In an era where more and more individuals continue working beyond the age of 65 due to employer-sponsored insurance, navigating the transition to Medicare Part B has become a pressing concern.
Senior65.com, a trusted source in senior healthcare guidance, typically advises individuals aged 65 and older to postpone their enrollment in Medicare Part B if they have access to work-related coverage, including coverage provided through a spouse’s employment.
This prudent approach aims to circumvent Medicare late-enrollment penalties and potential gaps in coverage, ensuring comprehensive protection.
For those wondering about the timing of Medicare Part B enrollment while covered by employer-based insurance, there are two primary windows of opportunity. Firstly, enrollment can occur while the work-related coverage remains active. Secondly, there’s an eight-month window following the termination of employer-based coverage or the conclusion of employment, whichever transpires first.
For a more in-depth exploration of this topic, readers are encouraged to review the full article on Senior65.com: Leaving Employer’s Insurance And Enrolling In Medicare Part B.
Amidst the multitude of Medigap options, the distinctions between Blue Shield’s Medigap Plan G, G Extra, and G Inspire stand out. Blue Shield of California holds the distinction of being the first to enrich the popular Plan G with supplementary benefits. Eligible California applicants, applying before the specified date, can avoid health-related inquiries, thus streamlining the enrollment process. Delve into the Medigap comprehensive comparison here, including pricing specifics.
Three Medigap Plans Explained
- All three plans necessitate payment of the Part B Deductible. G Extra and G Inspire elevate the coverage of Standard G, introducing provisions for hearing, vision, and Over-the-Counter benefits. G Inspire takes this a step further by including an AAA membership alongside the additional offerings.
- As a nonprofit health plan affiliated with the Blue Shield Association, Blue Shield of California remains steadfast in making quality healthcare accessible to Californians at affordable rates. Plan G ranks as a top-selling Medigap plan, and Blue Shield’s pioneering approach of enhancing it with vision, hearing, and roadside assistance has earned notable recognition.
- G Extra and G Inspire, with their appeal to a younger demographic due to their newer status, may carry the advantage of more competitive pricing. It’s important to note that availability of Blue Shield G Inspire may vary based on market locations.
If you still have any doubts about this topic, you can read more about it on Senior65.com in the article titled ‘Blue Shield Medigap Plan G, G Extra And G Inspire Compared’.
If you are Medicare-eligible, you have likely already enrolled in Original Medicare Parts A and B (If you want to know when your coverage will start, you can read the updated article: Medicare Part B: New Start Dates For Coverage In 2023). Most Americans then proceed to select additional insurance such as Medigap (Med Supp), Medicare Part D, and Medicare Advantage.
With numerous plans, carriers, and deductibles to choose from, selecting the wrong Medicare insurance plan is a possibility. Moreover, a plan that made sense when you initially enrolled may no longer be suitable. This is where Medicare Insurance switching comes into play.
Fortunately, there are safeguards in place to allow you to switch your Medicare insurance if you believe another plan could save you money or be more fitting.
That said, it’s worth noting that if you haven’t yet chosen a Medicare insurance plan, you should start with the best plan available. Reach out to Senior65.com, and they can assist you in doing just that (it’s free!!!).
For those interested in delving deeper into understanding the process of changing plans, the comprehensive details are available in the article titled “Medicare Insurance Switching: Ultimate Guide.” This resource will provide a thorough exploration of the intricacies involved in making informed decisions about your Medicare insurance. Feel free to refer to this guide on Senior65.com to gain a more comprehensive understanding of your options and the steps involved in switching plans.
One significant aspect that impacts your Medigap coverage is how insurance companies determine your premium. There are three common rating methods: Attained-Age, Issue-Age, and Community Rated plans.
Each has its own implications on how your premium will be calculated over time. In this article, we’ll delve into the details of each rating system, helping you make an informed decision about the best Medigap policy for your needs. If you still have any doubts about this topic, you can read an article about it on Senior65.com at the following link: Medigap: Attained-Age Vs. Issue-Age Vs. Community Rated.
The Attained-Age rated plan determines the premium based on your current age, causing it to increase as you grow older. In contrast, the Issue-Age rated plan sets the premium based on your age at the time of policy issuance, ensuring it remains constant as you age.
Lastly, the Community rated plan charges the same premium for everyone enrolled in that specific plan, regardless of age. While inflation may cause premiums to rise in all plans, age is only a factor in the Attained-Age rated plan’s increase.
Understanding these rating methods can significantly impact your Medigap policy costs and long-term affordability.
Senior65.com can help you compare costs and help you apply. If you need assistance feel free to call them at 800-930-7956.
The Medigap Household Discount can be a game-changer, saving you as much as 15% on your Medicare Supplement premiums. As you explore the various Medigap plans to find the right one for you, keep in mind that all Medigap policies come with standardized benefits and doctor networks. This means you can select an insurance provider based on the best price offered, including factoring in the valuable Medigap Household discount.
What Exactly is the Medigap Household Discount?
Recently, Accendo Insurance Company (ACC), an Aetna affiliate, made headlines with its announcement of a 14% household premium discount in many states, significantly above the industry average. Additionally, there is an unadvertised plan offering a remarkable 15% discount in select states.
The Medigap Household Discount provides a percentage off your monthly Medicare Supplement premium when two individuals from the same address are enrolled with the same Medigap insurance company. This discount applies to all types of residences, including houses, apartments, yurts, trailers, and more. However, the availability and requirements may differ depending on the state and carrier. Learn about the requirements to access the Household Discount in this article from Senior65.com: Medigap Household Discount: What Is It And Who Has The Best Deal
What is the Usual Household Discount?
Though not all insurance providers offer Household discounts, the typical industry average ranges from 5% to 7%. The current 14% offer by Accendo and the unadvertised 15% discount are exceptional opportunities available in specific states. For details on these discounts and more, call Senior65.com at 800-930-7956.
Switching from Medigap to Medicare Advantage is possible, and it may be a smart move for some Medicare-eligible seniors. Medigap can be more expensive than Medicare Advantage, so if you find it hard to afford the premiums, MA can save you money monthly.
