The federal Medicare program is a form of medical insurance which provides for most of the hospital- and doctor-related health costs of senior citizens. Unfortunately, there are coverage gaps that Medicare will not cover, and these gaps in coverage can be extremely expensive very quickly if you are dependent upon Medicare alone to cover your needs. Fortunately, there’s a form of supplemental insurance called “Medigap” which provides an affordable choice for senior citizens who would like to safeguard their finances from these gaps.
Federal Regulations for Medicare Supplements
The Centers for Medicare and Medicaid Services (CMS) are responsible for regulating Medicare supplement plans. This helps make certain that, of the 10 available plans, all insurance agencies in all 50 states provide the same exact plans and coverage options. In this way, the sole difference from one insurance carrier to another will be the cost of your monthly premium.
Medigap Enrollment In Vermont
Unlike other states, Vermont seniors prefer Medigap Plan C to all other plans, including the 100% comprehensive Medigap Plan F. Plan D is also fairly popular with Vermont seniors. Plan F, for reasons we will discuss below, ranks a distant 3rd in popularity.
Plan Coverage & Cost
The price you pay for your Medigap supplement plan may vary by state, by your zip code, and your individual characteristics, which include age, chronic illness, and smoking habits. There are several other additional factors which will affect your price.
The price of a Vermont Medigap plan will depend on how the company does its underwriting. They will potentially ask you about your overall health, age, gender and medical history, but they will also want to know the location you live in. The cost of quality healthcare across Vermont can vary area to area. Consequently, where you live, including your zip code will have an effect on your premium cost. To get an idea of what to expect, refer to the chart below showing what people who live near you are paying for their Medigap plans.
Most Popular Medicare Supplement Plans in Vermont
Plan F is the most popular plan in most states, due to the fact that it covers all of the Medicare gaps for one simple monthly premium. However, it is also the most expensive plan. But Vermont residents have discovered that, by paying a lower monthly premium as well as any Medicare Part B excess charges that might arise, they can save money with the nearly identical Plan C.
The same strategy applies to Plan D. Plan D is nearly identical to Plan C (and also very similar to plan F), but the Part B excess charges as well as the monthly Part B Medicare deductible are your responsibility. However, if these costs added together are less than the monthly premium for Plan F, then you could potentially save hundreds.
How do Medicare Supplement Ratings work?
Every year Medicare releases an evaluation of companies providing Medicare related coverage. It’s called the Overall Star Rating and it is compiled from data collected by Medicare on all the companies. The more stars a company has ranked, the better the performance. Factors reviewed and rated include how well a company adopts preventive methods like screening, tests and inoculations, how well it manages chronic diseases, what subscribers have to say about their experience with the company, complaints and customer service. You can use these ratings to help compare companies you are interested in.
Helpful Medigap Tips & Tricks
Doctor/Provider Network Restrictions
A Medigap policy isn’t your only coverage option, but it may be the best one – particularly if you have a specific doctor you like to see. Some Medicare supplement insurance, for example Medicare Advantage, limits the physicians and medical centers from which you are allowed to seek treatment. Going beyond your pre-approved PPO or HMO network may be expensive, if you get approval to begin with to look for treatment anywhere else. And for seniors who take a trip, getting ill and needing treatment when you find yourself hundreds or thousands of miles away from your network could be devastating.
Some plans limit your choice of physicians, hospitals, clinics and other providers to those that are in a specific network or on a PPO list. Not Medigap. If you purchase a Medigap policy, you have a pretty unlimited choice of doctors and medical facilities as long as they accept Medicare. You can even use any healthcare provider in the country which allows you to travel without worrying about having limited coverage while on your trip. Other plans will restrict coverage to emergency services only.
Drug, Vision and Dental Coverage
In the year 2010, the government passed legislation which altered the way in which a Medicare Supplement in Vermont managed prescription drug coverage. Since Medicare Part D is out there, All plans for Medicare Supplement in Vermont that offered prescription drug coverage are being eliminated. Vision and dental benefits are a different matter entirely. They have never been insured by either Medicare or Medigap, and ought to be obtained on their own from a private company should you have a need for those services.
Enrollment Options & Best Time To Enroll
Below are various ways you may get a plan for a Medicare Supplement in Vermont. Some companies may require you to answer questions about your state of health in advance of qualifying, others may well limit your options on account of pre-existing conditions. If you’re lucky, just being enrolled in Medicare might be enough to qualify you. For additional information, check out our Medigap Enrollment Options page, or get in touch with one of our licensed agents. They will make personal suggestions based on your unique circumstances.
- Initial Enrollment Period: Signing up for a Medicare supplement policy within your IEP (within 6 months of signing up for Medicare) guarantees your approval and coverage with no health surveys or medical exams.
- Guaranteed Issue: Prevalent among older persons who will be losing an employer or group health plan. The business you apply to will have to accept and cover you, regardless of your present health condition.
- Annual Enrollment Period (AEP): You are able to enroll in or change your Medicare supplement plan whenever you want; however, this is the recommended window for most forms of insurance policies (including, but not limited to, Medicare supplement policies).
- 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
For your protection, there exists a 30 day “Free Look” assessment period for each and every Medicare Supplement in Vermont issued. You have 30 days from your first day of coverage to determine whether your policy fits your needs. If you have a change of heart, you can stop the policy and receive a full refund.
What Medigap Plan Is Best For Me?
The best Medicare Supplement (Medigap) plan for you is one that provides the level of coverage you expect you will need, is reasonably affordable for your budget, one you have a good understanding of, and is easy to use. Rest assured that there is a fit, but it can be challenging to find without expert assistance. At Medigap.com we will give you an easy place to start. We have compiled a list of Medigap companies that are licensed to sell in Vermont. Just keep in mind that a low premium isn’t everything. You want to work with a company with a solid reputation and is financial stable.