“Medigap” is a form of Medicare supplement insurance policy created to fill in the coverage gaps connected with Traditional Medicare Parts A & B. Although Medicare tries to be comprehensive, there are numerous healthcare essentials that it will not cover. And if you don’t have any Medigap insurance to pay for those essentials, you could find yourself having to pay thousands in out-of-pocket medical costs. In order to acquire Medigap insurance, you have to first be enrolled in Original Medicare.
Federal Regulations for Medicare Supplements
To help make sure than a senior citizen in Montana gets the exact same benefits as a senior in Miami, the CMS (Centers for Medicare and Medicaid Services) are responsible for regulating the ten available Medicare supplemental insurance plans. Plans A, B, C, D, F, G, K, L, M, and N are presently available (E, H, I, and J have been discontinued). Since each plan is regulated, the only real difference between Plan G in Montana and plan G in any other state is cost, and company. The benefits are exactly the same from state to state.
Medigap Enrollment In Montana
Montana senior citizens are no different from the rest of the country in their preference of Plan F to all other Medigap policies. However, Plan C is also fairly popular, as well as plan G. It should come as no surprise that Plans C and G are nearly identical to Plan F in all ways but one.
Plan Coverage & Cost
The price you pay for your Medicare supplement plan will vary by county, by your zip code, as well as your unique characteristics, including age, chronic illness, and smoking habits. There are plenty of more complex factors that can have an effect on your rate.
When Montana seniors compare the cost of Medigap plans, which appear to have identical coverage, they may be surprised by how much the premiums vary. The coverage is identical if they are looking at the same “lettered” plan from two different companies. But each company may have different underwriting standards and those standards determine cost. Some of the standards include your overall health, age, gender, medical history, and use of tobacco products. They will also take into consideration where you live in Big Sky country. The cost of healthcare can vary widely from zip code to zip code within the state. We’ve provided a chart that shows what others living near you pay for their plan.
Most Popular Medicare Supplement Plans in Montana
Montana, like many other states in the nation, has more retirees participating in Medigap plan F than any other obtainable plan, making F the favorite by far. It isn’t hard to see why; Plan F covers all of the gaps which Medicare does not for one sole, straightforward, and relatively reasonably priced monthly premium.
Plans G and C are nearly identical, yet have a fraction of enrollees. This is because they don’t cover the monthly part B deductible (Plan G) or the excess charges associated with Part B of Medicare (Plan C). Apparently, not having these gaps covered is expensive enough in Montana that seniors feel justified paying the higher premium for Plan F.
How do Medicare Plan Ratings Work?
Medicare developed a rating system for companies providing Medicare plans called Overall Star Rating. Basically, Medicare compiles information on all companies and assigns a star rating that reflect how well Medicare thinks the company does in providing service. The areas that they look at include the use of screenings, tests, inoculations and other preventive measures to keep insureds healthy. As well as how well they manage chronic disease like diabetes, what members have to say about their experience with the company, launched complaints and changes in customer service performance. You can use the Medicare Star Rating (which is updated annually) to compare companies that you are considering buying insurance from.
Helpful Medigap Tips & Tricks
Doctor/Provider Network Restrictions
Medicare supplemental insurance isn’t your only choice for supplementing your Medicare coverage gaps – but it’s the most accommodating one. A number of other types of supplemental coverage, Medicare Advantage particularly, control which doctors you can go to and which facilities you can obtain proper care from. Going outside of these pre-approved networks can be expensive, and the approval procedure is often challenging. Medicare supplement, in contrast, will let you see any health care provider or visit any facility that will accept Medicare.
Given the distance between healthcare providers in some parts of Montana, it’s important that you get to keep going to the doctor you have and not have to drive further to another doctor possibly located some distance away. When you purchase a Medigap plan you are assured that you can keep your doctor or see any specialist, providing they accept Medicare assignment. Other types of plans often work with networks and restrict your choice of healthcare providers to those that are in a specific and limited network. This is one feature of a Medigap plan that you definitely need to consider before making a decision on purchasing a Medicare Supplement plan.
Drug, Vision and Dental Coverage
Sadly, neither dental nor vision care is covered by Medicare or Medigap. Until the laws change, you have to get vision & dental insurance from a private company on your own, or pay out of pocket. Prescription drugs, however, are a different story. Medicare supplemental insurance used to supply prescription drug benefits right up until Medicare Part D came along. Since Part D is offering that service for retirees, it is no longer necessary for Medicare supplement plans to give such benefits.
Enrollment Options & Best Time To Enroll
Before you enroll in a Medicare supplemental insurance policy, you must first be enrolled in Medicare Parts A and B. Then you can start the Medigap enrollment process. The quicker you sign up, the less difficult the process will be. But in case you put it off, you might need to answer personal questions about your health just to be considered eligible for coverage.
- Initial Enrollment Period: You are guaranteed coverage, no questions asked, if you buy a Medigap plan within your first 6 months of registering for Medicare.
- Guaranteed Issue: For anyone who is losing your employer or group plan, Guarantee Issue enrollment can get you covered by a Medigap policy regardless of your health status.
- Annual Enrollment Period (AEP): Unlike most kinds of insurance, you can enroll in a Medigap policy whenever you want. You aren’t restricted by an annual enrollment period.
- Underwritten: In the event you miss the IEP and don’t meet the requirements for Guarantee Issue, you may have to go through the underwriting process. This generally involves queries about your state of health, and maybe a medical exam in order to assess whether or not your insurance company can cover you.
Free Look Period
To help make the purchasing experience easy and hassle-free, all retirees have 30 days after purchasing a brand new Medicare supplement policy to determine whether or not they would like to keep it. In the event you determine inside of those 30 days that you’re not happy with your plan, you may get rid of your plan for a full refund.
What Medigap Plan Is Best For Me?
The best Medigap plan for you is one that provides you with the coverage your health circumstances require, one that you fully understand how to use, and one that fits within your retirement budget. It’s out there, you just have to find it. Which is why shopping and comparing is vital. There are a wide variety of companies providing Medigap plans. Medigap.com has put together a comprehensive list of Medigap providers licensed to sell in Montana to launch your search in the right direction. If you take the time to look over the other information we have provided on this site, we are confident you’ll find that perfect Medigap plan for you and get the protection you need.