The best time to make this switch is during the Open Enrollment Annual Election Period, which runs from Oct 15th to Dec 7th. By enrolling in an MA plan during this time, your coverage will begin on Jan 1st of the following year.
If you’re undecided between Medigap and Medicare Advantage, we recommend starting with Medigap first. If you later switch to Medicare Advantage, you’re guaranteed to be approved at the best price. The reverse isn’t always true.
Keep in mind that you cannot have both Medicare Advantage and Medigap at the same time. If you want to know more, read the Senior65.com article: Can You Switch From Medigap To Medicare Advantage?
Adding to the confusion about Medicare, one question arises: “What happens if I enroll in Medicare, then go back to work using my employer’s insurance, and then leave work again?”
Returning to Medicare doesn’t have to be complicated. When you return to work, check if you qualify for health insurance through your employer. If so, find out if you must maintain Medicare Part B while enrolled in the company plan. If you choose to stop Part B, you will also need to drop your Medigap policy. Note: If you drop Part B and later want to reenroll, you may not be guaranteed Medigap coverage. Insurers could deny coverage or charge more for preexisting conditions.
You will keep your Medicare Part A regardless. Depending on your situation, it may be cost-effective to suspend Part B and rely on work coverage. In other cases, it may be more affordable to keep both Medicare Part A and Part B, along with Medigap, and forego the work plan. Read more about it in this link What If I Have Medicare Then Return To Work?
Enrolling in Medicare after leaving work coverage
If you had Medicare but left it to obtain work coverage, and now want to return to Medicare, you can! You will have a Special Enrollment Period to enroll back in Medicare.
Medicare’s Special Enrollment Period grants you two full months to enroll in Medicare after leaving your employer’s insurance, even if you were previously enrolled in Medicare. You won’t have to pay any late-enrollment fees or penalties.
Enrolling in Medigap after leaving work coverage
Once you return to Medicare from work, you may also consider getting a Medigap Plan (Medicare Supplement). Approval for Medigap is not guaranteed, even if you had it before. Some companies may approve you without medical underwriting if you can provide proof of previous work coverage. We can help you identify which companies don’t require medical underwriting when returning to Medicare from work.
Different states have varying regulations on guaranteed issue for Medigap, separate from the federal government. If you live in one of these states, it’s advisable to check your rights. If you have questions, call Senior65.com at 800-930-7956, they can assist you in reviewing your options and reenrolling in a plan.
Switching Medigap plans can be a confusing process, but we’re here to make it easier for you. Whether you’re looking to switch to a different Medigap company or simply switch plans within the same company, we have all the information you need in one place. Discover the pros and cons of each option and learn about the unique switching rules in your state.
Medigap Open Enrollment?
Did you know that you have a chance to change Medigap plans during the General Enrollment Period (GEP) if you missed your initial enrollment?
The GEP runs from January 1 to March 31 each year, and starting January 1, 2023, your coverage will begin on the first day of the following month after you sign up. Don’t miss out on this opportunity to find a Medigap plan that better suits your needs.
Even if you don’t qualify for guaranteed switching, you can still switch Medigap plans by answering some medical questions.
If you need assistance, you can reach out to the team at Senior65.com, who will help you with the switching process and ensure a smooth transition for you.
How to switch Medigap Plan without medical questions?
Some states have laws that allow you to change Medigap plans without going through medical underwriting.
States like California, Oregon, and Illinois have the Medigap Birthday Rule, while Connecticut and New York offer guaranteed issuance for all at any time.
Explore the options available in your state and see if you qualify for these hassle-free switching opportunities.
Don’t let confusion or limited options hold you back from finding the right Medigap plan. If you have any questions, you can read Switching Medigap Plans: Complete Details from this link.
If you’re considering Medicare supplemental insurance, also known as Medigap, it’s important to weigh the pros and cons before making a decision. Medigap can enhance your Original Medicare coverage by providing additional benefits, but it does come with both advantages and disadvantages. To learn more read the article from Senior65.com Medigap: Pros And Cons.
Take a look at our list of Medigap pros and cons to determine if it’s the right choice for you.
- 1. Plans cover some or all of the additional fees associated with Medicare.
2. Medigap plans are easy to compare since they offer standardized benefits.
3. There is a guaranteed 6-month enrollment period when you’re first eligible for Medigap.
4. All plans provide an additional 365 days of hospital coverage.
5. Some plans offer extras like coverage for excess charges, foreign travel emergencies, and programs like Silver Sneakers.
6. Medigap plans provide nationwide coverage, utilizing the same network as Medicare.
- 1. Monthly premiums for Medigap plans can be costly.
2. It can be difficult to switch Medigap plans once you’re enrolled.
3. There may be limitations on enrolling in Medigap after the initial enrollment period.
4. Not all Medigap plans cover the Medicare hospital deductible.
5. Medigap plans do not include prescription drug coverage, requiring the purchase of a separate Medicare Part D plan.
6. Elective surgeries are not covered by Medigap.
It’s worth noting that Medigap plans are regulated and standardized, ensuring that each company offers the same benefits for a particular plan. While Medigap may have its drawbacks, it serves as a reliable secondary payer to Medicare, covering the costs that Medicare doesn’t. If you’re concerned about the cost of Medigap, you can obtain an instant quote to get an estimate based on your age and location.
For further assistance and guidance, you can reach out to Senior65.com at 800-930-7956.
Medicare can help pay for adjustable beds in your home. To qualify for coverage, you will need to check with your provider and the Durable Medical Equipment (DME) supplier to ensure they are Medicare Providers and accept assignment. If the supplier accepts assignment, you will pay 20% of the Medicare-approved amount, plus the Part B deductible. It is important to note that the bed must be deemed medically necessary and supported by a prescription from your doctor, along with relevant medical records.
Adjustable beds may be covered by Medicare if they are needed due to a disability that requires frequent repositioning, such as pain caused by cardiac disease, spinal cord injuries, or severe arthritis. The prescription from your doctor should specify any additional equipment required, such as special mattresses or bed rails. To learn more read the article from Senior65.com Does Medicare Cover Adjustable Beds?
