Have you considered Medicare Supplement Insurance? If you’re not sure if it’s for you, read this short article. It will help you understand how Medicare Supplement plans in Colorado work, and when you should consider one.
Medicare Supplement Insurance is an insurance coverage that works with, or supplements, your Original Medicare benefits. It is designed to help you pay for the amounts that you’d normally have to pay out of pocket. Since Parts A and B of Original Medicare don't cover 100% of your costs, you’re expected to pay for part of the cost for your care. The amounts Medicare doesn’t pay are known as gaps in coverage; Medicare Supplement Insurance is therefore often called Medigap. There are several gaps in Original Medicare; some of them are monetary, like co-payments and deductibles, and others are benefit-related like vision or dental coverage. Medigap is designed to help with the monetary gaps in Medicare, which include:
While each of these gaps comes with an out of pocket expense for you, the Part A deductible and Part B co-insurance are the main costs you’ll face. Although, if you should have a prolonged hospitalization (more than 90 days), daily Part A co-insurance can add up in a hurry. Medicare doesn’t cap how much you can spend in any one year; your costs are potentially unlimited. Medicare Supplement Insurance is a way to severely lower, or almost eliminate, your out of pocket costs when you use Parts A and B.
Since Medicare Supplement plans are a secondary coverage, they can only be used with Original Medicare. So, if you receive services or procedures that aren't Medicare-covered, Medigap won’t be any help at all. For Medicare-approved procedures and health care, your provider will bill Medicare as the primary payor. Medicare usually pays the first 80% of the cost for your care for Part B services. Your provider will also bill your Medigap plan the remaining 20%. Depending on which specific Medigap plan you have, they will probably pay the entire 20%, although some Medigap plans might leave a small portion for you to pay. While there are a total of 11 different Medigap plans, Plans G and N are two of the most popular.
Plan G is a very comprehensive plan. It covers almost all of the gaps in Medicare except for the Part B deductible. Each year, you’ll have to pay the Part B deductible before Plan G will begin to pay benefits for you. However, the Part B deductible is quite small ($233 for 2022). In most cases, this is the only amount you’ll have to pay out of pocket, which can give you great peace of mind. Besides this, Plan G also protects you when you’re outside of the U.S.
Plan N is very similar to Plan G in terms of benefits, but it’s noticeably less expensive. This is because of one unique feature: co-payments for office and emergency room visits. If you’re willing to pay $20 for office visits and $50 for ER visits, you can save on your monthly premium. Just make an estimate of how many times you’re likely to see the doctor in any given year, and multiply by $20. If the amount is less than the yearly premium for Plan G, you could save money for coverage that’s almost identical. The only other difference between Plans G and N is that Plan G covers Part B excess charges, and Plan N doesn’t. However, since most providers are prohibited from imposing excess charges, this rarely comes into play. Plan N also covers you outside the country.
Medicare Supplement plans are created and issued by private insurance companies. They charge premiums for your coverage. These premiums are in addition to the Part B premium you pay for Medicare. While they are a private, secondary, coverage, these plans are regulated by the federal government and the state of Colorado. The benefits provided by Medicare Supplement plans are standardized throughout most of the U.S. Only Massachusetts, Minnesota, and Wisconsin have their own individual rules and plans. Colorado has joined the other 46 states in adopting the standardized Medigap plans. There are 11 standardized Medigap plans available today. Every one of them provides a unique coverage: they each cover a different mixture of the gaps in Medicare.
It’s important to know when Medicare Supplement Insurance can make sense for you. Medigap plans are useful to people who want to significantly limit how much they pay for medical care during the year. Often, people who don’t want to pay co-payments every time they see a doctor end up using Medicare Supplement insurance. They’re also a good fit for people who expect to travel outside the U.S. frequently, because several Medigap plans will cover your internationally. Another benefit of Medicare Supplement Insurance is that they don't have any network restrictions or requirements. You are free to see any medical provider that accepts Medicare, anywhere in the country. Medigap plans aren’t for everybody, though. An alternative to them is Medicare Advantage. Medicare Advantage plans are a way to receive your Part A and B benefits through a private insurance plan. Medicare Advantage plans are often less expensive than Medigap plans. They also frequently come with extra benefits that aren’t provided by Original Medicare or Medigap plans; they can come with vision, hearing, and dental coverage. In exchange for the lower premium cost and the extra benefits they can provide, you can expect to pay a co-payment or co-insurance for most services and procedures you use during the year. For many people, this is a valuable trade-off. On the other hand, if you value the limited out of pocket costs and the flexibility to avoid networks and referrals, Colorado Medicare Supplement plans may be a good fit for you.
Yes. To do so, you’ll have to drop your Medicare gap and enroll in a Medicare Advantage plan during the Medicare Annual Election Period (AEP). AEP runs from October 15th to December 7th of each year.
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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