Supplement Insurance

Supplement insurance is secondary insurance to your primary government insurance (Medicare Parts A and B) offered by private insurance companies. Medicare supplement insurance can be purchased all year it is not confined to Medicare open enrollment.

The guaranteed coverage period is the month of your 65th birthday and six months after. It is different from the Medicare Enrollment Period which is three months before your birth month and three months after. It is the period when you are guaranteed coverage from a private insurance company with no health questions.

There are a number of Medicare supplement plans A-N but the most important popular are:

Plan F: We call it the Cadillac of plans it usually is the most expensive and pays 20% of the Medicare approved medical charges (Medicare Part A and Part B pays 80% of approved medical charges), as well as the Part A and B deductibles. You may be refused coverage (usually due to health) except during your guaranteed periods. when you are 65 (the month of your birthday and six months after) and when you first leave your employer insurance when you are 65 and older. Plan F is the only plan guaranteed issue when you leave your employer insurance if you missed your guaranteed period when you were 65.

Plan G: We call it the BMW of plans it pays the same 20% as Plan F but does not pay the Part B deductible. You can be refused coverage except during your guaranteed period when you are first 65. It also pays 100% of “excess charges” read individual policies for what is covered.

Plan N: We call it the Kia of plans it is the same as Plan F except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that do not result in an inpatient admission. It does not pay the Part B deductible. You can be refused except during your guarantee period when you first turn 65.

HDF (high-deductible F): We call it the Pinto of plans (not in all states). You must pay for all Medicare approved costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,140 (2015) before you policy pays anything. After you meet your annual deductible the plan pays everything like Plan F.

Supplement insurance is sold by private insurance companies but regulated and standardized by Medicare, the states of Massachusetts, Minnesota and Wisconsin have different rules. Insurance companies can offer additional benefits such as cover medical expenses when you are traveling out of the country. It is important to read your policy because all Insurance plans have a lifetime plan limit.

If you have Medicare supplement insurance you probably will need a separate drug plan, Medicare Part D. You can only enroll in a Drug Plan (Medicare Part D) during open enrollment for Medicare October 15 thru December 7 except when you first go on Medicare (when you have guaranteed coverage).

If you would prefer to contact us, please call 469-270-7025.

Medicare Supplement Insurance

Medicare Supplement Insurance, also known as Medigap, is secondary insurance to your primary Medicare Parts A and B. Offered by private insurance companies, Medigap policies cover additional healthcare costs that Medicare does not, such as copayments, coinsurance, and deductibles. This coverage can be purchased year-round and is not confined to the Medicare open enrollment period. Understanding the benefits and options available under Medigap can help you make informed decisions about your healthcare needs and expenses.

Understanding the Guaranteed Coverage Period for Medicare Supplement Insurance

The guaranteed coverage period for Medigap insurance is the month of your 65th birthday and the six months following. This period differs from the Medicare Enrollment Period, which spans three months before and after your birth month. During this guaranteed period, you can obtain coverage from a private insurance company without answering health-related questions. This ensures that you can secure the necessary supplemental insurance without being denied due to pre-existing conditions.

Detailed Breakdown of Popular Medicare Supplement Plans: Plan F, Plan G, and Plan N

Medicare Supplement Plans come in various options labeled A-N, with Plan F, Plan G, and Plan N being the most popular:

Plan F: Known as the Cadillac of plans, it covers 20% of Medicare-approved medical charges and both Part A and Part B deductibles. It is usually the most expensive plan and is only guaranteed during specific periods.
Plan G: Similar to Plan F, but does not cover the Part B deductible. It covers 100% of excess charges.
Plan N: Offers similar benefits to Plan F but requires copayments for some services. It does not cover the Part B deductible.

High Deductible F Plan and Its Coverage: What You Need to Know

The High Deductible F (HDF) Plan, often referred to as the Pinto of plans, is available in some states. Under this plan, beneficiaries must pay all Medicare-approved costs, including coinsurance, copayments, and deductibles, up to an annual deductible amount ($2,140 in 2015). Once the deductible is met, the plan covers the same benefits as Plan F. This option can be more affordable in terms of premiums but requires careful consideration of out-of-pocket expenses.

Importance of Reading Your Policy: Additional Benefits and State Regulations

Medigap policies are regulated and standardized by Medicare but can offer additional benefits, such as covering medical expenses while traveling abroad. It is crucial to read your policy thoroughly to understand the specific benefits, coverage limits, and exclusions. Different states, including Massachusetts, Minnesota, and Wisconsin, have unique rules regarding Medigap policies. Being aware of these differences can help you choose the best plan for your needs and ensure you receive the maximum benefits.

Enrollment in Medicare Supplement Insurance: Key Points to Remember

Automatic Enrollment: Not applicable for Medigap; manual enrollment is required.
Guaranteed Period: The month of turning 65 and the six months after, and when leaving employer insurance after 65.
Coverage Denial: Outside the guaranteed period, coverage can be denied based on health.
Additional Plans: Separate drug plans (Medicare Part D) are needed to be enrollable during open enrollment (October 15 – December 7).
Contact Information: For more details, visit the website or call 469-270-7025.