Once the above conditions are met, Medicare will cover up to 80% of the cost of the adjustable bed, after the Part B deductible has been paid.
In addition to Medicare coverage, Medigap plans can also help fill in some of the gaps that Medicare does not cover. For example, certain Medigap plans, like Plan F, may cover the 20% balance that Medicare doesn’t cover, as well as the Part B deductible. This means that individuals with these specific Medigap plans may not have to pay any out-of-pocket expenses for approved adjustable beds through Medicare. If you need assistance, the team at Senior65.com can provide guidance.
It’s important to keep in mind that coverage for adjustable beds under Medicare Advantage (MA) plans may vary. Since MA plans are not standardized, each carrier determines the extent of coverage they offer. Therefore, it’s advisable to review the details of your specific MA plan to determine the coverage it provides for adjustable beds.
Medigap plans are not mandatory, but they can be beneficial for certain individuals. Here are some reasons why people might consider getting a Medigap plan:
- 1. Chronic health conditions: Individuals with chronic health conditions often have high out-of-pocket costs with Original Medicare. Medigap can help cover these costs, such as coinsurance and copayments, providing financial protection for those with frequent medical needs.
2. Fixed income: For individuals on a fixed income who want to avoid unexpected medical bills, Medigap can be a valuable option. It offers more predictable out-of-pocket costs, allowing for better budgeting and reducing the risk of unforeseen expenses.
3. Frequent travelers: Medigap policies can provide coverage for emergency medical care when traveling abroad. This is particularly important for individuals who travel frequently or for extended periods and want the peace of mind knowing they have coverage while away from home.
4. Desire for comprehensive coverage: Some people prefer more comprehensive coverage than what Original Medicare provides. Medigap plans can fill in the gaps and cover expenses that Medicare doesn’t, offering a higher level of coverage.
It’s essential to carefully review the available Medigap plans in your area and choose the one that best suits your needs and budget. If you need assistance, the team at Senior65.com can provide guidance in selecting the right Medigap plan for you. To learn more read the article from Senior65.com Who needs Medigap Plans?
If you’re confused about switching Medigap plans, we’re here to provide all the information you need in one place. Whether you want to switch to a different Medigap company or change plans within the same company (e.g., from Medigap F to Medigap G), we’ll cover the unique switching rules for your state. While switching Medigap plans can be challenging, we’ll provide you with the necessary details to make the process easier.
Firstly, it’s important to note that Medigap plans do not have an annual switching period like Medicare Advantage and Medicare Part D. Instead, there is a one-time initial enrollment period known as Medigap Open Enrollment. This occurs when you are over 65 and enrolled in Medicare Part B. We often refer to it as Medigap Initial Enrollment because many people mistakenly assume it happens every year. During this 6-month period, you can enroll in any Medigap plan regardless of your health. If you choose a plan during this initial open enrollment period and later decide to switch, you can do so within the first 6 months of eligibility without any questions asked. Check here to see if there’s a lower-cost Medigap plan available in your area.
You can switch Medigap plans at any time by submitting a new application. Whether you want to switch from Medigap Plan F to Plan G, work with a different insurance company, or find a better-priced Medicare Supplement plan, you have the flexibility to do so. However, in most states, you’ll need to answer medical questions, and there’s a possibility of being denied coverage due to pre-existing conditions. The level of scrutiny and approval standards vary among insurance companies, with some having easier requirements and asking fewer medical questions.
The best way to learn more about this issue is to visit Senior65.com very comprehensive Medigap Switching Guide
If you need assistance selecting a plan with a higher chance of approval based on your health situation, feel free to call us at 800-930-7956. We have a track record of success in this area. However, before attempting to switch Medigap plans by answering medical questions, consider if you qualify for guaranteed switching as outlined below. We have also provided a detailed guide on Medicare Insurance switching options that do not require answering health questions.
Oregon Medigap Plans have a special rule that allows you to switch your Medigap Policy within 60 days each year, known as the Birthday Rule, which is available in only a few states.
OR Medigap Basics
Medigap, also known as Medicare Supplement Insurance, is a type of private health insurance designed to help cover the “gaps” in coverage left by Original Medicare (Parts A and B). These gaps can include out-of-pocket costs like deductibles, copayments, and coinsurance which can add up quickly for those with high medical expenses. Medigap plans are sold by private insurance companies and are regulated by both federal and state laws. For a detailed article about Medigap in Oregon check out the Senior65.com Oregon Medigap Buyers Guide
In Oregon, Medigap plans are standardized into ten different plan types, labeled A through N. This means that each plan type offers the same benefits, regardless of which insurance company you purchase it from. If you need help finding the right coverage for you, please contact Senior65.com at 800-930-7945 x 3. There is never a charge for their services.
Who is eligible for an Oregon Medicare Supplement Plan?
To be eligible for a Medigap plan, you must first be enrolled in Original Medicare (Parts A and B). You must also be a resident of OR and be at least 65 years old or have a qualifying disability or medical condition.
In addition to meeting these basic eligibility requirements, it’s important to note that you can generally only enroll in a Medigap plan during certain enrollment periods. During this time, you have a guaranteed right to purchase any Medigap plan available in your area, regardless of your health status.
After the initial enrollment period, you may still be able to enroll in a Medigap plan, but you may be subject to medical underwriting and may not be able to purchase the plan of your choice. This is why it is so important that you work with a licensed independent insurance agent to help you select the right plan when you are first eligible. Feel free to call Senior65.com at 800-930-7956 for assistance.
What is the Oregon Medigap Birthday Rule?
The OR birthday rule is a law that enables individuals with a Medigap plan to switch to another plan without undergoing medical underwriting. In OR, they have established an annual 60-day window based on your birthday to change plans, giving it the nickname “birthday rule”.
Most states do not have a birthday rule or similar option, so individuals outside of Oregon with Medigap plans who want to switch to a more affordable competitor usually must complete an application and answer questions regarding their current health condition to be approved.
