Medicare Supplements
Independent agents offering health and life solutions!
Navigating the waters of Medicare can be overwhelming. Original Medicare (Part A & Part B) covers a portion of your health costs once you’ve turned 65; however, having a Medicare Supplement plan will provide coverage that Medicare doesn’t provide, and it will help you avoid or reduce out-of-pocket expenses.
Key things to know about Medicare Supplements
- Medicare Supplement plans are all standardized – prices vary
- Access to any Medicare provider or facility in the US
- No referrals needed
- Guaranteed renewable for life
- Medigap only works with original Medicare (Part A & Part B)
- When is the best time to enroll in Medicare?
- When are the enrollment periods?
- How do I enroll in Medicare?
- What happens if I don’t enroll in Medicare on time?
- How do I sign up for Medicare?
- Sign up during your initial enrollment or special enrollment period to avoid late enrollment penalties
- Sign up before current coverage ends to avoid gaps in coverage
- Initial Enrollment period: three months before you turn 65, the month of your birthday and three months after you turn 65 if you are not covered by a group plan at age 65
- Special Enrollment period: if you are covered by a group plan at age 65
- General Enrollment period: January 1st – March 31st if you missed your initial or special enrollment period
- Medicare Open Enrollment period: October 15th – December 7th Change from Original Medicare to a Medicare Advantage plan (or vice versa). Switch from one Medicare Advantage plan to another Medicare Advantage plan. Switch from a Medicare Advantage plan that doesn’t have drug coverage to one that does offer drug coverage (or vice versa). Join a Medicare Prescription Drug Plan (PDP). Switch from one Prescription Drug Plan (PDP) to another PDP. Drop Medicare Prescription Drug coverage completely
- Medicare Advantage Open Enrollment period: January 1st – March 31st Switch from one Medicare Advantage Plan (with or without drug coverage) to another Medicare Advantage Plan (with or without drug coverage) Disenroll from a Medicare Advantage Plan and return to Original Medicare and join a Prescription Drug Plan if you choose
- If you are receiving Social Security benefits when you turn 65 you will be automatically enrolled in Medicare Parts A and B (they can be deferred to a later date)
- Coverage starts on the first day of the month you turn 65
- Part C (Medicare Advantage), Medicare Supplement and Part D are not automatic – you must choose a private insurer and select which plan you want
- If you are not receiving Social Security when you turn 65, you sign up through Social Security Administration during a Medicare enrollment period
- You may pay late enrollment penalties
- Your healthcare expenses may not be covered by insurance
- Your private insurance options will probably be limited
- Unless you are covered by an employer group plan, you should enroll in Medicare when you turn 65
- Visit http://www.ssa.gov
- Call Social Security at 800-772-1213
- Go to your local Social Security Administration office
- For general information about eligibility visit www.medicare.gov/MedicareEligibility
- Hospital: 100% of first 60 days
- Medical services (doctor visits, outpatient services): 80% of Medicare-approved amount
- Some preventive services (flu shots, certain screenings) Refer to ‘Medicare & You’ for complete list of covered services
- Dental and vision care
- Hearing aids and exams for fitting them
- Long-term care
- Care outside the U.S.
- Cosmetic surgery
- Acupuncture and other alternative care
- Amounts over Medicare approved amounts
- Offered by private insurance companies
- Standardized plans (MA, MN, and WI standardize their plans differently)
- Pay a monthly premium
- Costs vary by plan, carrier and location
- Accepted anywhere Medicare is accepted
- No networks, policy holders are free to choose their doctors and hospitals
- Plans cannot be cancelled as long as premiums are paid
- Guaranteed renewal
- Option to switch Medicare Supplement plans at any time
- The Part A deductible
- Hospital costs after 60 days
- The 20% of doctor bills that Medicare doesn’t pay
- Amounts the doctor charges over the Medicare-approved amount known as excess charges
- Prescription Drugs
- The deductible if applicable
- Most of the cost of certain drugs if a deductible applies and during the coverage gap (donut hole)