Medicare Coverage Essentials: Enroll and Choose Wisely

Shopping for more coverage? First, have you enrolled in Medicare Part A and Part B? That is the first step before choosing a Medicare Supplement (Medigap) plan or a Medicare Advantage plan. You are eligible to enroll in Medicare three months before your glorious 65th birthday. You can also enroll during your birthday month and up until three months after. This period, over seven months, is called the Initial Enrollment Period (IEP). You must be enrolled in Medicare A and B before shopping for more coverage.   

Original Medicare includes:

• Part A
  • Inpatient hospital stays
  • Skilled nursing facility care
  • Hospice stays
  • Home health care

• Part B
  • Doctor’s visits
  • Outpatient care
  • Preventative services

Once you have enrolled in Original Medicare, it is time for more coverage. You should make your decisions within six months of enrolling in Medicare Part B. Ideally, you have enrolled in both at the same time during your IEP. 

Now let’s talk Medicare Supplement Plans and then answer the top 10 questions you might have.

1. When is the best time to enroll in a Medicare Supplement plan also known as a Medigap plan? If you’re 65 or older, the best time to buy Medigap is within the first six months. This period starts the first day of the month when you enroll in Medicare Part B. This rule is valid even if you choose to delay enrolling in Part B. You may delay until you or your spouse stops working for an employer providing health insurance.

2. Can I be denied a Medicare Supplement plan (Medigap) due to a pre-existing condition? No, you will not be denied due to pre-existing conditions as long as you enroll during your open enrollment window. To be clear, there is a distinction between the initial open enrollment period for Medicare A/B. The Medicare Supplement open enrollment is a six-month window from the date of your enrollment. 

3. What is the difference between a Medicare Supplement Plan and a Medicare Advantage Plan? A Medicare Supplement Plan helps fill the gaps in coverage when enrolled in Medicare A and B. That is why it is called Medigap. It ADDS to your Original Medicare. A Medicare Advantage Plan REPLACES your Original Medicare plan with private insurance approved by Medicare. 

Some of the major differences between these plans include:

4. How much do Medicare Supplement Plans Cost? The cost of your Medigap plan will depend on your age, your location, and the insurance company’s pricing method. Medicare Supplement plans are standardized, but pricing is not. This means you are shopping for the best price, not the details of a plan. Working with an independent agent who has access to multiple providers provides you with the best pricing options. Book a Consultation with HHC today to get started. 

5. Do I have to renew my Medicare Supplement Plan annually? No, you only have to enroll in a plan once. A Medicare Supplement plan is a guaranteed renewable product as long as your premiums remain paid. 

6. Can I switch my plan at a later date? Yes, if you buy a Medigap Policy at other times, you will have to qualify. Insurers may reject you. They might also charge you more because of your past or current health.

7. What does a Medicare Supplement Plan cover? 

✔️ Medicare Part A coinsurance and hospital costs

✔️ Medicare Part B coinsurance or copayment

✔️ First 3 pints of blood

✔️ Part A hospice care coinsurance or copayment

✔️ Skilled nursing facility care coinsurance

✔️ Medicare Part A deductible

✔️ Medicare Part B deductible (on some plans)

✔️ Medicare Part B excess charges (on some plans)

✔️ Foreign travel emergency care (up to plan limits)

8. Do Medicare Supplement Plans cover prescription drugs? No, Medigap does not cover prescription drug costs. You will need to enroll in a Medicare Part D plan. You can do this during your Initial Enrollment Period (IEP). It can be done at the same time you enroll in Medicare Part A and Part B. You can also enroll during the Annual Enrollment Period (AEP) beginning October 15 to December 7th. If you lose employee coverage or move to a new area, you may qualify for a Special Enrollment Period (SEP). This allows you to enroll outside of the normal periods. These plans are typically a one-year renewable contract and should be shopped/checked annually. 

9. Can I choose ANY supplement plan available in my state? Yes, all plans are available to you as long as you are within the enrollment period. After that, you may be subject to a health questionnaire, and some plans may not accept you. 

10. Will my plan work if I move to a new state? Yes, your Medicare Supplement Plan will follow you however, you may be subject to different premiums depending on your location. 

Medicare Supplement Plans are ideal for people who want freedom, flexibility, and predictability. Medigap works with your Original Medicare Part A and Part B. It helps pay out-of-pocket costs such as copayments, coinsurance, and deductibles. It allows you to see ANY doctor or specialist nationwide that accepts Medicare. No network restrictions make it ideal for people who are planning on traveling after age 65. Supplement plans may have higher monthly premiums, but they also offer more consistent costs and fewer unexpected bills to manage. Medigap plans are ideal for people who are on the move, want to choose their doctors, and appreciate the peace of mind of knowing what they will pay when it comes to medical services. 

Enrolling in Medicare and choosing the right coverage to fit your needs can be confusing and overwhelming. Here at Harmon Healthcare Consulting we believe Insurance should be in harmony with your life. Schedule a Consultation today and let us walk you through the process. You only turn 65 once let us help you do it right in order to secure your future healthcare and life insurance needs. 

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HHC Healthy Hints – Brought to you by Michael and Shelley.

A few years ago, we set out to change our lifestyle and our relationship with aging. We now know everything we do counts towards longevity. Eating whole foods, avoiding alcohol and processed sugar, using our feet as transportation, and taking care of our mental health. Each week, we’ll list some easy and fun ways to create healthy habits and have fun while doing it. 

• Practice boxed breathing (also known as square breathing) throughout your day. Breathe in for four counts, hold your breath for four counts, exhale for four counts. Breath 1234, Hold 1234, Exhale 1234. Repeat. Repeat. Repeat! 

In my personal journey with chronic pain, I rely heavily on stress reduction techniques. Boxed breathing helps to center and ground me, making it easier, emotionally and physically, to deal with my nerve damage. It also helps if I am impatient while standing in line, before I start an important conversation, or when I just need to feel my body chill. Boxed breathing is one of the most important and effective tools I have in my “wellness toolbox”. I encourage you to try it and include it in yours. A 2017 study from Frontiers in Psychology found that these breathing exercises lower stress, reduce blood pressure, and anxiety. Navy SEALs have long been trained in box breathing, and it has been shown that it improves their cognitive control under pressure. So the next time someone says “just breathe”, go ahead and do it. 

Thanks for Reading,

Michael & Shelley @ HHC