How do Oregon Medigap Plans Implement the Birthday Rule?
The Birthday Rule for Medigap plans in certain states, including Oregon, allows individuals to switch plans during a 60-day window surrounding their birthday each year. Specifically, this window begins 30 days before your birthday and ends 30 days after your birthday. If you’re interested in making the switch, you can check out the following link to see which plans are available for exchange.
Before making the change, you have to keep this in mind:
- The change is guaranteed, regardless of your health.
- If you choose to switch from one Medigap Plan F High Deductible policy to another mid-year, the high deductible will restart under the new carrier’s policy contract. Therefore, it’s crucial to carefully consider the annual deductible before making the switch.
- New coverage for a Medigap plan typically begins on the first day of the month following the application date. It may be possible that coverage may even start before your birthday, depending on when you applied, the insurance carrier, and when your birthday falls in the calendar year.
- Finally, it’s crucial not to cancel your current Medigap policy until the new policy is issued. In some cases, you may even need to pay two premiums for a single month to ensure a seamless transfer from the old to the new policy.
How to Apply for Blue Shield Medigap Online
Applying for a Blue Shield Medigap plan is easy. It is now available 100% online with no printing or faxing required. Just click here to apply for Blue Shield Medigap.
Blue Shield Medigap Overview
Before we delve into Blue Shield Medigap, we want to first clear up some confusion. Blue Shield offers both Medicare Advantage plans and Medigap plans. What’s the difference?
- Medicare Advantage plans offer equivalent benefits as traditional Medicare Part A (hospital coverage) and Medicare Part B (doctor coverage). They can offer additional benefits such as prescription drug coverage or dental. Medicare Advantage plans are low cost but they have a limited HMO doctor network and offer very little coverage beyond the minimum requirements.
- Blue Shield Medigap plans offer additional benefits not covered under traditional Medicare. You will want to think of Medigap (which sometimes is referred to as Medicare Supplemental plans) as insurance you buy to cover all things that traditional Medicare does not cover. It is supposed to fill in the Medicare GAPS!
Here is what Blue Shield Medigap Plan F Covers:
- 1) Your Medicare Part A Hospital deductible
2) All the hospital stay costs during days 61-150 that are only partially paid by Medicare
3) All the hospital stay cost from 150 days-365 that are not covered at all by Medicare
4) All the skilled nursing cost from 21 through 100 that are not covered by Medicare
5) Your Medicare Part B deductible
6) Both the 20% of normal Doctor fees that Medicare makes you pay plus 100% of any fees your doctor may charge beyond the Medicare reimbursement rate
7) The first three pints of blood per calendar year
8) Foreign medical expenses
Medigap Plan F does a very good job of filling in most of the potential medical expenses that are not covered by Traditional Medicare. It is the most comprehensive and most popular of all the Medicare Supplemental plans we sell. It is also usually one of the most expensive. The cost of Plan F depends on your age and where you live. To get a Blue Shield Medigap quick quote here.
After you have signed up for Medigap you are not done
Medigap plans only cover medical expenses at the doctor and hospital and do not cover prescription drugs or dental coverage. Blue Shield of California will offer you dental right in the application. You will want to purchase a Rx plan as part of Medicare Part D prescription plan. To get started with your RX coverage visit Senior65.com section on Medicare Part D prescriptions.
Enrolled in another Medigap plan, but want Blue Shield?
Not a problem! Blue Shield has extended their Special Enrollment for those who currently have a Medigap plan and want to switch! You don’t have to wait until your birthday, you can do it now.
Anthem Blue Cross Medigap
Before you purchase a Medigap policy from Blue Cross you need to know a few things:
1) Blue Cross Medigap programs, like all Medigap programs, are intended only for people who are enrolled in both Parts A and B of Medicare,
2) As you know, Medicare Supplement Insurance plans (often called Medigap) are regulated, so, Blue Cross has to offer the exact same benefits as all other Medicare-Eligible supplement insurance providers.
3) Which Medigap plans Blue Cross offer (and more importantly at what price) can vary dramatically from state-to-state.
Blue Cross Medigap Quote in your State
Use this link to find Blue Cross medigap plans in your state. Here you will get a quote and a list of what benefits are covered under each plan in your state. If you are ready to apply for Blue Cross Medigap click on the arrow below.
For a Great Medicare Overview:
If you don’t already have Medicare you may want to check out this Medicare insurance website. It explains Medicare Part A and Part B (required before you can purchase Medigap),Part D prescriptions as well as Medigap.
Here is a general list of the kind of benefits offered under the Blue Cross Medicare supplemental plans. Make sure you get a Medigap quote to see the exact benefits.
Part A Deductible
- 365 Additional Hospital Days
Skilled Nursing Facility Coinsurance
First 3 pints of a blood transfusion
Part B Annual Deductible
Part B Excess Charges at 100%
Part B Coinsurance
Home health care
Additional Preventive Medical Care
Foreign Travel Emergency
Click here to compare Medigap plans.
The first thing that most Medicare-Eligible people considering health care ask us is, “Which is best: Medigap vs Medicare Advantage.” Before we can answer the question, however, we want to discuss how each product works because they are drastically different.
What is Medigap and What is Medicare Advantage?
Medigap refers to a group of supplemental insurance plans that work in conjunction with your regular Medicare benefits. They cover many expenses not covered under Original Medicare such as additional hospital days or international travel. Also Medigap plans often cover expensive deductibles or copayments that are charged to Medicare patients without Medigap. These cost can add up to hundreds of thousands of dollars should you have a major illness or accident.
The benefits of Medigap plans are standardized by the federal government, meaning that plans sold by different insurance companies all offer the same benefits. Click here to visit Senior65.com to get a quick Medigap quote
Medigap does not cover prescription benefits so most people purchase additional Rx coverage through Medicare Part D.
Now that you know a little more about Medigap, learn does Medigap cover dental?
