Do you know how much medical care can cost when you have Medicare coverage? If you don’t, you should find out before you enter Medicare. Out of pocket spending with Medicare can be a burdensome problem, but there are options for limiting the impact of these costs. One of these is Medicare Supplement Insurance. In this article, we’ll highlight the costs of Original Medicare and give you a thorough primer on Medicare Supplement Plans in Oklahoma.
This is the key question when it comes to making a plan for your Medicare coverage. The simple fact is that Medicare is not free (a common, but false, assumption). You will experience a variety of costs when it comes to actually using your Medicare benefits. Knowing these costs ahead of time will help you prepare for, and protect against, them. These costs are:
By far the biggest costs you’ll face are the Part A deductible and Part B co-insurance. The Part A deductible must be paid when you’re admitted to the hospital or skilled nursing facility. For 2023, this cost is $1,600 (it is $1,556 for 2022). Once you pay that amount, Medicare begins helping pay for the cost of your stay. It is technically possible to pay the Part A deductible more than once in a year, which is very unusual for health insurance. This would happen if you had separate hospitalizations that occurred more than 60 days apart.
When you use your Part B coverage, you’ll have to pay the Part B deductible first; this is $226 for 2023, and $233 for 2022. After this amount is satisfied, Medicare will pay 80% of the cost for your Part B care; you have to cover the remaining 20%.
The other costs are either rare or minimal. However, you need to know that your costs are potentially unlimited. There is no annual cap or limit on your spending; you pay your share no matter how much you’ve spent. When you consider the cost for certain kinds of medical treatment, this can be a major concern. Medicare Supplement Insurance exists to help you reduce or eliminate these costs.
Medicare Supplement Insurance,or Medigap, as it is also known, is secondary coverage provided by private insurance companies. It is a separate, optional, coverage that you can add to your Part A and B benefits. These plans are designed to lower or eliminate the amount you’d normally have to pay when using your Medicare benefits.
Oklahoma is one of 47 states, plus Washinton, D.C., that have adopted standardized Medigap plans. In these states, there are a total of 12 standardized Medigap plans. Each one of the standardized plans covers a different arrangement of the gaps in Medicare. Since there are 12 different plans, you are able to select a level of coverage that meets your needs. Of the 12 standardized plans, three are most popular: Plans F, G, and N.These three plans offer the most coverage of the gaps and protect your budget the most of the available plans. Since the plans are standardized throughout the 47 standardized states, the coverage for each of them is identical no matter where you live.
Medicare Supplement Plans don’t modify your Medicare coverage at all. Under the terms of Original Medicare, you can see any doctor, anywhere in the country, that accepts Medicare patients. When you use Medigap coverage, you remain free to see any provider, and you also don’t need to get referrals to see specialists. In comparison to your other main option for limiting your costs, Medicare Advantage, you retain the maximum level of physician choice and freedom.
Since your Medigap coverage works with Parts A and B, you’ll use both coverages when you get medical care. Medicare is the primary, or first, payer. Medicare will pay the first 80%. Your provider will bill your Medigap Plan for the remaining 20%. Your plan will pay some or all of this amount, depending on which standardized plan you chose. Either way, you will pay much less by using a Medigap plan than without it.
To give you an idea of the difference between a basic plan and a comprehensive plan, we’ll review the benefits provided by Plans A and G.
This plan offers the least coverage available. Plan A will only close these gaps:
Plan A provides no help with the Part A deductible or daily co-insurance for skilled nursing care. It also leaves you uncovered outside of the United States.
Plan G is the most comprehensive plan available to people who become eligible for Medicare after December 31, 2019. Plan G pays 100% of your costs except for the Part B deductible. Each year, you’ll have to meet this deductible before Plan G will pay for your care. Plan G also covers you in emergencies when you’re outside the U.S.
As you might expect, the premiums for these two plans are very different; a common sense rule of thumb is that the more comprehensive the coverage, the more it will cost you.
To enroll in a Medigap plan, you have to be active in both Part A and Part B. This happens for most people when they turn 65 years old. In some cases, though, you can get Medicare coverage early, before turning 65, or later than 65, if you choose to delay taking Part B. Regardless of when you enter Medicare, you will have the chance to get Medigap coverage at the same time.
You can enroll in a Medigap plan online, over the phone, or with a paper application.
This six month enrollment window for Medigap coverage opens when you are 65 years old and active in Part B. It can’t begin before age 65, even if you enter Medicare early. During this window, you can’t be declined for Medigap coverage.
Maybe. During your Open Enrollment Period, you can switch without any difficulties. However, if you try to switch after this time, you will likely have to answer health history questions, and your application may potentially be declined.
Yes. You have the right to do that during the Medicare Annual Enrollment Period in the fall of each year.
No. You will need to add standalone coverage for dental care if you want it.
No. You need to add standalone Part D drug coverage in addition to your Medigap plan.
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