Medicare Supplements: What's Cover & Does Not?
As people age, it's common for them to require more medical care. Medicare, a federal health insurance program, helps cover some of the costs of healthcare for those who are eligible. However, it doesn't cover everything. That's where
Medicare Supplements, also known as Medigap, come in.
Medicare Supplements are private insurance policies that individuals can purchase to help fill in the gaps that Medicare doesn't cover. Here's what Medicare Supplements do and don't cover:
What Medicare Supplements Cover:
- Medicare Part A Coinsurance and Hospital Costs: Medicare Part A covers inpatient hospital care. However, beneficiaries are responsible for paying a deductible and coinsurance. A Medicare Supplement policy can help pay for those costs.
- Medicare Part B Coinsurance and Copayments: Medicare Part B covers outpatient services, but beneficiaries are responsible for a deductible and coinsurance. A Medicare Supplement policy can help pay for those costs.
- Blood: Medicare only covers the cost of the first three pints of blood. If a beneficiary needs more blood, they will be responsible for the cost. A Medicare Supplement policy can help pay for those additional costs.
- Hospice Care Coinsurance and Copayments: Medicare covers hospice care, but beneficiaries are responsible for a copayment for prescription drugs and respite care. A Medicare Supplement policy can help pay for those costs.
- Skilled Nursing Facility Care Coinsurance: Medicare covers up to 100 days of skilled nursing facility care, but beneficiaries are responsible for a coinsurance payment after the first 20 days. A Medicare Supplement policy can help pay for that coinsurance payment.
What Medicare Supplements Don't Cover:
- Long-term care: Medicare Supplements do not cover the cost of long-term care, such as nursing home care.
- Prescription drugs: Medicare Supplements do not cover the cost of prescription drugs. Beneficiaries can enroll in a separate Medicare Part D plan to help cover the cost of their prescription drugs.
- Dental, vision, and hearing: Medicare Supplements do not cover routine dental, vision, or hearing care.
- Private-duty nursing: Medicare Supplements do not cover private-duty nursing care.
- Foreign travel emergencies: Medicare Supplements do not cover medical care outside of the United States. Beneficiaries can purchase a separate travel insurance policy to cover medical emergencies while traveling abroad.
It's important to note that Medicare Supplements can vary by state, so it's essential to review the specifics of the policy being considered.
Eligibility Criteria for Medicare Supplement in Idaho
Medicare Supplement Insurance is designed to fill the gaps in coverage left by Original Medicare (Part A and Part B). It helps cover co-payments, deductibles, and other out-of-pocket expenses, providing individuals with financial peace of mind regarding their healthcare costs.
- Age Eligibility: The primary criterion for Medicare Supplement eligibility is being 65 years or older. Individuals who are already enrolled in Medicare Part A and Part B are eligible to apply for a Medicare Supplement plan.
- Enrollment Period: The best time to enroll in a Medicare Supplement plan is during the Open Enrollment Period, which begins within six months of turning 65 and enrolling in Medicare Part B. During this period, insurance companies are required to accept applicants without considering pre-existing conditions, ensuring access to coverage without medical underwriting.
- Medicare Part B Enrollment: To be eligible for a Medicare Supplement plan, individuals must be enrolled in both Medicare Part A and Part B. Part B covers outpatient services, and having both parts is a prerequisite for accessing a Medigap plan.
- No Other Health Coverage: Individuals applying for a Medicare Supplement plan in Idaho should not have any other health coverage that duplicates the benefits provided by Medigap. This ensures that the supplemental coverage is appropriately utilized without redundancy.
- State-Specific Eligibility Rules: While the basic eligibility criteria are consistent nationwide, it's essential to be aware of any state-specific rules or regulations in Idaho. Consulting with local insurance experts or the Idaho Department of Insurance can provide clarity on any unique considerations.
Where To Buy Medicare Supplement Plans
Medicare Supplement plans, also known as Medigap, are private health insurance policies that can help cover the costs that Original Medicare doesn't cover, such as deductibles, coinsurance, and copayments. If you're considering purchasing a Medicare Supplement plan, you may be wondering where to buy one. Here are some options:
- Insurance Companies: Many insurance companies offer Medicare Supplement plans. You can purchase a plan directly from an insurance company, or you can work with an insurance agent who can help you compare plans and prices from different companies. Some of the largest providers of Medicare Supplement plans include AARP United Healthcare, Cigna, Mutual of Omaha, Humana, and Blue Cross Blue Shield.
- Online Marketplaces: There are several online marketplaces, such as eHealth and Medicare.gov, that allow you to compare Medicare Supplement plans from different insurance companies. These marketplaces typically require you to provide some basic information, such as your age and location, to generate a list of available plans.
- State Health Insurance Assistance Program (SHIP): The
State Health Insurance Assistance Program (SHIP) is a free counseling service that can help you navigate your Medicare options, including Medicare Supplement plans. SHIP counselors can provide you with information about available plans and help you compare costs and benefits.
- Employer or Union: If you have a group health plan through your employer or union, they may offer a Medicare Supplement plan as part of the benefits package. Be sure to check with your human resources department or benefits administrator to see if this is an option.
- Friends or Family: Talk to friends or family members who have Medicare Supplement plans. They may be able to provide you with recommendations or refer you to an insurance agent who can help you navigate the process.
Contact Chris Antrim Insurance For Medicare Supplement Plans
Buying a Medicare Supplement plan can be a good idea for people who want to keep their out-of-pocket healthcare costs low and have more control over their prices. Original Medicare doesn't pay for all medical costs, but a Medicare Supplement plan can help cover what Original Medicare doesn't. By paying a monthly premium, Medicare Supplement policyholders can get extra coverage for things like deductibles, coinsurance, and copayments, as well as other benefits like coverage for situations that happen while traveling abroad.
Private insurance companies also offer Medicare Supplement plans, which can give people a wide range of choices and options. To find the best Medicare Supplement plan for your needs and budget, you should do research and compare plans and prices. Overall, a Medicare Supplement plan can give peace of mind and financial security to people who want to make sure they are covered for unexpected health costs. For your Medicare Supplement Plans you can contact
Chris Antrim Insurance for you quotes and insurance needs!