Coming to grips with the out of pocket costs of Original Medicare is perhaps the most difficult part of planning your coverage. Understanding what those costs are, and how much they can be, is an important first step. Beyond this, considering the various private options to lower your expenses, like Medicare Supplement Insurance, will help you craft a helpful plan. In this article, we’ll review the costs of Parts A and B as well as the details on Medicare Supplement Plans in Indiana.
The best way to learn about the costs you’ll face with Medicare is to start with the very basics and review what Medicare covers, and which costs you’re expected to pay. Original Medicare, which is split into two interrelated “parts,” was designed to make healthcare more affordable, but not free. In other words, from the very beginning of the program (back in 1966), it was designed so that you would have to pay part of the cost for your care. The specific costs that you’re exposed to are:
An important point about these costs is that there is no provision for a cap. You simply keep paying them all year long. There is also no lifetime cap, so if you have several difficult years of health, with lots of out of pocket costs, you won’t get any relief. Having a plan for meeting these expenses is very important since most people are on some kind of fixed income when they take Medicare. Medicare Supplement Insurance is designed to do just that.
Medicare Supplement Insurance is a specialty health insurance product that pays some, or all, of the costs that you’re normally responsible for. These policies are offered by private insurance companies; they come in a variety of standardized coverages. Since Medicare Supplement Plans are said to cover or fill in the gaps of Parts A and B, they are frequently called Medigap Plans for short. Much of the rules and regulations concerning Medigap Plans are set at the federal level. Individual states had the option to adopt standardized plans and laws; 47 of them did so, including Indiana. In these so-called standardized states, Medigap Plan benefits are standardized in 11 different Plan options: Plans A, B, C, D, F, G, K, L, M, and N. Besides these there are High Deductible versions of Plans F and G. It’s important to note that for people who become eligible for Medicare after December 31, 2019, Plans C, F, and High Deductible F are no longer available. Anyone eligible before that date preserves the right to choose those plans. Each of the 11 standardized plans offers a different coverage level. In other words, they each cover a different arrangement of the gaps in Medicare. Only Plan F (available to Americans eligible before January 1, 2020) covers all of the gaps. The least comprehensive plan, Plan A, covers these costs for you:
All other costs are uncovered; you’ll have to pay them. The uncovered costs are:
The most comprehensive Medigap Plan available to people who become eligible after December 31, 2019 is Plan G. Plan G will cover 100% of all the costs for you except for the Part B deductible ($233 for 2022). Once you meet that small amount, Plan G will cover all of your Medicare-approved costs for the rest of the year. The other standardized Plans have coverage somewhere in between Plans A and G. By having this variety of coverage options, you’re able to select the level of benefits that meets your needs. When it comes to using your Medicare Supplement Plan, you’ll simply give your providers both your Original Medicare card and your Medigap plan card. Your provider will bill both Medicare and your Plan. Medicare is the primary payor; in the case of Part B services and procedures like office visits, lab work, or diagnostic testing, they’ll pay the first 80%, assuming you’ve already met the Part B deductible. Your provider will bill your Plan the remaining 20%. Most Medigap plans will cover this completely, but in some cases you might have a small remaining balance, which you’ll be responsible for paying.
Everyone who is enrolled in both Part A and B of Original Medicare is eligible for Medicare Supplement Insurance in Indiana. This includes people who qualify for Medicare before turning 65. However, the premiums that insurance companies can charge for people under 65 are not regulated. This can make it hard to find affordable Medicare Supplement Plans in Indiana for people under 65.
Choosing a Medigap Plan is an important decision and needs to take into consideration many factors. As a general basis for making a decision consider these questions:
The general idea is to get a Plan that will meet your coverage needs (close the gaps that you’re likely to need help with) while keeping the premiums affordable. The need for international coverage alone will narrow your choices since only Plans C, D, F, G, M, and N offer this benefit.
Yes. You can drop your Medicare Supplement Plan and enroll in a Medicare Advantage Plan during Medicare’s Annual Election Period (AEP). AEP is 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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