Medicare Supplemental Insurance Plans

Medicare covers important services but comes with costs – premiums. deductibles. and copays. Medicare Supplemental Insurance Plans, also called Medigap, help pay for these costs. It is important to understand the charges and your options.

Consider the different ways that an insurance company can determine the premiums charged when selecting a Medicare supplement policy. They can use the Issue Age (age at which you were when the policy was issued), Attained Age (age you reached) or Non Age Rating to determine what amount you pay each month. Issue Age is your age when the policy was first issued. Attained age is how old you currently are. Non-Age rating is when you don’t pay a higher premium because of your age and the premium stays the same every year.

Medicare Advantage Plans are available as an alternative to Supplemental Health Care Plans. These are private health insurers that offer a full replacement of Original Medicare, and usually include Part D (prescription drug coverage). Medicare Advantage plans can offer additional benefits, such as fitness programs and vision, hearing, and dental coverage. Some plans even include extra benefits, such as transportation and in-home care services.

These extra benefits vary by region and plan. Some plans are able to offer these services as they are deemed “primarily health related” and can use rebate dollars to cover some of the costs. Others are limited to specific groups of beneficiaries, such as those diagnosed with certain chronic illnesses, or are available through a Special Needs Plan.

Plans B,C,F,G and N cover emergency healthcare for travelers outside the United States. In some cases they will cover up to 80% of medical costs, but you have a maximum amount that you can pay per year.

Medicare Advantage PPOs, unlike other Medicare Advantage Plans, allow you to visit providers in and outside of the network. Most of these plans have lower costs if you go to in-network doctors. Some plans have a preferred provider’s list, which lists the most affordable providers. If you choose to see doctors outside of the network, your plan will only pay a portion of their charges.

Many health insurers offer Medicare Advantage SNPs, some even offering multiple plans within the same county. Blue Cross Blue Shield is the leader, offering 18 plan choices in six counties. Humana, with its 14 options across five counties, offers the second-highest number of plan options. Other Medicare Advantage companies, such as CVS and Centene, offer up to 13 plans per county. Special Needs Plans target a particular group of beneficiaries. They can offer additional benefits that don’t necessarily relate to health. Some SNPs offer their enrollees bathroom safety devices or telemonitoring. These plans can be more expensive than Medicare Advantage plans but they are the best option for those with specific needs, which are not covered by other plans.

Additional Resources:

 

NAP

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