If you’re worried about how much you’ll pay out of pocket with Medicare you’ll need to consider the private options available to help reduce them. These private plans are designed to help you save money when you use your Medicare benefits. One of the most popular kinds of coverage available is Medicare Supplement Insurance. In this article, we’ll review the ins and outs of Medicare Supplement plans in Georgia.
Medicare Supplement Insurance is a private insurance coverage designed to work with Parts A and B of Original Medicare. Since Medicare doesn’t cover 100% of the cost for your services and procedures, you’re exposed to out of pocket spending. The costs that you’re exposed to include:
While the Part B deductible is only paid once, all of the other costs under Original Medicare can be experienced throughout the year. These costs are not capped in any way. Medicare doesn't come with an Out of Pocket Maximum (OOPM) like other forms of health insurance you likely had before Medicare. Instead, you pay the Part A and B costs throughout the year, no matter how much you’ve paid already. Medicare Supplement Insurance was created to help alleviate the impact of these costs. Since the various costs you’re expected to pay are referred to as gaps in Medicare, Medicare Supplement plans are frequently called Medigap plans.
Medigap plans are what’s called secondary coverage. That means they only work with a primary coverage, in this case Parts A and B of Original Medicare. Medigap plans provide no coverage on their own; they only pay benefits after the primary coverage has paid a claim. Medicare Supplement plans are standardized across 47 of the United States, including Georgia. This means that the benefits for the individual plans are the same in all 47 states. There are 11 standardized Medigap plans. They’re known by letter: A, B, C, D, F, G, K, L, M, and N. There are also high-deductible versions of Plans F and G. Since the benefits are standardized, the coverage provided by Plan K in Georgia is the same as Plan K in Montana. This makes it very easy to choose Medigap coverage: all of the standardized plans are the same, regardless of which insurance company you use. When you use your benefits, say by visiting the doctor, you’ll give them both your red, white, and blue Original Medicare card and your Medigap plan card. Your doctor will bill Medicare; for Part B services like office visits, Medicare will pay the first 80% of the cost. Your doctor will also bill your Medigap plan the remaining 20%. Your Medigap plan will pay the amount they’re contracted to pay; in most cases, they’ll pay all of the outstanding amount. You might have a tiny remaining amount to pay; this is your responsibility. You can see the value of Medicare Supplement plans if you consider expensive treatment like chemotherapy. IV-based chemotherapy is usually covered under Part B of Original Medicare. Normally, you’d be responsible for 20% of the cost. Most Medicare Supplement plans, however, will cover all of your share of the cost, which can be a real financial savings. To give you an idea of how Medigap benefits vary between the standardized plans, let's look at what Plans A and G cover.
Plan A is very basic; it covers the fewest number of gaps in Medicare. Medigap Plan A will cover:
That’s it. Plan A gives you no help with:
Plan G is a much more comprehensive plan; it is, in fact, the most comprehensive plan available for most new Medicare Beneficiaries. Plan G fills in all the gaps in your Medicare coverage, with one exception: the Part B deductible. The only cost you’re likely to pay during the year is the Part B deductible; for 2022, the deductible is $233. You’ll pay that amount first, then Plan G covers all of your Medicare-approved costs for the rest of the year. Plan G also provides coverage for emergency care if you’re outside of the United States. The other standardized plans have benefits somewhere between these two. You can choose your level of coverage and control your costs by selecting the standardized plan that matches your needs.
If you’ve decided to get Medigap coverage, you’ll need to determine the level of coverage you want. This coverage level should balance two conditions:
In other words, you’ll want to make sure your basic needs are covered, but that you can afford the cost of the coverage. If you have had health struggles already in your life, or if you have a family history of serious illness, you should consider the more comprehensive Medigap plans like Plans G, N, and D. If you’ve been in excellent health, and you want Medigap coverage “just in case” you might consider a less comprehensive plan like Plan A, B, or L. A part of your consideration should also take into account the cost for your coverage. As a general rule, the more out of pocket costs you’re responsible for, the less expensive the coverage tends to be. The premiums also generally rise at a slower rate for plans that call for you to share more in the costs.
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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