Why Do I Have To Pay For A Medicare Supplemental?

Enrollment into the federal Medicare program alone does not provide the comprehensive health coverages that senior Americans may require or in many cases—mistakenly believe they have. Original Medicare by itself, even with the elective Part B and Part D prescription coverage, does not exempt beneficiaries from having to pay for deductibles, copayments, or coinsurance for medical services and supplies. For Medicare recipients without additional coverages offered through a Medicare Advantage plan, union, employer or military/veterans’ benefits, purchasing a medicare supplemental plan can help to widen the Medicare safety net.

The Nuts and Bolts Of A Medicare Supplemental Plan

A medicare supplemental plan, also known as a “medigap” policy, can fill or offset some of the gaps left by Original Medicare which excludes costs like deductibles and copayments. Medicare supplemental plans are sold by private, third-party insurance companies but are still regulated by state and federal laws. For example, all supplemental policies and their marketed materials must be plainly identified as “Medicare Supplement Insurance.” In most states, supplemental plans are standardized under a “letter” plan typically from A-L. (The exceptions are Wisconsin, Massachusetts, and Minnesota where supplemental plans are standardized differently.) All medigap policies will extend the same core benefits or can offer identical benefits with the only difference being the deductible. In addition to supplementing costs on existing Medicare services, medigap plans can provide extra benefits such as foreign travel medical coverage, at-home nursing and recovery, preventive medical services, and door-to-door transit.

Major Considerations When Choosing A Medicare Supplemental Plan

Competing medicare supplemental policies can be evaluated by comparing the range of benefits being tendered in addition to the standardized core benefits. However, medicare supplemental plans with the same exact coverages can (and often do) have varying and greatly different premiums depending on the insurance company. Some policies augment premiums with increasing age as well so shopping around is imperative. Make sure that a medigap insurance company can justify any higher costs through reputable customer service, quick claims processing, or other tangible benefits. Medicare supplemental plan owners should also be aware that spouses are not covered by the medigap policy and that the ideal time to purchase a supplemental plan is within the six-month window of first enrolling for Medicare and Part B.

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