When you turn 65 and enroll in Medicare, you might think that your healthcare is all taken care of. However, while Medicare Parts A and B will cover a portion of your healthcare expenses, everything you need will not be covered. You’ll still need to pay out of pocket for a portion of your medical expenses, and some services, like vision and dental, aren’t covered by Medicare at all.
For that reason, many Medicare beneficiaries opt to purchase a Medicare supplement plan, also known as Medigap insurance. These policies literally “fill the gaps” in Medicare coverage, offering additional services and benefits for a monthly premium. Medigap plans ensure that you have access to the services you need without incurring significant costs.
And there are plenty of plan options – 12 to be exact.The Centers for Medicare and Medicaid Services (CMS) has determined what each policy type, distinguished by a letter name (Medicare Part D, for example), will cover, and all of the policies are identical regardless of carrier. So if you purchase a Part N plan from one insurer, the plan with another insurer will offer the same benefits and coverage, and the only difference may be the price. While that takes some of the guesswork out of choosing a policy, there are some other questions you need to ask before you choose a Medigap plan.
Question 1: What Are My HealthCare Needs?
Because each Medigap policy type is different, you can choose the plan that meets your healthcare needs now and in the future. Before making a decision, consider what type of services you use most regularly to ensure that they are covered. But keep in mind that the unexpected can happen, and should you become more seriously ill, you do not want to be left with inadequate coverage. Choose a policy that will take care of your needs both now and in the future.
Question 2: Which Providers Are in the Plan’s Network?
If you have been seeing the same doctor for many years, you’ll probably be disappointed if you purchase a new health insurance policy only to find that your doctor isn’t a part of the insurer’s network. Before signing up for any plan, confirm that the doctors and hospitals you use the most participate in the plan.
Question 3: What Benefits Are Included in the Policy?
The government is responsible for determining what each Medigap policy type includes. Some plans are basic, such as Medicare Part D, which only covers prescription drugs, while others are more comprehensive and pay for services not covered by Medicare, such as preventive care, while also taking on a portion of the Medicare co-pays and deductibles. Some specific plans offered by individual insurers also offer additional benefits that aren’t required by law, allowing you to choose the best plan for your needs.
Question 4: Does the Carrier Use Medical Underwriting to Determine the Cost of the Plan?
Again, the only difference between Medicare supplement policies from different insurers is the cost — and in some cases, that cost is determined by medical underwriting. In other words, your health status can influence how much you pay for a policy, and you may be eligible for discounts if you are healthy, do not smoke or fall within a certain age bracket. Keep in mind that if you purchase a Medigap policy during your open enrollment period (the six-month period that begins on the day that you are both 65 and enrolled in Medicare Part B), the company cannot use medical underwriting to determine your premiums, which might save you money.
Question 5:How Does the Premium Compare to Others?
The fact that each Medicare Supplement policy type is the same regardless of the carrier makes it somewhat easier to choose a plan — but be wary of basing your purchase decision on price alone. Sometimes the lowest-priced policy is not the best value. Compare the benefits and network, but also look at the plan’s rating within your state. CMS rates plans based on the quality of coverage, customer satisfaction, payment of claims and other factors, and you may be happier paying a slightly higher premium for a plan that offers better value and service than another.
Choosing a Medigap plan is a major decision and not one to be made lightly. But asking these questions and making an informed choice will help ensure that you have the coverage that you need and that you’re happy with it.
About the Author: Wiley Long is the President of Medigap Advisors. He writes extensively on ways to intelligently plan for your financial and health care future. If you are looking for a Medigap plan, review Medicare Supplement Plans at MediGap Advisors and find the plan that meets your needs.