How familiar are you with the costs you’ll pay when you use your Medicare benefits? Most people understand that they’ll have to pay something, but they don’t really know the full picture. In this article, we’ll review the details of the expenses of Medicare and also how Medicare Supplement Plans in Kansas can help protect your wallet.
Original Medicare is an umbrella term referring to Parts A and B of Medicare together. Part A provides hospital insurance, protecting you when you need institutional care. Part B is medical insurance, which helps you pay for the cost of your outpatient care. These two coverages work together to reduce the cost of health care. The coverage they provide is excellent, but they don’t cover every penny of your costs. In fact, they leave a significant cost that you’re expected to pay. The costs you’ll face are:
The major costs are the Part A deductible and Part B co-insurance. You might actually have to pay the Part A deductible more than once in a year, which is an unusual feature. Basically, if you experience a hospital stay, you can expect to pay at least $1,500, which isn’t exactly a small sum. Throughout the year, you’ll pay 20% (your Part B co-insurance obligation) for every Part B service and procedure you use. Mostly these will be small amounts, but if you need major services like chemotherapy, your portion can become very expensive. Not only are you exposed to these costs, but Original Medicare doesn’t provide any kind of cap or maximum on your spending. This factor can lead to runaway spending for care when battling major illnesses. Such uncertainty, and potential expenses, can be relieved with Medicare Supplement Insurance.
Medicare Supplement Insurance, also known as Medigap coverage - the terms are synonymous - is designed to pay some or all of the costs that you’re exposed to under Parts A and B. As a supplemental, or secondary, coverage, Medigap pays only after Medicare has paid its share. Medigap also doesn’t cover anything that’s not covered by Part A or B; it works only with Original Medicare. When you have Medicare Supplement Insurance, you will give your medical providers your Original Medicare card and your Medicare Supplement card. They will bill both parties for you, you don’t have to submit claims or anything like that. Providers will bill Original Medicare first, since it is your primary coverage. Medicare will pay their amount (80% of the cost for Part B services). The provider will also bill the left over 20% to your Medigap plan. Depending on which Plan you’ve elected to enroll in, the Plan will pay some or all of the 20% you’d normally have to pay. Medicare Supplement plans are standardized in most of the country; 47 states, including Kansas, have enacted standardized laws for Medicare Supplement Insurance. Minnesota, Massachusetts, and Wisconsin have chosen to implement their own plans. In Kansas and the other 46 states, Medigap benefits are standardized in 11 different Plan options: Plans A, B, C, D, F, G, K, L, M, and N. There are also high deductible options for Plans F and G. People who gain Medicare eligibility after December 31, 2019 are not eligible for Plans C, F, or High Deductible F. Each one of the 11 standardized plans covers a differing mixture of the costs of Medicare. For instance, Plans B, C, D, F, G, and N cover 100% of the Part A deductible. Plan A doesn’t cover it at all, and Plans K, L, and M partially cover this cost for you. It is the same for all of the other costs that we listed earlier: the Medigap plans cover all of them in different combinations. Since you have so many options for coverage, it gives you the opportunity to select a level of coverage that accomplishes what you need, without paying for unneeded benefits.
The basic eligibility rule for Medigap is that you have to be enrolled in Part A and Part B of Original Medicare. For most people, this happens when you turn 65 years old. In some cases, you might delay taking Part B because you’re still working. When this is the case, you’ll have the opportunity to enroll in Part B when your employer coverage ends; this will also give you the chance to enroll in a Medigap plan. The case is somewhat different for people who enter Medicare before age 65. Federal rules don’t require insurance companies to offer Medigap coverage to people in this situation, it’s left up to the individual states. Kansas is one of the states with the most generous provisions. Kansas requires that Medigap insurers offer coverage to people under age 65. Kansas also restricts how much they can charge for this under-65 coverage. This means that people under 65 years of age will have solid and affordable options for finding Medicare Supplement Insurance plans in Kansas.
This is a very important question, and the answer will be different for each person. Medigap is definitely a good fit for many people, but not for all. Here are a few questions you can ask yourself to determine if Medigap is something you should pursue.
Medigap plans are generally a good fit for people who need international coverage, don’t want to pay co-payments, want to be able to see any doctor they desire, anywhere in the country, and can afford the premiums. People who are uncomfortable paying for Medigap, who don’t mind networks of doctors, or want to have extra benefits like vision and dental, are likely to be more drawn to Medicare Advantage plans.
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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