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.

Determining the price of your Medicare supplement plan is no easy task. It will depend on how old you are, where you live in Pennsylvania, and your health. If you have any unhealthy habits – such a smoking, for example – you may want to prepare to pay a higher premium. But the extra expense could potentially be offset depending on the quality of care in your immediate area. You can help yourself get a better deal by shopping around, as you can see below:

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.

How do Medicare Supplement Ratings work?

Medicare supplement plan ratings work by evaluating many important benchmarks which elucidate whether or not a company deserves your business. Part of this is feedback from current or past customers who have something to say about their customer service, quality of care management, and the ease of filing claims. The financial strength of the company and its stability are also evaluated. The cumulative score of all these factors is determined on a five-star scale. The more stars, the better.

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

You won’t have to worry about whether or not you will have access to the doctors and facilities you need with Medicare supplement insurance. Almost every caregiver who accepts Medicare assignment will also accept Medigap insurance. This means that they will only charge you the Medicare approved price and they will even file the claims for you. But if your plan includes coinsurance or co-pays – or deductibles – you will have to handle those costs.

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?

Most Medicare Supplement insurance companies want you to stick with them for the rest of your golden years. As such, it can be difficult to transition to a new company or a different plan if your needs change or you aren’t satisfied. It’s a good idea to take your time, do your research, and make sure that you make the right decision about which company to purchase a health insurance policy from.

The coverage you choose is also very important and may be difficult to change in the future. There are 10 plans available which each cover different benefits because no one person’s needs are the same. You will have a brief evaluation period at the beginning of your coverage, but if you are unsatisfied and don’t switch to a better plan in time, you could end up locked in that particular plan for life. So, make sure you get good advice in order to make a sound decision.

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