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As you approach age 65, navigating Medicare and all of its parts and plans may sound daunting, but it can be easier than you think. Original Medicare contains two parts: Part A and Part B. Medicare Part A covers hospital care, skilled nursing facility and hospice fees, and is usually premium-free. Medicare Part B covers medical and preventive services, as well as some medical equipment, for which there is a monthly premium (typically deducted from your Social Security payments).
In addition to Original Medicare, many people choose to purchase a Medicare Supplement plan to cover services like routine hearing, eye exams and other costs not covered by Parts A and B. Here’s what you need to know about Medicare Supplement plans.
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Compare And Find The Best Medicare Supplement Insurance Plan
Medicare Supplement plans are sometimes called Medigap plans because they help fill the coverage gaps left by Medicare Part A and Medicare Part B. You must enroll in Original Medicare Parts A and B to purchase a Medicare supplement insurance plan. Most Medigap plans cover some or all of the 20% not covered by Parts A and B.
Private insurance companies sell Medicare Supplement plans. Each plan is required by the Centers for Medicare and Medicaid Services (CMS) to provide the same benefit coverage nationally, but premiums can vary from provider to provider. All policies are meant for individual coverage only, so if you and your spouse need a Medicare Supplement Plan, you must each purchase one separately.
Medigap plans cover all or some of the following costs, with a few exceptions:
Medicare Supplement plans don’t typically cover the following services:
Currently, there are 10 standardized Medicare Supplement plans with letter names A through N offered by private insurance companies. Visit insurance company websites to review their Medigap plan offerings.
The costs of Medicare Supplement plans vary by state and by insurance company. The main factors that determine cost are your location and age. Keep in mind that a policy that looks less expensive at age 65 could become the most costly at age 85, so ask the insurance company how they set their premium pricing.
Policy prices are determined in three ways:
Not all companies offer all Medigap plans. Rates may vary depending on the company, and some plans may be provided with a high-deductible option.
People ages 65 and older who have already enrolled in Medicare Part B are eligible to purchase a Medicare Supplement (Medigap) plan. In some cases, Medigap plans may be available to customers under the age of 65 if they have qualifying disabilities.
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Need Help Finding The Medicare Supplement Insurance Options That Work Best For You?
“Anyone concerned about the out-of-pocket costs of Medicare alone should consider the purchase of a Medicare Supplement plan,” says Brandy Corujo, partner and co-owner of Cornerstone Insurance Group in Seattle. “Medicare has cost-sharing in the form of deductibles and coinsurance. For example, there is a 20% coinsurance for all Medicare-approved services with no limit to out-of-pocket exposure.”
Consider the following when purchasing a Medicare Supplement plan.
The best time to apply for a Medicare Supplement plan is during your six-month open enrollment period. Open enrollment begins during the first month you’re 65 and enrolled in Medicare Part B. After this one-time open enrollment, you may not be able to purchase a Medigap plan or you might pay a lot more.
If you or your spouse already have group health care coverage and aren’t ready to enroll in Part B, you can apply for Part B without penalty during a Special Enrollment Period after your Initial Enrollment Period has ended. Call the Centers for Medicare & Medicaid Services (CMS) for details if you think you may be eligible.
There are a few steps involved when applying for a Medicare supplement plan.
Decide which benefits you want, and then examine Medigap Plans A through N to see which one(s) meet your needs. Consider your current and future health status—and keep in mind your family’s health history, as it may be difficult to switch plans later.
Research which insurance companies in your state sell Medicare Supplement plans and which ones offer the plan(s) you want. Visit Medicare.gov to search by ZIP code to find companies in your area.
Contact that insurance company to request a quote and purchase your Medicare Supplement plan. “An agent can assist the process, or a client can deal directly with the carrier. You can typically complete an application via phone, online or on paper,” says Corujo.
Medicare Supplement open enrollment begins the first month you’re insured by Medicare Part B and at least 65 years old. In some cases, younger people may qualify if they have certain disabilities. This open enrollment period lasts six months, during which you may purchase any Medicare Supplement plan available in your state. After this initial Medicare Supplement open enrollment period ends, you may not be able to purchase a Medicare Supplement plan, and if you are, it may be more expensive based on your health status.
Medicare Advantage is a type of private insurance that provides additional coverage to Medicare Part A and Part B, including vision, hearing and dental coverage. Most Medicare Advantage plans offer prescription drug coverage (Part D) as well.
Medicare Supplement plans, also known as Medigap plans, can be purchased to fill specific gaps in Original Medicare coverage. These plans typically do not cover long-term care, vision, dental, hearing aids, private duty nursing and eyeglasses. They’re sold by private insurance companies but are regulated to provide the same standard benefits across providers. They cannot be used to pay copays, deductibles or premiums associated with Medicare Advantage plans.
Medicare Supplement plans are regulated by the federal government and your state’s federal insurance department.
Medicare Supplement open enrollment begins the first month you’re covered by Medicare Part B and 65 years old. This initial enrollment period lasts six months.
Medicare Supplement plans should renew automatically so long as you pay your monthly premium.
