The federal Medicare program is a form of medical health insurance which provides for several of the hospital and doctor health-related expenses of older persons. Sadly, there are actually coverage gaps that Medicare doesn’t cover, and these gaps in coverage could become extremely expensive rapidly for anyone who is dependent upon Medicare only to cover their medical bills. Fortunately, there’s a kind of supplemental insurance known as “Medigap” which supplies a reasonably priced option for retirees who want to shield their finances from these gaps.
Federal Regulations for Medicare Supplements
There are actually ten Medicare supplemental insurance plans on the market, all of which are regulated by the Centers for Medicare and Medicaid Services (CMS). In line with the CMS rules, All Medigap plans have to offer the same coverage, regardless of the company providing the policy or the state they’re in. Just what does this imply for you personally? Well, this would mean that Plan A is exactly the same in every state. The only points that can change are the overall cost, along with the company which offers your policy.
Medigap Enrollment In Hawaii
There are thousands of seniors living in Hawaii right now who are choosing to supplement their Medicare benefits with a Medigap policy. As you can see, they prefer Plan F to all other available plans. Plan C is a distant second, with a little over 500 members.
Plan Coverage & Cost
Many factors will determine how much your insurance company might charge you for your Medicare supplemental insurance policy. For example, a 65 year old, male non-smoker in Denver will pay a considerably different premium from a 75 year old female in Hawaii who routinely uses tobacco products.
The price of any insurance product is determined by underwriting factors. With Medicare Supplemental plans, those underwriting factors can include your medical history, general health condition, use of tobacco products, age, and gender. Those are pretty standard for any kind of health plan. But with Medigap policies, where you live, even down to your zip code, can play a role in developing a premium price. Healthcare costs can vary from area to area and that’s taken into consideration when calculating a premium. We’ve provided a chart that shows what people near you are paying for their plan to give you an idea of what to expect.
Most Popular Medicare Supplement Plans in Hawaii
Like many other states, Hawaii citizens favor Medigap Plan F to all of the other obtainable plans. The reason behind this is quite simple: Plan F covers each and every gap in Medicare coverage, and all seniors have to do to protect themselves is pay one affordable monthly premium. Seldom is any other action demanded on their part.
The next most popular plan is Plan C, which offers almost the exact same coverage as Plan F, but with one important difference. Plan C does not protect against any of the excess doctor/hospital fees which Medicare refuses to pay. So if you don’t anticipate many doctor or hospital visits, or of you believe your medical treatment will be covered by Medicare, Plan C might be a more affordable option for you.
How do Medicare Plan Ratings Work?
Every year Medicare releases a report on what they believe is the performance of insurance companies providing supplemental Medicare coverage. The report assigns stars for rating. You can use these ratings to get a feel for how a specific company performs. The categories that Medicare rates are the company’s use of screenings and tests as a form of preventive medicine, how a company manages chronic disease, what the members of the plan think of the company, complaints and increase or decreases in performance level, and customer service.
Helpful Medigap Tips & Tricks
Doctor/Provider Network Restrictions
One of the many reasons Medicare supplement policies are so well liked among golden-agers is their flexibility. Unlike other supplement programs, Medigap insurance doesn’t come with any restricted HMO or PPO provider networks. You may use any doctor which takes Medicare, in any state, wherever you are. If you wish to take a trip, if you are in an outlying area, or in case you travel seasonally, your access to suitable medical care will never be restricted.
Do you like the doctor you have now? If you do, and you have a Medigap plan, you will be able to stay with him or her. Other types of plans commonly restrict the healthcare providers that you can use to those that belong to a specific network. With Medical Supplement (Medigap) plans, you can use any provider providing they accept Medicare assignment. What that means is if your doctor accepts Medicare payment schedules, will file medical claims to Medicare on your behalf, and agrees not to charge you more than the copay required by the plan, you can use your Medigap coverage.
Drug, Vision and Dental Coverage
In case you were unaware, Medicare Part D is now largely accountable for providing seniors with prescription drug coverage. Due to this, it’s no longer required for Medicare supplement policies to provide prescription drug coverage as being an option. Vision and dental are extra kinds of coverage which Medigap and Medicare will not pay for. You have the option to either find those covered privately on your own, or to pay out-of-pocket if you find it cheaper than insurance coverage.
Enrollment Options & Best Time To Enroll
When you enroll in a Medigap policy, you should first be participating in Medicare Parts A and B. Then you can start the Medicare supplemental insurance enrollment process. The sooner you sign up, the less complicated the process will be. But in the event you put it off, you might have to answer personal questions about your health to be deemed eligible for coverage.
- Initial Enrollment Period: Enroll in a Medigap plan inside your first 6 months of receiving Medicare benefits, and you won’t get asked any intrusive health questions or turned down coverage.
- Guaranteed Issue: Common among seniors who are losing an employer or group health plan. The business you apply to must accept and cover you, regardless of your existing health condition.
- Annual Enrollment Period (AEP): Medigap insurance coverage is one of the few types of insurance which is not impacted by the AEP. You can register for or change Medigap plans at any time all through the year.
- Underwritten: If you miss the IEP and don’t meet the criteria for Guarantee Issue, you might have to go through the underwriting process. This usually entails questions about your health, and even a medical exam in order to evaluate whether or not your insurer can cover you.
Free Look Period
The free look period safeguards retirees such as you from being stuck with a Medicare supplemental insurance plan which isn’t going to meet your needs. Inside your first 30 days of getting a new plan, you are free to decide if you should keep your coverage, or terminate it without having to be financially responsible. Any upfront expenses you pay during your first 30 days are going to be returned in case you decide to terminate your benefits.
What Medigap Plan Is Best For Me?
The best Medigap plan is the one that best suits your personal health circumstances, that you fully understand, and that fits into your retirement budget. It takes a significant amount of research to find that plan particularly if you are trying to find it by yourself. At Medigap.com we have provided a wealth of information regarding this type of Medicare insurance and we hope it will help you to find “the best Medigap plan” for you.