In contrast, Medicare Advantage (MA) plans replaces Original Medicare. Medicare Advantage plans are run by private companies and must provide equivalent coverage as Medicare A and B, but vary beyond this minimum set of benefits. Medicare Advantage can still leave open the gaps that Original Medicare leaves in case of major medical issue. Some Medicare Advantage plans offer dental, vision, or prescription coverage. Many Medicare Advantage plans are HMOs, therefore have a smaller network of doctors than those that accept Original Medicare.
Medicare Advantage plans are often less expensive than Medigap plans. So, if you’re willing to deal with the restricted network (i.e., you don’t plan on traveling the country) and your funds are limited, the Medicare Advantage plan may be the best choice for you.
One nice thing about Medicare Advantage is that each year there is an Annual Enrollment Period (AEP) where you can switch companies. The AEP is from October 15 to December 7 each year. If you are looking to get a quote visit Senior65.com’s instant Medicare Advantage quote
|Typically More Expensive||Typically Less Expensive|
|Fills in the cost “gaps” not covered Medicare||Equivalent coverage as Medicare|
|Same Network of Doctors as Medicare||Some times smaller network of doctors than Medicare|
|Does not cover RX||Can include RX coverage|
|Contact us for a recommendation||Contact us for a recommendation|
Making the Choice of Medigap vs Medicare Advantage
At the end of the day, only you can determine which is the correct type of plan for you. We like to say that the decision comes down to “pay now or pay later.”
Pay Now Medigap plans are usually more expensive each month but will save you a significant amount money if you need extensive medical services. If you budget can afford a Medigap plan, they may be a good way at protect your wealth.
Pay Later Medicare Advantage will almost always be less expensive in the short run because their monthly premiums are usually lower than Medigap. Out-of-pocket costs for many services such as hospital stays, however, can be more expensive with Advantage plans than they are with Medigap plans. You should contact your physicians to ensure you can keep seeing them if you go with Medicare Advantage.
If you are still unsure you might want to check out this simple wizard to help you decide if Medigap or Medicare Advantage is right for you.
If you need help along the way contact our licensed agents at 800-930-7956.
The Medicare-Eligible health plan landscape can be split into two main categories: Medicare and Medigap. Most US citizens aged 65 and older are eligible for Medicare (also some people aged lower than 65), but because Medicare doesn’t cover all of the services that many need, Medigap (also called Medicare Supplemental Insurance) exists to fill in the gaps. Following are the main points to consider when researching health plans.
Keys to the four parts of Medicare
Part A: You get premium-free Medicare part A as long as you paid enough taxes into Medicare while working; a good gauge is if you’re eligible to get Social Security, then you’re likely eligible for premium-free Medicare part A. But part A only covers hospital services such as inpatient care in hospitals and skilled nursing facilities.
Part B: More general medical services such as doctor’s visits and outpatient care are covered by Part B.
Part C: Also called The Medicare Advantage Program, Part C offers an alternative by skipping Part A and B and instead going with private insurers. The benefits offered in Part C include those from Parts A and B, as well as other benefits such as additional medical, dental and vision coverage. Some Part C plans require policy holders to pay a separate premium in addition to the premium for Part B.
Part D: The final part of Medicare helps offset the cost of prescription drugs. To enroll, you need to choose a separate Medicare-approved plan offered by a private insurer, or select a Part C plan that includes Part D coverage.
Keys to Medigap Health Plans
Medigap plans are offered by private insurers as a supplement to parts A and B of Medicare. While the premiums for Medigap plans are usually more than those for Part C Medicare Advantage plans, the copayments and deductibles are often less.
Tip: Because Medigap plans and Medicare Advantage plans are both designed to fill the gaps left by regular Medicare coverage, you should NOT consider purchasing both.
Like the parts of Medicare, Medigap plans are identified by the letters of the alphabet. There are many different Medigap plans: A through D, F, G, and K through N. Additionally, the benefits for all Medigap plans are standardized, so all same-lettered plans include the same benefits. This makes it easy to compare plans sold by different insurance companies because the only difference is often cost.
It’s also important keep in mind how Medigap plans are rated, which effects how the costs rise over time. There are three ratings: (1) Issue-Age-Rated, in which the premiums are set based on your age at the time of purchase, (2) Community-Rated, in which the premiums are the same for everyone in a defined community, and (3) Attained-Age-Rated, in which the premiums change to reflect your age as you get older.
Now that you understand Medigap a little better, you will want to learn if Medigap covers dental.
Once you’ve processed the above, click here to learn more about how Medigap plans are rated and to get a Medigap quote
What does Medigap cost? Figuring this out requires a little education, and some old-fashioned research. Below you will find a breakdown of how all Medigap plans are priced, and how to find the best price where you live.
Medigap Cost Basics
The first thing to understand about Medigap plans, also called Medicare supplemental insurance plans, is that the benefits for every plan are standardized. This means that the benefits for Medigap Plan A offered by one insurance company will be the same as the benefits for Plan A offered by any other insurance company.
Once you know which plan has the right benefits for your needs, you simply need to find the insurance company that offers the best price. But there are a few things to keep in mind about how the prices for Medigap plans are set.
How Medigap Plans are Priced
While the benefits of all Medigap plans are standardized, the costs are not. Insurance companies are free to set the price for premiums for their plans however they see fit. They can also determine if the costs will rise as you get older. There are three ways that insurance companies rate their plans that determine how the costs rise over time:
- Community-Rated (also called No-Age-Rated): Everyone in the community with the same Medigap plan pays the same monthly premium, regardless of age.
- Issue-Age-Rated: The monthly premium is based on your age when you buy the plan. Premiums are more for older purchasers.
- Attained-Age-Rated: The initial premium is based on your age when you purchase the plan, AND, the premium goes up as you age.
According to our experience here at Medicoverage, the majority of plans are Attained Age. Some Community-rated almost offer a “discount” to younger members that goes away as you get older. To learn more or get a quote check outSenior65 Medigap Plan
Other Factors Affecting Medigap Costs
Medical Underwriting: This refers to the practice of insurance companies using your medical history to determine the cost of your plan, or in some cases, deny offering you coverage.
