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Medicare Supplement Plans In Delaware

When deciding on your Medicare coverage, it can be difficult to understand how it all works. Whether you’re soon to enter Medicare, or have already had it for some time, you’ve probably heard about Medicare Supplement Insurance. To help you get a feel for what it is, and how Medicare Supplement Plans in Delaware work, please read this informative article.

What Is Medicare Supplement Insurance?

Medicare Supplement Insurance is a health coverage that’s designed to help lower your out of pocket spending when you use your Medicare benefits. To really understand how it works, it’s important to know how Original Medicare works, and what kind of costs you’re expected to pay out of pocket. Medicare, which is split into two “parts” - Part A, which provides hospital and institutional benefits, and Part B, which provides medical insurance - is designed so that you share in the costs for your care. When using your Medicare benefits, you can expect to encounter these costs:

  • Part A deductible
  • Part A daily co-insurance and co-payments for hospital, skilled nursing, and hospice stays
  • Part B deductible
  • Part B co-insurance (20% of the cost for all Part B-covered services and procedures)
  • Part B excess charges (up to 15% of the cost for some Part B services)
  • Emergency coverage outside the U.S.

Under the terms of Original Medicare, there are no limits on how much you pay out of pocket. You pay for the services and procedures you use during the year; if you encounter major health issues like cancer or prolonged hospitalization, you’ll be responsible for large medical bills, sometimes into the tens of thousands of dollars. To help reduce these costs, Medicare Supplement Insurance was created.

How Does Medicare Supplement Insurance Work?

Medicare Supplement Insurance helps pay for many of the costs that you’d normally have to pay out of pocket. It is said to close the gaps in Medicare, so many people call it Medigap insurance.  Medigap plans are regulated at the state and federal level. On the federal level, various legislation shapes the rules and benefits of these plans. Besides this, CMS, the Centers for Medicare and Medicaid Services, also provides ongoing regulation of Medigap plans. At the state level, each state is able to regulate premiums and the eligibility requirements for people who get Medicare before age 65. In Delaware, state law requires Medigap insurers to offer coverage to people who become eligible before turning 65 years old. Medicare Supplement Insurance is issued in standardized plans throughout 47 of the United States and Washington, DC. In these standardized states, there are 11 Medigap plans available. Each one is identified by letter, so the standardized Medigap plans are: A, B, C, D, F, G, K, L, M, and N; besides these, there are high deductible versions of Plans F and G. Every one of these standardized plans covers its own unique combination of the gaps in Medicare. Since Medigap plans are standard, the benefits are the same regardless of which of the 47 states you live in. So, the benefits provided by Plan B in Oregon are exactly the same as Plan B in Florida. This fact makes shopping for coverage very easy; any plan available from an insurance company comes with standard benefits that are easy to compare.

Should I Consider Connecticut Medicare Supplement Plans?

Before you choose a Medicare Supplement Plan in Connecticut, you should first decide if one is appropriate for you. Your other major choice is a Medicare Advantage plan. Medicare Advantage plans are completely different from Medigap coverage. For one thing, Medicare Advantage plans are an alternative to Original Medicare; they’re a way to use your Part A and B benefits through a private insurance company. You cannot combine Medicare Advantage with Medigap coverage; you have to choose one or the other. Medicare Advantage plans are very popular, but there are two main characteristics you need to be aware of:

  • They often have fixed networks, and you may have to receive care only from in-network doctors and providers
  • You will pay a co-payment or co-insurance amount with most services you use, up to an annual cap

Medicare Advantage plans are generally considered less comprehensive than Medigap; you can expect to pay more out of pocket on services and procedures with Medicare Advantage, although Medicare Advantage plan premiums are usually less expensive than Medigap. What are the advantages of Medigap over Medicare Advantage? People who choose Medigap usually do so because there is much greater flexibility to see providers. Medicare Supplement plans don’t have any networks. You don’t need referrals to see specialists. Besides this, many people would rather pay a higher monthly premium in exchange for little or no out of pocket costs for all the services they use during the year. Once you’ve decided that you want Medicare Supplement coverage, you’ll need to pick a specific Medigap plan. To do this, you’ll want to assess your needs:

  • Do you need international coverage?
  • Do you want maximum coverage, no matter the cost?
  • Or, would you rather pay a few out of pocket costs in exchange for a lower monthly premium?

Once you settle on a standardized Medigap Plan, you can compare quotes for that coverage from multiple insurance companies in your area to shop for the best deal.

When Am I Eligible For Medicare Supplement Plans In Connecticut?

We already reviewed that there are no age conditions for Medigap coverage in Connecticut; you can get coverage even if you enter Medicare before turning 65. To qualify for Medigap, you have to be enrolled in both Part A and Part B of Medicare. You also have to keep paying your Part B premium. If for some reason you stop paying your Part B premium, your Medigap coverage will end. Since most people get to enter Medicare when they turn 65, that’s when you’re likely to have the chance to enter Parts A and B. As you enter Original Medicare, you’ll also have the option to add Medicare Supplement insurance. If you delay taking Part B because you’re keeping your employer coverage, you’ll have the chance to get Medigap whenever your employer coverage comes to an end and you activate Part B.

FAQ About Delaware Medicare Supplement Plans

Can I switch from Medigap to Medicare Advantage?

Yes. You have the right to drop your Medigap coverage and get a Medicare Advantage plan. You’ll have to do this during the Annual Enrollment Period (AEP), which runs from October 15th to December 7th of each year.

Do Medigap Plans cover my prescriptions?

No. To get drug coverage you’ll have to enroll in a separate Part D drug plan.

Do Medigap Plans help with vision, hearing, or dental?

No. Since these services aren’t covered by Original Medicare, they’re not covered by Medigap plans. You’ll have to look into separate, stand-alone coverage for those benefits.

When is the best time to enroll in a Medigap Plan?

The best time is during your Medigap Open Enrollment Period. This enrollment window lasts for six months and opens when you are age 65 or older AND active in Part B.

Can I switch Medigap Plans?

Potentially. You have the right to apply for Medigap coverage at any time. However, if you apply outside of your Medigap Open Enrollment Period, you may have to answer health-related questions, and you could potentially be declined or assessed a higher premium due to your health status.

Selection Matters Most When You Choose a Medicare Supplement Plan

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.

Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a special enrollment period.

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