If you are receiving Social Security or Railroad Retirement benefits and have reached the age of 65, you’ll find that you are automatically enrolled in Medicare Parts A and B. The primary focus of Part A is to cover inpatient hospitalization and services like those in a skilled nursing facility (SNF). It also includes nursing home care in a SNF that is short term.
Medicare Part B covers doctor’s services, lab tests, durable medical equipment and outpatient care. Part B does not include routine vision, hearing and dental services nor does it provide coverage for prescriptions you pick up yourself. Because of gaps in coverage and the Medicare co-pays, co-insurance and deductibles, insurance companies are allowed to sell Medigap plans that are each tailored to different needs and offer varying coverage.
How Medicare Supplement Plans Work
Basically, medicare supplements work in the following way. Let’s say you go visit your doctor. Your physician provides medical services to you and then bills Medicare for the services rendered. If there is an excess (unpaid) amount and you have a Medicare supplement then Medicare sends the excess amount over to your Medigap supplement and they pay according to the terms of your plan.
The Medicare supplement plans are identified by different letters, ranging from A to N. You will see different offerings such as Plan A, Plan B, Plan G and so forth. In general, except in a few states, what’s covered under each plan is the same no matter which insurer is offering it. For these plans, the difference may be the premium for the coverage.
Important Features with Traditional Medicare and Medicare Supplements
When you have coverage from traditional Medicare and one or more of the Medicare Supplements you have the freedom to select your own hospitals and doctors. You can go to any provider that accepts Medicare. Unlike HMO-style plans, you do not need a referral to visit a specialist. Your out-of-pocket fees and expense are predictable and you are covered across the entire United States.
One of the big benefits is that you will have guaranteed renewability. Your insurance company is not allowed to change your coverage or drop you from coverage because of a health issue. It’s important to note that regular Medicare and the supplements do not cover medications so you’ll want to buy Medicare Part D to cover your prescription needs.
Looking at Different Medicare Supplement Plans
There are 10 different Medicare Supplement Plans: A, B, C, D, F, G, K, L. M and N. The best way to look through what each supplement has to offer is to find one of the great Medigap policy charts online. These provide a detailed grid, in table form, that clearly shows the level of coverage for each major type of service.
One of the things to note is the recent changes to Plan F and Plan C. Because of its full coverage, Plan F has been the most popular plan over the recent years. Effective in January 2020, though, Plans C and F are no longer available to new Medicare enrollees.
If you want to have peace of mind, it’s a good idea to purchase a Medicare supplement that provides coverage for Medicare co-pays, co-insurance and deductibles. If you want advice of which plans are right for you, talk to a top-notch local firm that sells Medicare Supplements.