Medicare Supplement Insurance

Is a Medicare Supplement Insurance Plan better than a Medicare Advantage Plan?

Hard to say. They are very different approaches to covering the same needs. The supplement pays your share of the expense after Medicare has paid (your doctor files two claims). With the Medicare Advantage insurance plan, your doctor/provider files one claim with an insurance company and Medicare does not pay claims any more. Medicare pays the premiums for the insurance provided by the Medicare Advantage Insurance Plan. Medicare rules require the insurance company to cover all health claims at least the same as Medicare or better. They are nearly always paying “better” than Medicare (but not better than Medicare plus a supplement) in order to market their insurance plan against Medicare, offering lower monthly premiums (often as low as -0-), and such extras as dental, and vision services and a Prescription card. A Medicare Supplement insurance plan will typically cost $1,200+ a year or more in premium (increasing yearly) and then to add a Prescription card will cost another $500 a year. The Medicare Advantage Insurance Plan may have a $-0- premium but various copays and deductibles for their services. You have to decide if the required annual premium for the supplement plus the Prescription card are better or worse than having to pay the various deductibles/copays you may have to pay in the Medicare Advantage Insurance Plan.

I see this Plan A through N; what is this about?

Go to the Resources tab and then click Medicare Sup Standardized Benefits for an explanation. Remember that a Plan F with one company is exactly the same as a plan F with another. Only the premium is different.

What is this “Guaranteed Open Enrollment Period” I have heard about?

All medigap insurance plans are underwritten for health, like life and health insurance applications, except for an Open Enrollment Period. This Open Enrollment is the first six-month period beginning on the first day of the month in which you are enrolled in Medicare Part B. If you are on Medicare under age 65, you will also have a six month Open Enrollment Period when you reach age 65.

Can I change my Medicare Supplement Insurance Plan to a different company?

Yes and no. After the Open Enrollment period, any change of plan or company will require underwriting of your current health. If you have developed diabetes, had heart surgery, etc., you may likely be declined during underwriting by a new plan or company. If your health is good, you can most likely change. I recommend my clients look to change their company every 3-4 years in order to keep their premiums low and competitive.

Can my insurance company cancel my coverage or raise my premiums?

An insurance company cannot cancel or alter your coverage once your policy is issued. An exception is that your policy will change in accordance to any change mandated by Medicare. An example is that Medicare deductibles have changed every year which requires the supplement insurance plan to change. Conversely, they can/will increase your premiums every year as you age and as inflation increases costs. The changes for most companies come twice a year at your policy anniversary and at your birthday month. You generally can expect 8-15% a year increasing a bit more as you age.

Can I only change my Medicare Supplement Insurance plan once a year?

No. Unlike Medicare Advantage and Prescription drug insurance plans which cannot be changed accept once a year during the AEP, Medicare Supplement Insurance plans can be changed at any time with generally a 30 day notice.

Can I get a supplement that has prescription drug coverage included?

No. If you have a Medicare Supplement insurance plan then you will need to buy a standalone Prescription drug insurance plan from a providing company for your county.