This article is meant to provide information about Medicare Supplement plans known as Medigap. We will also discuss how Special Needs Plans(SNPs) provide the same quality healthcare as other Medicare Advantage plans at a reduced cost to you.
Medigap is a Medicare Supplement Plan Separate from Medicare Advantage
The term Medigap refers to Medicare Supplement Plans sold by private insurance companies. These Supplement Plans help to fill the coverage gaps left in Original Medicare. Over a third of all Medicare recipients are enrolled in a Medigap plan. The purpose of a Medigap plan is to help cover monthly premiums and out-of-pocket costs associated with Original Medicare. It is important to remember that Medigap is a Medicare Supplement Health Insurance and is not a Medicare Advantage Plan.
Medigap Supplements Original Medicare Parts A and B Coverage
Original Medicare covers hospital stays, emergency care, and other inpatient services under Medicare Part A. Visits to your doctor, surgeries, and other outpatient services are covered under Medicare Part B.
Medigap coverage comes in different forms. The ten plans offered are lettered A to N and offer varying coverage. Medigap plans help members pay for Medicare expenses such as copays, deductibles, and coinsurance. If you are considering Medicare supplement health insurance, it is a good idea to shop around. Monthly premiums range from $150 -$200 and the coverage received depends on the plan.
To be eligible for a Medigap policy you must have Medicare Part A and Part B benefits. With a Medigap plan, you will continue to pay the monthly Medicare Part B premium. Additionally, you will be required to cover a premium to the Medigap insurance provider. If you pay your premium, your Medigap policy is guaranteed renewable. This means that Medigap plans are automatically renewed each year. Assuming the premium is paid, your coverage is guaranteed year after year.
Medigap Supplement Plans do not cover prescription Medication costs. This is a major disadvantage over something like a special needs plan.
When Can someone sign up for Medigap coverage?
Those enrolling should do so during the 6-month Medigap Open Enrollment Period. This period will offer the best price and most options for plans. Individuals with preexisting conditions are guaranteed acceptance during this time. The Medigap Open Enrollment Period starts the first month you have Medicare Part B (Medical Insurance) and 65 or older. It can’t be changed or repeated. After this enrollment period, acceptance is no longer guaranteed, and you may be charged a much higher premium.
Most Medicare supplement plans do not offer nontraditional benefits
A study conducted by the CommonWealth Fund found that only 7% of Medigap plans offered nontraditional benefits. Millions of seniors are without dental, vision, or hearing coverage. In order for a senior to get dental or hearing coverage they must either be approved by a private insurer or enroll in a Medicare Advantage Plan.
Medicare Advantage Plans offer More Coverage
Nearly half of all Medicare members have enrolled in a Medicare Advantage Plan. Medicare advantage plans offer a similar experience to that of private insurance but at a lesser cost.
One of the main benefits of a Medicare Advantage Plan is that it includes prescription drug medication. Medicare Advantage plans also offer nontraditional benefits such as vision, hearing, and dental coverage.
Special Needs Plans
Medicare Advantage Special Needs Plans (SNPs) offer the best possible Medicare coverage for those who qualify. Seniors eligible for both Medicare and Medicaid can enroll in a special needs plan at any time. Unlike standard Medicare Advantage plans, an eligible individual does not have to wait to enroll. There are several groups that are eligible for a special needs plan. These groups include individuals living in nursing homes, home nursing care recipients, and those with specific or disabling conditions.
Open enrollment for eligible individuals
Most Medicare Advantage plans have a limited enrollment period. A Special Needs Plan allows eligible individuals to enroll in Medicare Advantage any time of year. There are many instances in which a senior or disabled person would be eligible for a Special Needs Plan.
Offer the best Prescription Drug Coverage
Special Needs Plan members benefit from having the best possible Medicare drug benefits. These benefits cover brand name and generic drugs. Members of SNPs avoid the Prescription Drug Coverage gap known as the “donut hole.” This coverage gap affects Medicare Advantage Members once they and their provider have spent a combined $4660 on covered Drugs.
Original Medicare coverage can be supplemented with Medigap and optional Part D coverage or with Medicare Advantage. We have found through our years of caring for Medicare patients that Medicare Advantage has certain benefits that are very helpful to them. Medicare Advantage plans offer high quality insurance at a reduced price. We look forward to seeing you again soon and are here to help with any questions you may have.