It can be difficult to know how to set up your Medicare options when you first enter the program. With all the advertising and information floating around the internet, it can be hard to know what to trust. One of the most important things to do when you get near Medicare is to make a solid plan based on the facts of what Medicare provides and what it doesn't provide. Medicare Supplement Insurance can help cover the costs that Medicare doesn’t. In this article will review the basics of Medicare Supplement Plans in Michigan.
It's important to understand that Medicare doesn't cover all of your expenses. Medicare was designed so that you would have to share in the cost of some of them, and certain services and procedures are just not covered at all. Your share of costs can include:
In addition to this original Medicare does not cover either International emergency coverage or prescription drug coverage, except in extraordinarily limited circumstances. The worst news of all is that all of these costs are not capped. In other words, your costs are potentially unlimited. This is exactly why Medicare Supplement Insurance was created.
Medicare Supplement Insurance is a private insurance coverage that is designed to go hand in hand with your Original Medicare, Part A and Part B benefits. Medicare Supplement Plans are also known as Medigap, and they are specifically designed to help pay for what original Medicare does not. They are known as supplementary, or secondary coverage. This means that they function as a secondary payer. They're only job is to supplement and work with Part A and Part B.
As mentioned earlier, Medicare Supplement plans work by paying what original Medicare does not. These plans have been standardized throughout most of the United States. In fact, 47 of the United States plus Washington, D.C. have all adopted standardized Medigap rules, including Michigan. This means that the benefits provided by the standardized Medigap plans are the same in all of the standardized states. The benefits are also the same from one insurance company to another. There are 10 standardized Medigap plans available in the standardized states. Each Medigap Plan is identified by letter, so the available plans are: Plan A, B, C, D, F, G, K, L, M, and N.
Each one of these standardized Medigap plans covers a slightly different mix of the costs for Medicare. For instance, some of them will cover the Part A deductible fully, others will cover it partially, and one of them, Plan A, will not cover it at all. Since each of the plans offers a separate benefit package, you can customize your coverage easily.
When you go to visit the doctor, have to stay in the hospital, or need other Medicare covered medical care, you will provide both your original Medicare card and your Medicare Supplement card. The provider will bill both Medicare and your plan. Medicare will pay what they are obligated by law to pay, which in the case of Part B services like a doctor's visit, is the first 80% of the cost assuming that you have already met your Part B deductible for the year. Your provider will also bill your plan for the remaining 20%. Depending on which specific Medigap plan you've chosen, your plan will pay some or all of this amount.
In the state of Michigan, Plans G and N are very popular. These two plans offer very similar coverage, and they are both considered to be quite comprehensive. Let's review the benefits provided by both plans.
Plan G is the most comprehensive Medicare Supplement Plan available to people who become eligible for Medicare after 2019. Plan G will cover 100% of all the gaps in Original Medicare with the exception of the Part B deductible. Plan G also covers you when you are outside the country for emergency services. Because it is so comprehensive, Plan G is also one of the most expensive Medicare Supplement Plans in terms of monthly premium cost.
Medicare Supplement Plan N is nearly as comprehensive as Plan G, but with two differences. The first difference is that Plan N does not cover Part B excess charges. These are charges that certain providers are allowed to charge if they don't accept Medicare standard pricing. The other slight difference between Plan N and Plan G is that with Plan N, you will pay a small co-payment of no more than $20 for Part B office visits. There is also a $50 copayment for emergency room visits, but if you are admitted to the hospital the co-payment is waived. In exchange for paying these small co-payments throughout the year, the premium for Plan N is usually noticeably smaller than for Plan G.
To be eligible for Medicare Supplement Plans, you must be actively enrolled in both Part A and Part B of Original Medicare. For most people, you get your first chance to enroll in Medicare when you turn 65. When this happens, you have a 7 month enrollment window during which you can enroll in Parts A and B. When you enroll during this window you have the right to enroll in a Medicare Supplement Plan also.
It is possible that you might enter Medicare before age 65. In this case, your benefits will begin before 65, perhaps even many years before you turn 65. Federal regulations do not require Medigap insurers to provide coverage to people under 65 years old. They leave that up to the states, and each state has set its own rules. In Michigan, these plans are available to people under 65 years old. However, they are not necessarily guaranteed, and the premiums tend to be significantly higher.
The best time to enroll in a Medigap plan is during your Medigap open enrollment period, which occurs when you are both actively enrolled in Part B and 65 years or older. This window of time lasts 6 months, and during it, you can enroll in any Medigap plan available in your state. Your acceptance is guaranteed, and you cannot be charged higher premiums based on your health status.
It is not always possible to switch. If you try to switch outside of your 6-month open enrollment window, you will have to go through Medical underwriting. When this is the case, your health is investigated and you may be declined or charge a higher premium based on your health history.
No, Medicare Supplement Insurance does not cover dental, vision, or hearing. You will need to look into standalone coverage for those services.
No. To get help with prescription drug costs you'll need to enroll in a standalone Part D drug plan.
Yes, you can do that. You can do that during the Medicare annual election period, which runs from October 15th to December 7th of each year.
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