much the same coverage, with the same letter code from A to L.  But new laws have led to new standards, and effective June 1, 2010, two new Medigap plans shall be making their debut in the insurance market.  Here we see how these particular Medigap plans work, how Medigap Plan M and Medigap Plan N differ, and in general, what’s in it for you should you be wanting to enroll to either plan once effective.

Before going into further detail on the plans itself, we might as well discuss what this means to new subscribers or existing subscribers.  New subscribers, preferably those who had just recently turned 65 as of June 1, 2010, would be saving money compared to current Medigap plans.  Existing subscribers, particularly those who used to be on the Medicare Advantage program, may not be saving that much, but would nonetheless be able to save some money as Medicare Advantage premiums are expected to go up once the upcoming changes take effect. 

Medigap Plan M is notable for its cost-sharing feature, which would certainly help reduce your monthly premiums.  With the lower monthly premiums in place, those subscribed to Medigap Plan M would split the Medicare Part A deductible of $1068 (as of last year) with the insurance company at an even 50-50.  While the Medicare Part B deductible is not covered at all in Plan M, Medigap Plan M would eliminate doctor’s office co-pays after you meet the required Part B deductible.  Most current Medigap subscribers are under Plan F, and many believe Plan M would allow consumers to save around 15% by choosing this particular plan.

Like Plan M, Medigap Plan N also utilizes cost-sharing, but unlike Plan M, Medigap Plan N is more geared towards using co-pays to reduce premium costs.  The co-pay system set to take effect with Medigap Plan N is as follows –  $20 for doctor’s visits and $50 for emergency room visits.  Just like Medigap Plan M, meeting the required Medicare Part B deductible is a prerequisite.  It is only then when the co-pay system would take effect.  Again, this spells a projected saving when compared to the usual Medigap Plan F currently on the market.

After analyzing both plans, there are definitely some very distinct and useful advantages if you’re considering either Medigap Plan M or Medigap Plan N.  While these plans may have been introduced at the “expense” of a few existing plans, the bottom line is not just savings and added coverage, but also simplicity, having less Medigap plans to choose from come the 1st of June.  But whether you’re on an existing Medicare Supplement plan, about to go on one of these plans, or currently on Medicare Advantage, Medigap Plans M and N are both very worthy options to consider when the time comes around.

Medigap Plans – A Nice Way To Stay Secured During The Golden Years

Monday, May 10th, 2010

When one turns 65 years of age and/or retires from work, the first thing to consider is an insurance plan.  Most retired consumers would go with the Medicare Original policy, and it is indeed a good decision, considering potential illnesses and physical concerns that one may encounter once retired.  Most major illnesses are covered by the Medicare Original policy, but what is one to do when a certain type of illness is not covered, or a certain amount of money is required but not covered by Medicare Original?  That’s where Medigap plans come in.  If you’re wanting to save more money and fill in the gaps, it would be a good idea to consider Medigap plans, as they help fill in the gaps, as implied.  If you have taken advantage of Medicare Original and are wanting more, Medigap plans are sure to provide not only ways to save money, but also additional coverage that would bring things closer to the plan you really desire.

Medigap plans come in twelve different varieties, ranging from A to L, with different levels of coverage to suit your needs.  New laws have been passed, though, and certain Medigap plans (E, H, I and J) are set to be phased out as the current structure makes said plans redundant.  Two new plans (M and N) are set to take effect on June 1, 2010, which is also when E, H, I and J are to be phased out.  It is always prudent to consult with a Medigap plan advisor before requesting for a plan, so you can take advantage of the proper level of coverage.  Lists of Medigap plan advisors are accessible on the Internet, or you can also go to websites like http://www.medicaresupplementplans.com for the latest and most updated information.

Since Medigap plans are required to follow Federal and State laws, there will naturally be limitations to what you can and cannot take advantage of.  And for those who are married, spouse’s Medigap plans would need to be purchased separately.  Such limitations are understandable, as there is no such thing as a perfect insurance plan, and these laws have been created with the best consumer interests in mind.

There is no doubt about it, insurance is very important for those “Golden Years”, the years spent relaxing after a long career in the industry, and the years enjoying one’s retirement.  Emergencies are naturally almost impossible to predict, but having a good insurance plan alleviates a lot of concerns along the way.  But having a Medigap plan present is sure to, at the very least, help you save more money in the long run, or take advantage of benefits not otherwise covered in a standard Medicare policy.

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