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What is Medigap Insurance (a.k.a. Medicare Supplement)?

When an American citizen turns 65 years of age, they have the option to enroll in Medicare (they may also qualify before the age of 65 if they are eligible for disability benefits). Basic Medicare, which includes Parts A and B, cover most of your basic hospital and doctor expenses, respectively. Unfortunately, "most" does not mean "all". The expenses which Medicare does not cover - sometimes referred to as "gaps" in coverage - are what Medigap insurance protects you from. It is a private plan designed to cover the medical expenses where Traditional Medicare falls short of the mark.

Who is Eligible for Medigap Insurance?

If any of the following scenarios apply to you, then you are already guaranteed "eligible" to purchase Medicare supplemental insurance:

  • • You are currently covered under Medicare Parts A & B
  • • You are within 6 months of turning 65
  • • You are within 6 months of receiving Part B coverage
  • • If you are about to lose your group health insurance plan

Please note that you may still be required to answer some medical questions about your overall health and wellness. For further clarification, or if you have any questions, please do not hesitate to contact us at (844) 875-9502. Give us a call today.

When Can I Sign Up for Medigap Insurance?

Based on the convoluted rules of Medicare enrollment, many seniors mistakenly believe that signing up for Medigap is similarly complicated. The good news is that you can sign up for Medigap insurance at any time. However, there are some "sweet spot" time frames which, if you apply during those opportunities, will make the process much easier:

  • 1. The Initial Enrollment Period. During your first 6 months of Part B coverage, your acceptance is guaranteed, regardless of your current level of health
  • 2. The "Guaranteed Issue" Period. If you are on the verge of losing coverage through an employer, you will have a "guaranteed issue" period lasting 63 days where you can purchase any Medigap policy with no health questions asked.

If you apply for Medicare supplement at any point outside of these time frames, you will likely have to go through the complicated process of medical underwriting and answering lots of invasive health questions. To learn more, and to get help going through the process, call us today at (844) 875-9502

Who Purchases Medigap Insurance?

It doesn't matter whether you're struggling to get by, on a fixed income, or enjoying incredible wealth in your golden years - all seniors from all walks of life can benefit from a Medicare supplement insurance policy. Medicare provides standard coverage to every beneficiary, regardless of income. What it does not provide, however, is 100% coverage of your medical costs. Therefore, the more vulnerable you are to the gaps in Medicare coverage, the more you can benefit from the protection of a Medigap policy.

Starting January 1, 2020, Medigap plans sold to people who are new to Medicare won’t be allowed to cover the Part B deductible. Because of this, Plans C and F won’t be available to people who are newly eligible for Medicare on or after January 1, 2020. If you already have either of these 2 plans (or the high deductible version of Plan F) or are covered by one of these plans before January 1, 2020, you’ll be able to keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans. A new Plan G high-deductible plan will be available starting January 1, 2020.

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SENIORS! Are you paying too much for your Medicare Supplement?

FYI, Medicare Supplement and Medigap are interchangeable terms and this is not to be confused with the Medicare Advantage Programs (Big difference).

Let’s face it, seniors that have a Medicare Supplement REALLY LOVE THEM; including my wife and I and especially if they have a Plan F or a Plan G. As of January 1, 2020, the Plan F is no longer available unless you turned 65 before that. If the Doctor, Hospital etc. accepts Medicare the Plan F covers everything that Medicare does not cover including excess charges. The Plan G however, which is becoming more and more popular, covers the same as Plan F except for the, once a year, $198.00 deductible for Medicare Part B, in 2020. The annual difference between the Plan F and G premiums are usually more than that $198.00 deductible. Example given: A 69-year-old Medicare beneficiary has the Medicare Supplement Plan F at $173.00 a month while the Plan G maybe $130.00 a month, the difference is $43.00 a month. $43.00 x 12 months = $516.00 minus the $198.00 deductible = $318.00 saving per year with a Plan G over their Plan F.3

As folks get older their Med. Supp or Medigap policy premium slowly gets more and more expensive. The one thing to remember is that all Med Supp plans, F, G, N etc. cover the same thing no matter which company sells it. All Plan F’s are the same, all Plan N’s are the same etc. Those benefits are controlled by our government. What is not the same, is the monthly premium that different companies charge for them. Example given: for a 70 year old, a Plan F premium can be anywhere from $177.00 per month to over $368.00 a month for that same exact coverage. After the premium is paid there is no more out of pocket costs. This gives you, the senior, Peace of Mind and the knowledge that you are always within budget. The Plan G is the same except a Deductible of $198.00 for the year. The monthly premium is of course way less for the plan G.

Insurance companies have different experiences with different age groups and/or different plans. They set their rates depending on whether they’ve had good or bad or unknown experiences with a group or plan.

Companies that sell Medicare Supplements are allowed to use medical underwriting to decide whether to accept your application due to your health situation or pre-existing condition. There are only a couple of situations that they cannot hold your health against you. One is when you turn 65 and another is if you have lost credible Medigap coverage; out of your control i.e. the company discontinues your plan in your state. Otherwise, if you are healthy you won’t have a hard time being accepted but if you have some health challenges you may not be given the coverage and you will have to go with a Part C, otherwise known as an Advantage Plan or simply stay with Original Medicare (without any supplement coverage). With Original Medicare only; you would be responsible for the deductible for Part A of $1408.00, the monthly premium for Part B of $144.60, the deductible for Part B $198.00 and generally 20% of everything else plus excess charges. At that point you would still need a standalone PDP, Prescription Drug Plan, or also know as Part D.

Here is a reference for you to use at the Idaho Department of Insurance to compare Medigap rates. https://doi.idaho.gov/shiba/shmedigap The rates are a little off on their site but you will get the idea on the different rates companies can and do charge.

BTW, Medigap policies do not cover long-term care, vision, dental care, hearing aids, eyeglasses, or private-duty nursing.

For more in-depth information call Bob Arnett, at 208 570 8390; or go to my website at www.alisprotect.com

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