Medicare Supplemental Insurance simply means a plan that will enable you to access cover beyond what Medicare offers. This means that you will not have to spend out-of-pocket in case of an ailment or condition that is not covered by the common Medicare plan. The package is provided by private companies that are approved by the government. They will cover your health needs including prescription drugs. Beyond medigap plans affecting your out-of-pocket expenses on health, you will feel an effect on your administrative convenience, the ability to select a doctor or health expert, quality of health services you receive and your benefits.
Categories of Medciare Supplemental Insurance
- Medigap– these are standardized packages offered by private insurance companies. They are clustered into twelve plans that run from A to L. They work alongside the services offered under Medicare. Though they are not connected to the common plan by the government officially, every insurer is required to provide similar cover. The only areas that differ from one insurance provider to the other is on monthly premium and customer services, among other aspects aimed at attracting clients.
- Medicare Advantage– this can be considered as a privatized version of Medicare. Instead of engaging Medicare systems directly, the insurance provider does it on your behalf. The plan covers the general provisions of Medicare which are parts A and B then extends to cover C or the Medigap package. There are restrictions on, for instance, the doctors and hospitals you can visit. This depends on the plan you enroll. The advantages of the Medicare Advantage Plan include a maximum Out-of-Pocket feature. It places a cap on the amount you can spend especially in case of a medical catastrophe.
When making a choice of the plan to enlist, consider the following points:
- The level of cover is standardized across all plans. To gain maximum advantage, always compare the prices. However, what appears cheap today might become expensive in the long run. Scrutinize the long term package of each plan before buying to avoid future financial burdens.
- Medigap plans have no ratings- unlike Medicare Advantage, Medigap operates uniformly across all cover providers. They all do not operate through a network of hospitals and doctors. They simply obtain your details from Medicare and automatically release your payments. However, while the federal government sets basic rules, states make additional demands with the aim of protecting consumers. You will pretty much get the same services across board.
- Future costs will be affected by your current premium- it is important to have a long term view of the cost of your plan. What might appear cheap today may end up being expensive in future. Premiums are set in three ways. Community-rated premium is where everyone pays a uniform amount regardless of age. This is considered the least expensive over time. The Issue Rated premium is based on you age at the point of purchasing the plan. While it never goes up essentially, it is affected by inflation. The Attained Age Rated premium is where you begin at the bottom and go up with age. This is considered the most expensive plan over time.
There are circumstances under which you can be denied Medigap cover or be charged more. The situations go beyond the Guaranteed Issue, which is the minimum requirement for insurers. People with existing conditions are most affected by the rule. People with disability also receive special consideration at federal and state levels.
Buying of Medigap Plans can be done directly from Healthcare.gov. Insurance companies also sell the plan directly to clients. The other option is to work with a local insurance agency or broker to choose a suitable plan.