Chapter 4 – Medicare Supplement Insurance

Understanding Medicare Supplement Insurance

The costs associated with Medicare Parts A and B, such as copayments, coinsurance, deductibles, and out-of-pocket expenses for services that are not covered, can be quite expensive. This is why many people consider purchasing additional Medicare Supplement Insurance. 

Also Known as Medigap

Often called Medigap, Medicare Supplement Insurance is a policy sold by private insurance companies. A variety of plans are available to cover services that “Original Medicare” does not cover. Medigap policies typically do not have plan networks making it easier to use the provider of your choice, even when you are traveling. Keep in mind, Medicare Supplement Insurance policies only cover one person, so if you and your spouse both need a policy, you will each have to purchase one individually.   

Enrollment May Begin at Age 65

You must be enrolled in Medicare Parts A and B in order to purchase a Medicare Supplement policy. The Open Enrollment period for a Medicare Supplement policy begins when you are 65 or older. For example, if your 65th birthday is in July, and you just enrolled in Medicare Parts A and B, then your enrollment is open for six months – from July to December. 

What If I Don’t Retire Until After Age 65?

If you are covered at work, then you may not need Medicare Supplement Insurance. But let’s say you retire on your 67th birthday, which falls in August. Your Open Enrollment for Medicare Supplement Insurance would be from August to January, because enrollment is available for six months. In addition, you must be enrolled in Medicare Part A and Part B in order to purchase a Medicare Supplement policy. 

Eligibility & Cost for Supplement Insurance

Open Enrollment should allow you to get a Medicare Supplement Insurance policy without medical underwriting. Your monthly premium will be based on your age, gender, geographic location, and the plan you select. The premium may change annually. Along with the Supplement premium, you will also have your Part B premium. Your annual renewal is accepted regardless of any health issues as long as you pay the premium. However, if you have missed the six-month Open Enrollment period, you may have fewer options, and coverage may cost more.

How Does it Work?

If a provider of medical services accepts Medicare, they will also accept Medicare Supplement Insurance. Supplement policies generally do not have networks. With most policies, your Medicare Supplement Insurance company will pay the doctor directly. Some form of coverage for overseas emergencies is typically available as well. 

What Is Not Covered by Supplement Insurance? 

Medicare Supplement Insurance does not cover prescription drugs and generally does not cover long term care, private-aid nursing, vision services or dental services. It is common to combine a Medicare Supplement Insurance plan with a Medicare Prescription Drug Plan (PDP) in order to obtain prescription drug coverage.

You May Not Need Supplement Insurance

If you believe you will not need a Medicare Supplement Insurance plan because you are using another medical health benefit program, check with both Medicare and the other program provider just to be safe. For information on available Medicare Supplement Insurance policies, contact us at 888-509-8205.