Medicare Supplement Plans

What Are Medicare Supplement Plans?

Traditional Medicare (Part A and B) does not provide 100% coverage for medical expenses such as deductibles, co-payments, and co-insurance. Therefore Medicare Supplement Plans were designed to help pay the costs that Medicare does not cover. Medicare Supplement Plans are also referred to as Medigap.

Medicare Supplement Plans add additional health care insurance coverage provided by private insurance companies to cover the gaps in the traditional Medicare Plan. Medigap policies are regulated by Federal and State Laws in order to protect you as a consumer. Medigap policies have to be clearly labeled as Medicare Supplement Insurance, and the policies are standardized for each State.

Medicare pays the private insurance company a set amount of money for each person who enrolls in their plan. The insurance company then pays the medical bills for the enrollee. The enrollee is responsible for co-payments as described in each plan’s summary of benefits.

Am I Eligible For A Medicare Supplement Plan?

Medicare Supplement Plans only work in conjunction with Traditional Medicare.

Typically, you must have Medicare Part A and Part B in order to be eligible for a Supplement Plan.

Your application will be accepted if you are 65 or older and apply within six (6) months of your initial enrollment in Plan B of Medicare. Under certain circumstances pre-existing conditions might be waived.

As Medicare Supplement Plans only cover one person per policy you and your spouse must each buy separate policies.

Do I Have Medicare Part D Prescription Drug Coverage With A Medicare Supplement Plan?

If you have a Medicare Part D Prescription Drug Plan and a Medicare Supplement Plan that covers drugs, you need to tell your Medicare supplement insurance provider to remove the drug coverage from your policy.

You cannot have both Medicare Part D and Medicare Supplement plan drug coverage at the same time.

Attention: At times, Medicare Part D coverage is more beneficial than the Medicare Supplement plan drug coverage, so compare both carefully.

Can I keep my current Medicare Supplemental Insurance or switch to a different Medigap policy if I move out-of-state?

You can keep your current Medicare Supplemental Insurance Plan (Medigap policy) regardless of where you live as long as you are still in Original Medicare.

How Do I Cancel My Medicare Supplement Plan (Medigap Policy)?

If you decide to drop your entire Medicare Supplement Plan policy, you need to be careful about the timing. For example, you may want a completely different Medigap policy (not just your old one without the prescription drug coverage), or you might decide to switch to a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drugs.

You can join a Medicare Advantage Plan between November 15 through December 31 each year.

If you drop your entire Medicare Supplement Plan (Medigap policy) and the prescription drug coverage wasn’t creditable or you go more than 63 days before your new Medicare coverage begins, you will have to pay a late enrollment penalty.

Does Medicare Supplemental Work With A Medicare Advantage Plan?

No, you have to select one or the other. If you enroll in a Medicare Advantage Plan, your Medicare Supplement Plan coverage will not work.

You should (although legally you don’t have to) cancel your Supplemental policy if you choose to join a Medicare Advantage Plan.

What happens to my Medigap policy (Supplemental Insurance) if I join a Medicare Advantage Plan?

A Medicare Supplemental Insurance (Medigap policy) does not work with Medicare Advantage Plans. This means it won’t pay any deductibles, co-payments, or other cost-sharing under your Medicare Health Plan.

If you decide to keep your Medigap policy, you will have to pay your Medigap policy premium, but the Medigap policy won’t pay any deductibles, co-payments, or coinsurance under a Medicare Advantage Plan. So, if you want to join a Medicare Advantage Plan, you may want to drop your Medigap policy.

Attention: If you leave your Medicare Advantage Plan you might not be able to get the same Medicare Supplemental Insurance policy back you previously had, or in some cases, any Medicare Supplemental Insurance policy, should you later decide to switch back.

How Much Does Medicare Supplemental Insurance Cost?

Each plan’s basic and additional benefits are regulated by the State, so they are the same for every insurance company.

However, each provider can select which policies they want to sell and set their own prices, so Medicare supplemental insurance comparison is very important in order not to overpay!

What Is New For Medicare Suplemental Insurance Plans In 2010?

While Medicare Supplement plans have been standardized since 1992 and have seen few monumental changes since then, there will be significant changes for Medicare Supplemental Insurance Plans in 2010.

In June 2010 two new additional plans, Plan M and Plan N will be put into effect, and four currently existing plans, Plan E, H, I and J will be eliminated. Medicare Supplement plans M and N will have similar benefits to Medicare Supplemental Insurance plan D. The purpose of these changes is to reduce the cost of premiums and other associated expenses with an enrollment in Medigap policies.

In addition, all Medicare Supplement plans will be stripped of their Preventative Care benefit and At-Home-Recovery benefits. Medicare has deemed these two benefits unnecessary in the current Medicare structure. In addition to these changes, a Hospice Care benefit co-insurance coverage will be added to all new Medicare Supplemental Insurance policies.

Current Supplement policy holders are allowed to keep their existing Supplemental Insurance (Medigap) policies, however as of June 2010, enrollment will cease into all current plans. Existing Medigap policy holders will be partitioned into one group, and all plans purchased after June 2010 will be segregated into new policy groups.

All plans purchased after June 1st 2010 will be in the new plan policy design. Many Medicare Supplement providers will offer the new plans N and M.

If your plan is being eliminated, you really have no other option than to review and compare the new rules of different coverage options.

So no matter what Medigap policy you currently have, you are advised to review your plan carefully and decide whether to keep your it or switch to a new Supplemental Insurance Plan.

Medicare Expands Coverage For Tobacco-Related Counseling

The Hill: “The Obama administration on Wednesday expanded Medicare to cover more seniors hoping to kick their tobacco habits.” Previously, Medicare rules allowed the program to cover tobacco-related counseling only for beneficiaries who already suffered from a tobacco-related disease. “Under the new policy, Medicare will cover up to two tobacco-cessation counseling tries each year, including as many as four individual sessions per attempt. … If successful, the new tobacco policy could pay dividends. Of the 46 million Americans estimated to smoke, roughly 4.5 million are seniors older than 65, HHS says. And nearly 1 million more smokers are younger than 65, but eligible for Medicare benefits. … Tobacco-related diseases are estimated to cost Medicare roughly $800 billion between 1995 and 2015″ (Lillis, 8/25).

The (Lakeland, Fla.) Ledger: “The U.S. Department of Health and Human Services calls tobacco use the leading cause of preventable illness and death in the U.S. Centers for Disease Control and Prevention estimates tobacco use causes 1 of 5 deaths in the U.S. each year” (Adams, 8/25).

Continued here:
Medicare Expands Coverage For Tobacco-Related Counseling

Next Page »