Medicare Supplement, or Medigap insurance, fills in gaps in coverage left by Original Medicare, including deductibles, Coinsurance, and copays. In over 47 states, there are at least 10 different Medicare Supplement insurance plans recommended reading which are designated by the letters A – J (planned, authorized, or selected) for each state. Each state has different regulations for choosing a Medicare Supplement plan. Although all ten of the states offer Medicare Supplement plans, their rules for selecting plans vary.
Most of the states’ Medicare Supplement plans are sold by private insurance companies called “exchange carriers”. An “exchange carrier” is an entity that sells Medicare Supplement plans, subject to federal regulations. The “exchange carriers” sell the Medicare Supplement plan(s) to Medicare Advantage Plans and to private insurance companies that participate in the Medicare Shared Savings program. In addition to selling the Medicare Supplement plan(s), the private insurance companies that participate in the Medicare Shared Savings program must also offer coverage for “core Medicare” or “fee for service” hospitalization.
If you are over the age of 65, the government does not cover any of your out-of-pocket expenses for Medicare. Even if you have guaranteed issue rights to purchase a Medicare supplement policy, you may pay higher premiums than if you were younger. If you are enrolled in Medicare Parts A and B and have a Medicare Supplement Plan designation, you cannot enroll in Medicare Parts C or D if you are under the age of 65. “Genetic uncertainty” is a factor that also applies to enrollment in Medicare Parts A, B, and C.
Medicare Supplement plans are standardized and offer similar benefits to traditional Medicare. Unlike Medicare Advantage plans, you cannot buy more than one kind of Medicare supplement insurance policy. You can choose from two broad groups of plans – “Medigap Policy” and “Mixed Strategy Medicare Supplement Insurance”. A Medigap policy covers the same items as a Medicare Advantage policy, while a mixed strategy Medicare supplement insurance plan allows you to select the types of providers that participate in Medicare.
Premiums for a Medicare Supplement plan are based on your current age, sex, primary coverage type, current income, height and weight, and medical history. If you are pregnant, you will automatically be excluded from a Medigap policy. Pregnancy can also result in reduced breast size, which could increase your premium. You are allowed to enroll in a Medicare Supplement policy even if you are currently unemployed.
There are two other eligibility factors for choosing a Medicare Supplement plan called “Coinsurance Ratio and Enrollment Complexity”. The coinsurance ratio is the percent of overall premium that is dedicated to pay deductibles and coinsurance. The enrollment complexity refers to the number of different covered services and providers that Medicare pays. In order to receive Medicare supplement insurance coverage, you must meet both these criteria. Medicare’s eligibility requirements are the same as those of most private health insurance companies, and most people qualify for at least some of them. Some of the coverage options available to you include: Vision insurance, dental benefits, hearing aid coverage, prescription drug coverage, hospital costs coverage, and extended hospital stay benefits.