High-Deductible plans: Insurance companies in your area may offer high deductible options for Plans F and G. This means your monthly premiums will be lower, but you’ll have to pay more for medical services before your Medigap coverage kicks-in.
Medicare Select: This is a type of Medigap plan with lower costs, but that requires policy-holders to use a pre-defined network of hospitals, and sometimes doctors. Medicare Select plans are not available in all states.
Now that you know the factors affecting Medigap costs, the next step is to see what plans insurance companies are offering in your area. Get a quote to compare Medigap plans now.
Doing a Medigap compare can be tricky, but a little basic information can illuminate the key differences in all Medigap plans. Understanding these differences will allow you to make an informed purchase of the Medigap plan that fits your needs.
First, a little general info on Medigap plans
Medigap plans, also knows as Medicare supplemental insurance plans, are designed to fill the gaps left by Medicare coverage. Each plan is identified by a letter, either A through D, F, G, or K through N. Even though Medigap plans are sold by private insurance companies, the federal government has standardized what all Medigap plans must cover, so while different health insurance companies may offer a different price for, say, Plan A, the coverage and benefits for every plan A are the same no matter which company you choose.
You will also want to learn, does Medigap cover dental?
Compare Medigap Benefits
Because the benefits for all Medigap plans are standardized, you need not worry about searching exhaustively among insurance companies for the benefits you need from Medigap.
The cost of Medigap plans can vary widely among insurance companies. This is because, while the benefits are locked, insurance companies can still set the cost of premiums. So, in general, your best bet is to go with the insurance company that offers the best cost—but there is one caveat: insurance companies can also set how the premiums will rise over time based on age. Each plan is rated as such by the insurance company in one of three ways:
- Community-rated (also called No-Age-Rated): Everyone in the community who has the same Medigap plan pays the same monthly premium, regardless of age.
- Issue-Age-Rated: The monthly premium is based on your age when you purchase the plan. Premiums are higher for older purchasers.
- Attained-Age-Rated: The initial premium is based on your age when you purchase the plan, AND, the premium increases as you age.
Note: With all three ratings, premiums may rise over time because of inflation or other factors.
Always make sure to check how the plans are rated when comparing Medigap plans. To sign up for Medigap go to our Medigap Home Page.
Get a quote and start a Medigap compare.
If you want to run a Medicare supplement comparison right now, visit our quote engine, enter your zip code (all other info is optional) and click on the “Next Step” button. You’ll get a list of Medicare supplemental plans available in your area, along with their prices.
If you want to educate yourself a bit first, read on.
People often feel overwhelmed at the prospect of selecting a health insurance plan to supplement their Medicare for one reason: it’s confusing territory. But with a little background information and some guidance, you’ll be able to run a Medicare supplement comparison and make an informed decision about which is the right Medicare supplemental plan for you.
Step 1: Know the Definition of Medigap Insurance.
Medicare supplemental insurance is commonly referred to as Medigap because it was designed to fill in the gaps left behind by Medicare. Medigap is different from Medicare Advantage Plans, which are a way to receive Medicare plus additional benefits. Medigap plans were designed to help you pay for things that Medicare does not, such as Medicare coinsurance and copayments or skilled nursing care. Medigap plans are sold by private insurance companies, but standardized by the Federal government and they are named for the letters of the alphabet.
Step 2: Set Your Priorities.
As you saw in the PDF table above, Medigap plans cover a specific set of benefits. The way to choose the right for you is to know which benefits you value and which you can do without. Print the table above and circle those benefits you value most. Then check to see which lettered Medigap plans offer the benefits you want. Cross off the plans that don’t offer the things you care about most.
Step 3: Understand Medigap Pricing.
Medigap plans are generally priced in one of three ways as outlined below.
- Attained Age: these plans are priced based on the subscriber’s age at any give time. That means the premiums go up over time as you age and they can quickly get expensive.
- Issue Age: these plans are priced based on the subscriber’s age at the time they first enroll in the policy. Premiums do not go up as you age, but only moderately in the event of health care inflation.
- Community Rated: these plans are priced based on where the subscriber lives and like the issue age Medigap plans, they do not increase over time because the subscriber has aged.
If possible, we recommend that you select an issue-age or community rated plan. Though these may appear to be more expensive in the short run, they tend to be much less expensive in the long run because the premiums are locked in and do not continue to steadily rise as you age. Click here if you’re ready to sign up Medigap Overview Page.
Step 4: Get a Quote.
Now that you’re armed with some information (have that marked-up PDF table at your side!), you’re ready to get a quote. Just visit our quote engine, enter your zip code (all other info is optional) and click on the “Next Step” button. You’ll get a list of Medicare supplemental plans available in your area, along with their prices. Any plan that is not available for sale in your area is automatically excluded from your results.
If at any time you would prefer to speak to a licensed Medicoverage agent, just visit our contact page and give us a call. We’re here to help.
The landscape of Medicare supplemental plans can seem quite confusing at first glance, but if you know a few basic facts up front, you’ll be better prepared to make sense of your Medicare supplement quotes when you get them.
Basic Medigap Facts
Fact 1: Medicare supplemental plans are private health insurance plans, often referred to as “Medigap” plans that are designed to fill in the gaps left by Medicare. Medigap policies can help pay your share (including coinsurance, copayments, or deductibles) of the costs of Medicare-covered services. Some Medigap policies also cover certain benefits that original Medicare doesn’t cover. Click here for more information on Medigap Policies.
Fact 2: There are different Medigap plans offered and each plan is named for the letters of the alphabet.
Fact 3: These lettered plans are standardized by the Federal government, meaning that, regardless of which insurance company sells them, all the A plans are the same, all the B plans are the same, and so on through the alphabet.
Fact 4: Just because the C plan offered by one company is exactly the same as the C plan offered by another, does not mean that the price of all the C plans are the same. So when you’re shopping for a plan, be aware of what you’re getting versus the price you’re paying. But before you blindly choose the lowest-cost plan, make sure you look at the company’s customer reviews before you choose. A Medigap plan is not a bargain if you can’t get the services you need when you need them.
