Millions of Americans use Medicare Supplement Insurance to enhance the benefits provided by Original Medicare. If you’d like some help figuring out how this coverage works, read this short article; we’ll be reviewing the details of Medicare Supplement plans in Arkansas.
You might be wondering if you actually need Medicare Supplement Insurance. After all, doesn’t Original Medicare cover your health insurance needs? To be honest, no, you don’t have to have Medicare Supplement Insurance. However, you should consider it in the context of how much care costs under Original Medicare. In other words, Parts A and B don’t cover every cost for your care. In fact, Parts A and B leave quite large gaps in your coverage. The gaps in coverage are:
The two biggest gaps in Medicare are the Part A deductible and Part B co-insurance. Not only is the Part A deductible one of the largest expenses in Medicare, it’s actually possible to pay it more than once in a year, which is one of the most infamously unique aspects of Original Medicare.
Original Medicare doesn’t have any provision for a cap or limit on your yearly or lifetime spending. You simply keep paying for each and every service or procedure you utilize. Because of this un-capped feature, Medicare Supplement Insurance is a compelling option.
Medicare Supplement Insurance is an insurance coverage offered by private insurance companies that works with, or supplements, Original Medicare. It is designed to pay some, or all of, the costs that you’d normally encounter when using your Medicare benefits. Because this coverage is said to “fill in” the gaps in Original Medicare, it's often called Medigap insurance.
Since Medigap plans fill in the specific gaps in Parts A and B, it’s important to understand that it doesn’t provide any coverage on its own. Medigap plans must be paired with Original Medicare. When you have Medicare Supplement Insurance, it works like this:
You go to the doctor, or visit a medical facility like a hospital or lab. You give the provider both your Original Medicare card and also your Medigap plan card. The provider bills both; they bill Medicare first. Medicare pays the bulk of the claim - usually 80% of the cost. Your provider then bills your Medigap plan for the remaining amount - usually 20% of the cost for your services. Depending on which specific Medigap plan you have (we’ll review your options later in the article), your insurance company pays the entire 20%.
Medicare Supplement Insurance is regulated at the federal level and also at the state level. It is regulated by a number of federal laws and also by the Centers for Medicare and Medicaid Services (CMS). Besides this, state laws also have bearing on the rules of Medicare Supplement plans in Arkansas.
Most of these laws are standardized across the U.S.; 47 of the States have adopted the same basic benefits for Medigap plans. Minnesota, Wisconsin, and Massachusetts have their own rules, regulations, and plans. For the rest of this article, we’ll be talking about plans in the 47 standardized states, of which Arkansas is one.
There are a total of 11 standardized Medigap plans, and they are identified by letter. Each one of these 11 plans covers a different mixture of the out of pocket costs of Original Medicare. To help you understand how the coverages differ, we’ll look at two common plans: Plan G and Plan K.
Plan G is one of the most popular plans; it is also the most comprehensive plan currently available to all Medicare Beneficiaries. Plan G provides:
The only out of pocket cost that Plan G doesn’t cover is the Part B deductible. You have to pay that small amount each year before Plan G begins to help.
Because Plan G is so comprehensive, it is also one of the most expensive Medigap plans.
Plan K is much less comprehensive than Plan G; it provides partial coverage of most of the gaps in Medicare:
Besides the other 50% of the above costs, Plan K provides no coverage at all for:
Plan K does provide an Out of Pocket Maximum (OOPM) amount; you’ll never pay more in a year than that amount.
Because you are exposed to so many costs, Plan K is one of the least expensive Medigap plans available.
When you enroll in an Arkansas Medicare Supplement plan, you can choose the exact level of coverage you want by selecting the appropriate standardized Plan.
To get Medigap coverage, you must be enrolled in both Parts A and B of Original Medicare. While there are no age restrictions in Arkansas - you can get Medicare Supplemental Insurance if you enter Medicare younger than age 65 - there is very limited choice of Medigap plans for people younger than 65. Besides this, the premiums for people below 65 years of age can be substantially higher than for those age 65 and up. Because of this, people younger than 65 may prefer to wait until they turn 65 to get Medicare Supplement plans in Arkansas.
The best time to get Medigap coverage is during your Medigap Open Enrollment Period. This enrollment period runs for six months. It begins only when BOTH of these are true:
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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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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