To get the most out of your Medicare benefits, it’s important to make a plan for minimizing your out of pocket costs. As part of your plan, you should consider all of your options, including Medicare Supplement Insurance. To help you get started, we’ve created this short guide to Medicare Supplement Plans in Hawaii.
Medicare Supplement Insurance, or Medigap, as it’s often referred to, is an insurance coverage that is designed to integrate with your Original Medicare benefits. Original Medicare, which consists of Part A and Part B, remains the primary insurance coverage. Medigap fulfills a supplemental role as the secondary payor. Medigap plans are specifically designed to cover the costs that you’re expected to pay when using your Medicare benefits. There are a number of costs you’re responsible for, including:
There are no caps or limits on your spending under Medicare. You’ll keep paying for every service or procedure you receive through the year. There are also no lifetime caps. To avoid overspending on health care, many people turn to Medicare Supplement Insurance.
Medigap coverage is offered by private insurance companies. Although the coverage is private, it is subject to regulation from both the federal government and the state of Hawaii. At the federal level, Medigap is regulated by legislation as well as by the Centers for Medicare and Medicaid Services (CMS) on a year-by-year basis.
Medicare Supplement Insurance plans have been standardized throughout 47 of the states, as well as in Washington, DC. Minnesota, Wisconsin, and Massachusetts have their own rules and plans. As one of the 47 standardized states, Hawaii has 11 Medigap plans available. Medigap plans are identified by letter, so the standardized plans are Plans A, B, C, D, F, G, K, L, M, and N. Besides these nine, there are also high deductible versions of Plans F and G. Each of the standardized Plans offers a different coverage level, so each of them covers a different range of costs for you. Since the Plans are standardized, the benefits are the same from insurance company to insurance company, and from state to state. This makes comparing plans and choosing your coverage level much easier. When you have Medigap coverage, you’re still using your Part A and B benefits at the same time, so you’ll need to give your doctors both your Medicare card and your Medigap Plan card. Your doctor and other providers will bill Medicare first. They will also bill your Plan for the remaining amounts due. In many cases, your Plan will pay the entire outstanding balance, although under the terms of certain Medigap plans you might still be responsible for some of the bill. The major point is, though, that your Plan will cover much of your out of pocket costs, if not all of them. To give you a feel for how the benefits can differ between the standardized Medigap plans, we’ll review the coverage available from Plans G and N.
This is the most comprehensive Medigap plan available to people who become eligible for Medicare after December 31, 2019. Before then, Plan F was the most comprehensive Medigap plan. Plan G covers 100% of all the gaps in Medicare except for the Part B deductible. With Plan G, you’ll pay the Part B deductible first - for 2022, this is $233 - and Plan G pays for all other costs, including emergency coverage outside the country. Since this is the most comprehensive plan, it’s also the most expensive for people who are ineligible for Plan F.
Plan N seems a lot different from Plan G, but the basic coverage is almost identical. The main difference is that Plan N doesn’t help with Part B excess charges. If you encounter these, you’ll have to pay for them out of pocket. However, excess charges are fairly rare because they can only be assessed by providers who don’t accept Medicare’s pricing. Most providers do accept Medicare’s pricing, so excess charges are only rarely assessed. The other difference with Plan N is that you’ll end up paying small co-payments for office visits ($20) and emergency room trips ($50). If you’re admitted to the hospital, though, the $50 co-payment is waived. If you only go to medical providers a handful of times a year, Plan N can save you money over Plan G, without giving up much out of pocket protection if you have a “bad” year and need a lot of medical treatments.
The main requirement for getting Medicare Supplement coverage is that you have to be active in both Parts A and Part B of Original Medicare. For most people, this doesn’t happen until they turn 65. In some cases, though, people choose to delay taking Part B because they’re still working and will remain covered by their employer plan. When this is the case, they’ll get the chance to enroll in a Medigap plan once their employer coverage ends. In other cases, some people are able to enter Medicare before turning 65. This is an ambiguous situation because federal rules don’t require Medigap insurers to offer coverage to people under 65s years of age. This is left up to the individual states. For Medicare Supplement Plans in Hawaii, the state requires that insurance companies offer coverage to people under 65. They also restrict how much the companies can charge the under-65 population, which is an important protection.
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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