Now that you know some basic facts, you’re ready to get a Medicare supplement quote.
How Do I Get a Medicare Supplement Quote?
Simply visit our Medicare Supplemental Insurance quote engine and enter your zip code in the box at the top. There are fields for your contact information as well, but these are optional. Filling them in will be helpful if you’d like personalized help from an agent, but you can get a set of Medicare supplement quotes with your zip code alone.
Once you get your quotes and are ready to make a decision, be sure to factor in what’s important to you. Are prescription drugs more important than emergency care? What about help with paying your Medicare coinsurance? Are you facing the need for hospice or other long-term care? Make sure the policy you pick offers the coverage that’s most relevant to your needs. Conversely, you might choose to save money by selecting a policy that does not cover those things that you don’t anticipate needing in the future.
And if you need assistance, contact a licensed Medicoverage agent. We’re here to help.
Medicare Part D insurance is the newest addition to Medicare—it’s the prescription drug coverage that’s got everyone talking. What’s the big deal? Probably the fact that this coverage helps to protect Medicare-Eligible people against the very real financial risk of needing extremely expensive prescription drugs to maintain a healthy lifestyle.
Who is Eligible for Medicare Part D Insurance?
Everyone who is already enrolled in Medicare. Even if you need brand-name prescription drugs. Even if you have very expensive prescriptions for pre-existing conditions.
How Does this Medicare Prescription Drug Coverage Work?
You can enroll in Medicare part D insurance as soon as you become eligible for Medicare, which is 3 months before you turn 65, through 3 months afterward. If you miss this window to sign up, there are open enrollment periods during each calendar year that are updated by the Federal government each year, however you may pay a penalty.
Your decision about how to obtain prescription drug coverage depends on the kind of health care coverage you have now. There are 3 different ways to enroll in a prescription drug plan:
1) Join a stand-alone Medicare prescription drug plan
2) Join a Medicare Advantage Plan that includes prescription drug coverage
3) Join another Medicare health plan that offers drug coverage
Regardless of how you choose to enroll in prescription drug coverage, having Medicare drug coverage will help you by covering both generic and brand name prescription drugs at pharmacies right in your home town. Ready to get started with Medicare Part D? Click here for Medicare Part D Prescription Plans.
Just like any other insurance, when you enroll in a Medicare Part D plan, you can expect to pay a monthly premium, which varies by plan, and a yearly deductible. But even once you are covered and pay your premiums, your prescriptions are generally not free. You can expect to pay at least a part of the cost of your prescriptions, including a copayment or coinsurance. These costs will vary depending on which plan you choose, so pay attention when you shop for a plan. Some plans may offer more coverage and additional drugs for a higher monthly premium. If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible, but qualifications for this assistance are very specific. For more information on how to qualify for assistance, visit the social security website.
If you want personalized help in selecting a plan, contact a Medicoverage agent.
Recent news that the Federal government may consider cuts to Medicare that could adversely affect Medicare-Eligible citizens can be quite worrisome, which may prompt many to explore medical insurance plans.
As it stands, Medicare can be confusing, but it helps to understand Medicare before you shop for supplemental plans. So let’s start by breaking Medicare down into it’s four parts, which are named, quite simply, Parts, A, B, C and D.
Medicare Part A
Covers hospital treatment as an inpatient, hospice care and nursing home care as well as some care in the person’s own home. There is no monthly premium for this aspect of Medicare, as it is covered by taxes.
Medicare Part B
Outpatient hospital care and general practitioner costs, including any equipment, as well as occupational and physical therapy. Similar to a regular, individual health insurance plan, you pay a monthly premium and an annual fee for these services.
Medicare Part C
This is where you can find what are called the “Medicare Advantage Plans,” which are Federally approved medical insurance plans that combine the benefits of parts A and B above, plus additional benefits, such as covering prescription drugs.
Medicare Part D
This is the newer Medicare prescription drug coverage.
Medicare Has Gaps
Medicare does not provide comprehensive health coverage. Medicare-Eligible insurance plans designed to fill in the gaps left by Medicare are often called “Medigap” plans. The best place to learn about Medigap is Senior65.com.
Medigap plans are sold by the insurance companies that many of us have heard of, such as Blue Cross, Blue Shield and Aetna But what’s different about these plans is that they have been approved and standardized by the Federal government.
There are different plans to choose from and they are named with the letters “A” through “L.” While you will find more than one “A” plan offered for sale by the various insurance companies, they’re all the same standardized plan. So when you compare “A” plans between two companies, be aware that they are the exact same coverage but not necessarily the same price. This means that each individual insurance company that offers a certain Medigap A plan must offer the exact same benefits as another company offering a competing Medigap A plan. The same is true for all of the “B” plans, the “C” plans, and so on.
But when you shop for medical insurance, remember that price may not be your only factor in deciding which company you want to provide your Medigap plan. Quality matters too, so pay attention to those online customer reviews as well. Also, learn if Medigap covers dental.
To get quotes on Medigap plans in as little as 10 seconds, visit our Medigap Quote page.
In recent months there has been quite a bit of discussion around Medicare and health insurance. Medicare supplemental plans, which are often called “Medigap” plans, are meant to fill the gaps left by Medicare.
While post-retirement life is supposed to be at least somewhat of a carefree time, this is is not the case for many. As people get older, their need for medical and hospital treatment increases and can eat away at people’s savings. Medigap plans are health insurance plans that the United States Government introduced to help alleviate the burden of health costs.
Medicare Supplemental or “Medigap” Insurance
One of the problems with Medicare was that it did not give older people full health coverage, and an increasing number of them had trouble paying for all of the treatments and services they needed. To help older people with the cost of health insurance, Medicare supplemental insurance plans have been put forward as a means of filling these gaps. The companies that sell this type of insurance provide specific health plans that have been screened and approved by the Government. However, not everyone will benefit from these plans, as the recipient must already be enrolled in Medicare parts A and B in order to be a candidate.
