Medicare Supplements

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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)
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  • 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
  • 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)

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We will look for solutions that truly support your lifestyle and financial goals

We will guide you through the variety of choices so you feel confident in your decision

We will stay connected, checking in each year to ensure your coverage still feels right

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