Introduction to Medicare Supplement in Pennsylvania (Medigap)

The federal Medicare program is a form of health care insurance which provides for most of the hospital- and doctor-related medical costs of senior citizens. Unfortunately, there are actually coverage gaps which Medicare will not cover, and these gaps in coverage may become expensive very quickly if you’re relying upon Medicare only to cover your needs. Thankfully, there’s a kind of supplemental insurance known as “Medigap” which provides a reasonable choice for retirees who would like to defend their finances from these gaps.

Federal Regulations for Medicare Supplements

The Centers for Medicare and Medicaid Services (CMS) are accountable for managing Medicare supplement plans. This helps make sure that, of the 10 available plans, all insurers in all 50 states provide the identical plans and coverage options. In this way, the sole difference from one insurance company to another is the price of your monthly premium.

Medigap Enrollment In Pennsylvania

Pennsylvania is one of the few states in the country where Plan F is not the most popular Medigap supplement among senior citizens. Plan C has over a quarter million seniors as members, which is more than twice that of plan F.

Plan Type A B C D E F G H I J K L M N
Enrollment 7,330 51,068 261,430 17,426 21,956 108,347 15,789 21,310 16,235 25,563 1,870 8,401 1,286 21,557

Plan Coverage & Cost

The price you pay for any Medigap policy is dependent upon a number of different elements. Your overall health is a large issue, and your fee can change based upon things such as your smoking habits, how old you are, and gender. Your premium will also be based on your geographical area, right down to your county and local zip code. Below is a chart which estimates what individuals in your town are paying for their plans:

Most Popular Medicare Supplement Plans in Pennsylvania

As discussed earlier, the most popular plan in the state of Pennsylvania is Plan C. The only difference between this plan and the next most popular supplement, Plan F, is that C does not cover the Medicare Part B excess charges.

It may very well be that medical facilities and doctors in your state do not often charge in excess of what Medicare believes most treatment should cost. If this is the case, then Plan C might be a better option than the often preferred Plan F. Plan C charges a lower monthly premium, and if you aren’t also paying excess charges for Medicare Part B treatment, then it could save you over Plan F over time.

Helpful Medigap Tips & Tricks

Doctor/Provider Network Restrictions

One of many reasons Medigap plans are so well received among older persons is the versatility. In contrast to other supplement plans, Medicare supplement insurance doesn’t come with any restricted HMO or PPO provider networks. You may use any doctor which welcomes Medicare, in any state, regardless of where you are. If you want to take a trip, if you are in a non-urban area, or in the event you are amongst the millions of “snow birds” who migrate south for the winter, your access to suitable healthcare isn’t going to be constrained.

Doctors List

Drug, Vision and Dental Coverage

In the year 2010, the government passed legislation which altered the way in which Medicare supplement insurance managed prescription drug coverage. Given that Medicare Part D is out there, All Medicare supplemental insurance plans that supplied prescription drug coverage have been eliminated. Vision and dental benefits are a different subject entirely. They have never been insured by either Medicare or Medigap, and must be purchased on their own via a private company for those who have the need for those services.

Enrollment Options & Best Time To Enroll

The Medicare supplemental insurance application process will change depending on how old you are, your Medicare enrollment status, and the company issuing your Medicare supplement policy. A number of companies will immediately accept you, with no hassle, if you are newly enrolled in Medicare Parts A and B. But should you wait to enroll, or in case you have other health complications, the process may well be a bit more involved.

  • Initial Enrollment Period: Once you sign up for Original Medicare, you have 6 months to also enroll in a Medigap policy so that you can be eligible for the initial enrollment period. Registering during the IEP assures automatic approval and coverage.
  • Guaranteed Issue: You aren’t going to be turned down for coverage, even with a health problem. This is a popular option among seniors switching from an employer or group plan.
  • Annual Enrollment Period (AEP): You can easily register for or change your Medigap plan anytime; however, this is the favored window for many varieties of insurance coverage (including, but not limited to, Medicare supplement policies).
  • Underwritten: The process whereby a company asks you questions and maybe runs medical tests in order to determine whether or not they can provide you with coverage.

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?

Compare Medigap Plans Online