While there were four parts to the Medicare plans, there are actually twelve different Medigap plans, which are designed to meet different health care needs. Each offers a slightly different set of benefits to meet the varying needs of different individuals. To browse the plans and look for the one that suits you, read our Available Medigap Plans page.
Companies Filling the Gap
The companies selling the Medigap plans usually have an insurer acting on their behalf to supply Medicare-Eligible citizens with the right, and most affordable plan for them. The guidelines for this health insurance (medicare supplemental plans) are set by the government; however, you should be aware that the cost of these policies will vary because they are set by the individual companies.
By definition, Medigap plans do not cover all health care requirements, so as you shop for a plan, make sure you pay attention both to what is offered and to what is left off the list. For the most up to date information go to the Senior65 Medigap Page.
Getting Help Finding Affordable Medicare Supplemental Insurance
If after browsing through our Medicare-Eligible Health Insurance pages you still have questions, you can contact a licensed Medicoverage agent at any time. We would be happy to help you find the right coverage for you.
A recent insurance industry survey indicates the odds of an individual experiencing a disability or illness requiring extended custodial or medical support are 120 times greater than losing a house due to fire or some other catastrophe. At the same time, while advances in medicine and technology are extending people’s lives, the cost of long-term medical care is rising at an alarming rate. Put all this information together and it seems clear enough that long-term care (LTC) insurance seems like a very good idea.
What is it: LTC is the kind of care a person, young or old, needs when assistance is required to perform normal life activities such as bathing, dressing, eating or just moving around. The need for such care can result from a variety of circumstances, ranging from old age to sickness, accidental injury or any disability that prevents an individual from performing these tasks. Sometimes this care is provided in a nursing home, but it may surprise you to know that approximately 85% of LTC is provided at home or in assisted-living facilities.
Medicare may provide short-term coverage for stays in skilled nursing homes, but it is not intended to cover custodial or assisted-living care, nor does it cover extended home health care. As a result, the United States Government Medicare guidebook suggests that Americans should not count on Medicare as their primary source of LTC funding.
Fortunately, the tax law provides benefits to encourage individuals to purchase LTC insurance.
Tax deductions: If you purchase a qualified LTC policy, you may be able to treat the premiums as medical expenses, assuming you itemize your deductions. You may be able to claim a deduction to the extent your total medical expenses (including LTC premiums) exceed 7.5% of your adjusted gross income. There is a dollar limit, however, on the amount of the premium that can be treated as a medical expense.
Self-employed taxpayers, meanwhile, can deduct 100% of their health insurance premiums, whether or not they itemize their deductions. And for this purpose, health insurance includes qualified LTC insurance. However, the deduction for LTC insurance premiums is subject to the dollar limits mentioned above.
Caveat: In order for an LTC policy to be a “qualified” plan certain requirements must be met. For example, policy must be guaranteed renewable and the policy generally cannot provide for a cash surrender value or other funds that can be paid, assigned, borrowed or pledged as a loan. And the policy issuer must inform you that the policy is intended to be a qualified policy.
For your consideration: As LTC policies covers you for long-term care, Medicare Supplemental, AKA Medigap, fills in the gaps of what Medicare doesn’t cover for extended stays -protecting Medicare-Eligible people from healthcare financial burdens. To learn more about Medigap or to apply today go to the Medigap Policy Overview Page.
Final point: There is legislation pending in Congress that would create additional benefits for purchasers of LTC insurance. Refer back for any late breaking tax developments affecting LTC policies.
Please note that this is not tax advice. Please consult a tax professional.
Not knowing where and when to find affordable Medicare-Eligible health insurance can be frustrating for many people. The fact that insurance information is confusing and full of industry jargon only further serves to aggravate the situation. According to the Kaiser Foundation, lack of affordable health insurance is restricting patients’ ability to get the proper care and medical treatment they need. This is a problem that can be addressed, to a large degree, with proper education.
Here are some easy to understand facts and information that pertain to affordable health insurance plans. This information can help you choose the right coverage for yourself, your parents, or others that you care about.
The first step is to see if you qualify for Medicare. Medicare is intended to be used by people who are 65 years of age, or older. There are provisions that also provide Medicare health benefits to specific individuals who are younger than 65. People who suffer renal diseases or have become disabled generally who are not yet 65 can meet the qualifications for Medicare. If you are not sure if you qualify, visit www.senior65.com and start on step 1.
After you sign up for Medicare you then want to consider additional options. Although Medicare provides a moderate amount of health benefits to nearly 50 million people in the US, it was never meant to be used as a standalone health package. If this is the only health care benefits that you currently have, you most likely do not have enough coverage to take care of all your medical needs. Even using low cost health clinics that are in your community is not enough help to make up the difference.
If you are concerned that Medicare will not meet all your health care needs you will need to select one of the following: A) Medicare Advantage Plan or B) Medigap insurance.
A) Medicare Advantage Plan
With Medicare Advantage, qualified individuals can sign up for plans that often offer more health care benefits and extended coverage options. Medicare Advantage is handled through private insurance companies and provides health care services covered under Medicare Parts A and B and may offer additional services not covered under Medicare. Medicare Advantage plans are usually HMOs but some are PPOs. These plans can even include prescription coverage. Medicare Advantage plans are typically only good within a local coverage area and not all doctors accept these plans. In general Medicare Advantage plans premiums are lower than Medigap plans but copayments for certain health benefits can be much more expensive. While this is often an affordable Medicare-Eligible health insurance plan that helps you lower health care costs, it can end up costing more if you have many health insurance needs.
Medigap is a popular term used for Medicare supplemental insurance. When you sign up for this type of plan, the policy will help bridge the difference (gaps) between actual health care charges and the amount of money that Medicare pays. Like Medicare Advantage, Medigap is also offered by private health insurance companies but is highly regulated. Each private company must offer the same exact benefits so it makes comparing Medigap plans very easy. Medigap plans are PPO plans and often have national networks of doctors. Medigap insurance is the best way for you cut your out-of-pocket expenses and protect you from the high cost of procedures not completely covered under Medicare. A new site, Senior65.com, was recently created to help seniors figure out and purchase Medigap insurance.