If you are an American senior citizen approaching the age of 65, you are probably already aware of Medicare. But did you know that, despite being designed to help seniors reduce their medical expenses, it doesn’t cover all of your needs? These gaps in Medicare coverage could end up costing you thousands if you don’t protect yourself. Luckily, there are simple and affordable insurance supplements – called “Medigap” policies – which can protect you from these disastrous gaps in Medicare coverage.
Federal Regulations for Medicare Supplements
The Centers for Medicare and Medicaid services are responsible for regulating both Medicare, and the Medigap policies which are designed around Medicare Parts A and B. In most of the 50 states, seniors have access to 10 different Medigap plans, named alphabetically: Plans A-D, F, G, and K-N. And the coverage is uniform across every state in which these plans are available. Plan A in Texas is identical to Plan A in Oregon. However, the price you pay will vary, as well as the company who sells you the Medigap policy.
Medigap Enrollment In Oregon
In many states, Plan F is the most popular Medigap policy available for purchase, and things are no different for seniors in Oregon. However, Plans C and N are also fairly common supplements for retired persons. Below, we’ll go into detail about the differences between them, and what it could mean to you.
Plan Coverage & Cost
The price you pay for a Medigap supplement will vary depending on a great number of individual factors which are unique to you, and your life circumstances. Age, location, tobacco use, exercise habits, your health history, and gender are only a few.
It’s very difficult to say how much a Medicare Supplement (AKA Medigap) plan will cost. It depends on things like your age, your location, and how healthy you are. Older, unhealthy seniors who engage in risky habits (such as smoking) may have to pay a higher premium. But your location can help you save money, especially if you shop smart and shop around to compare quotes between different providers (as shown here):
Most Popular Medicare Supplement Plans in Oregon
When looking at the chart above, you may have wondered: why is Plan F so much more popular than the other options? Well, the simple answer is that it is the most comprehensive. All a golden-ager has to do to protect themselves (and their savings) from devastating medical bills is to pay one affordable monthly premium if they buy Plan F. No other action is required on their part.
Because Plan F is the most comprehensive, it is also the most expensive plan. Some seniors can actually save money by looking at plan C, for example. The only difference between Plans C and F is that C does not cover excess charges from Part B of Medicare. If you live in an area where your doctor or hospital doesn’t charge more than Medicare thinks they should for treatment, you could pay a lower monthly premium for Plan C and pay what little excess charges you run into out of pocket, if you have any at all. This could save you a fair amount of money in the long run.
How do Medicare Supplement Ratings work?
Finding an affordable rate is half the battle. Getting a low rate from a quality company is the other half. Each year, Medicare evaluates many of the best Medicare supplement providers using a 5-star rating. This takes the guesswork out of finding an insurance company who will give you quality customer service and competent care management. They also evaluate financial strength so that you know the company will be there for you no matter what.
Helpful Medigap Tips & Tricks
Doctor/Provider Network Restrictions
A Medigap policy isn’t your only coverage option, but it might be your best one – especially if you are a senior on the go. Some Medicare supplement insurance, such as Medicare Advantage, restricts the doctors and hospitals from which you are allowed to seek treatment. Going outside of your pre-approved network could be costly, if you get permission in the first place to seek care elsewhere. And for seniors who travel, getting sick and requiring treatment when you are hundreds or thousands of miles away from your network could be disastrous.
The great thing about Medigap insurance is that it is very widely accepted, just like Medicare is. It’s a process called Medicare assignment, and it’s what happens when your doctor or medical facility takes care of the claims filing for you and only charges you the Medicare approved discount price for services rendered. Just keep in mind that you will be responsible for deductibles, coinsurance, and any co-pays which are outlined in your insurance plan.
Drug, Vision and Dental Coverage
Sadly, vision and dental coverage have never been provided by either Medicare, or Medigap supplement plans. If you need this type of medical care, you could pay out of pocket or purchase coverage for yourself from a private company. Medicare Part D, however, does offer prescription drug coverage. Medigap no longer provides such benefits, because Part D does it for them (and for you).
Enrollment Options & Best Time To Enroll
For the easiest, quickest, and most hassle-free enrollment experience, you should enroll in a Medigap policy as soon as you are enrolled in Medicare Parts A & B. If you wait, then getting insured could become extremely difficult and/or expensive.
- Initial Enrollment Period: Enroll during the same window that you are eligible to enroll in Medicare, and you will be automatically accepted without hassle
- Guaranteed Issue: Enroll in a Medigap policy outside of your IEP, but before you lose coverage from a group or employer plan for a similarly hassle-free experience
- Annual Enrollment Period (AEP): AEPs don’t apply to Medigap policies, so feel free to enroll at any time during the year
- Underwritten: If you miss the IEP or the Guaranteed Issue enrollment period, you will likely have to have your Medigap policy underwritten. This means that your insurer will ask a lot of questions about your medical history, your current medical state, and may even require a physical exam by a doctor before they will agree to sell you a policy
Free Look Period
Each senior citizen who buys a Medigap policy has 30 days to evaluate it and determine whether it will meet their needs or not. If you are unsatisfied, you are entitled to cancel your coverage and have your first month of premiums refunded to you, no questions asked.
What Medigap Plan Is Best For Me?
We cannot emphasize enough how important it is to choose the right Medicare Supplement insurance company. Not all of them will give you the high quality customer service and care that you deserve. But if they have a long history of business, a strong financial standing, and a 5-star rating from Medicare, that’s a good sign you can trust them.
You also need to make sure you purchase a health plan that will cover all of your needs into the foreseeable future. Yes, you want the lowest monthly premium right now. But you also want to make sure you purchase enough coverage to protect yourself from potentially unforeseen medical expenses down the road. Not every single plan does this. So, make sure you review your options carefully before you make a final decision.