Entering Medicare is usually a money-saving milestone for Americans. The benefits provided by Original Medicare are often more comprehensive and less expensive than the employer or individual insurance they’ve had prior to entering Medicare. Despite this, many people are concerned about the amount of out of pocket spending they’ll encounter while on Medicare. A very popular tool to reduce out of pocket spending for Medicare services is Medicare Supplement Insurance. Read our guide to Medicare Supplement Plans in Arizona to see if one is right for you.
Medicare Supplement Insurance plans are issued by private insurance companies as an add-on, or supplemental, coverage to Original Medicare (Parts A and B). This coverage is designed to work with Original Medicare. It is an optional coverage; there’s no requirement to purchase it. However, millions of Americans choose Medicare Supplement plans to enhance their Medicare coverage.
As mentioned before, these policies supplement the benefits you receive from Original Medicare Parts A and B. Medicare Supplement plans are a secondary payor, which means that they are obligated to pay benefits only after the primary payer has paid; the primary payor is Medicare. When you see the doctor or use some other Medicare-covered benefit, Original Medicare pays the primary amount to your provider. Your Medicare Supplement plan then pays the amount that they’re obligated to in the terms of the plan. Because these plans are said to “close the gaps” in Medicare, they are frequently called Medigap plans.
How much your plan pays, and which expenses they pay, are determined by the specific plan you choose. In most of the United States (47 of the states, plus Washington, DC), there are a total of 11 standardized Medigap plans available. Minnesota, Massachusetts, and Wisconsin have their own rules and plans. These standardized plans are identified by letter. The three most popular Medigap plans are Plans A, G, and N.
The Medigap plans provide varying degrees of coverage; Plan A offers the fewest benefits, and leaves the most gaps un-protected. Plan G is the most comprehensive plan available to newly eligible Medicare Beneficiaries; it leaves only one gap unprotected: the Part B deductible. The Part B deductible is quite small, not more than a few hundred dollars, so if you use Plan G, you are essentially limiting your out of pocket spending to a couple hundred dollars a year.
As you might expect, you get what you pay for. The less comprehensive the plan, and the fewer the benefits, the smaller the monthly premium is. The opposite is also true: Plan G, the most comprehensive, is the most expensive Medigap plan for people who become eligible for Medicare after December 31, 2019. Note that, prior to that date, Plan F was the most comprehensive plan.
We already mentioned that these plans are offered by private insurance companies. While they are a private, secondary, product, they are still subject to state and federal regulation. Medicare Supplement plans in Arizona are regulated by federal law, state law, and CMS, the Centers for Medicare & Medicaid Services.
The most basic requirement for Medigap eligibility is that you must be enrolled in both Part A and Part B of Original Medicare. You can’t get Medigap coverage without already being enrolled in Original Medicare.
The other eligibility criteria is age. Federal law does not regulate the minimum age at which Medicare Supplement insurance has to be offered to people; it just says that anyone age 65 and older is eligible. Each state is able to make its own rules about people who enter Medicare before age 65. In Arizona, there is no requirement for insurance companies to offer Medigap plans to people under age 65. For those people who do qualify for Medicare before age 65 in Arizona, they’ll likely have to wait until they actually turn 65 in order to get Medicare Supplement Insurance. In this case, they might want to consider using a Medicare Advantage plan until their 65th birthday.
Since there are 11 standardized Medigap plans, and dozens of separate insurance companies, you have many options for choosing your coverage. There is no perfect plan for all people, so it’s helpful to ask yourself some questions about your needs and preferences for care. You should ask:
The answers to these questions can help guide your decision-making when it comes to choosing a Medigap plan.
For instance, if you need coverage outside the United States, you’ll definitely want to consider Plans D, G, M, and N, since these are the plans that cover you outside the United States.
For the other questions, it comes down to likely needs and peace of mind. If you want or need to protect against high out of pocket costs, then a more comprehensive plan like N or G is likely a good fit.
On the other hand, if you’d rather save on the monthly premium, and don’t mind a few out of pocket costs, your decision might come down to Plan N or Plan L.
There are, of course, other criteria or questions you can ask yourself, but if you start with these, you’ll be well on your way to finding the plan that’s a good fit in terms of benefits.
Once you’ve found the Medigap plan that you think will best cover your needs, you can then start comparing the prices for your coverage at different insurance companies. Since the benefits for Medigap are standardized, you can easily shop based on price.
No. If you need help with these benefits, you’ll need to consider adding private insurance coverage for them.
Every Medicare Supplement plan with the same plan letter (F, G, etc) offers precisely the same benefits to you, but prices vary widely from one insurer to another. It’s in your best interest to have access to as many plans by as many insurers as possible when you make your Medicare Supplement plan.
That’s where Medicare Consumer comes in. When you speak with our experts you get access to plans from dozens of different insurers. They’ll guide you to the right plan for you at the best possible rate.
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MedicareConsumer.com is a non-government agency and is on a mission to help current and future Medicare recipients find the best Medicare supplement plan for their unique needs. Medicare insurance logos as seen on MedicareConsumer.com belong to the respected trademark owners in our available network of Medicare insurance carriers. Any and all rate quotes for Medicare supplement plans are free to consumers and you are not obligated to purchase any plan from any carrier.
Participating sales agencies do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.
Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP]organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.
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