If you’re approaching your entry into Medicare and worry about how much it will cost, it’s important for you to consider the options available to limit how much you’ll pay. One of the chief options is Medicare Supplement Insurance. To help you get a feel for this coverage, we wrote this article explaining how Medicare Supplement plans in Kentucky work.
Medicare Supplement plans exist to help you pay for many of the costs that you’re normally responsible for paying when you use your Medicare benefits. It can be a surprise to many people to learn that you will still have to pay for some of the cost of your care when you have Medicare. It is nonetheless true; Medicare pays for most of the cost for your health care, but you are required to pay a portion of the costs. The costs that you’ll have to pay with Original Medicare (besides the premiums, which you pay whether you use your benefits of not) include:
You have to pay the two deductibles first; Part A is for hospital and institutional care, so you’ll pay the Part A deductible when you need this kind of care. Once your deductible is paid, you’re entitled to a certain number of hospital or skilled nursing facility stay days. After you use up those days, you begin to pay a daily co-payment. For Part B, you pay the small deductible first. Once you’ve paid that amount, you’ll be required to pay co-insurance of 20% for all Part B services/procedures you use during the rest of the year. You can also be responsible for Part B excess charges of up to 15% if you see providers who don’t take Medicare “assignment” - which means they don’t accept Medicare’s standard prices. Most providers DO accept Medicare’s prices, so these charges are relatively rare. Unlike with other health insurance you’ve probably had, there are no limits on your spending. You simply keep paying all year long now matter how much you’ve spent. Medicare Supplement Insurance can help protect you from the specific costs we just reviewed, and also help limit your medical spending during the year.
Medicare Supplement Plans are a form of private insurance coverage. The coverage is supplemental in the sense that it supplements Original Medicare. Medicare remains your primary coverage; they pay the majority of your medical expenses. Your Supplement plan functions as a secondary payor; they will pay some or all of the amounts that Medicare doesn’t pay. In practical terms, when you see the doctor they will bill both Medicare and your Medicare Supplement plan. Depending on the specifics of your plan, it may pay all of the remaining amount, or only some of it. Medicare Supplement Plans (also called Medigap Plans) are subject to federal and state regulation. Through a combination of state and federal legislation, Medigap plans have been standardized in 47 of the states, including Kentucky. In these standardized states, there are a total of 11 Medigap plans: 9 standard plans: A, B, C, D, F, G, K, L, M, and N, and two High Deductible versions: High Deductible F and G. All of the standardized plans offer a different mixture of coverage for the costs you’d normally have to pay out of pocket. Some of these plans are more comprehensive - they offer more coverage, meaning you end up paying less for your care, and others less so - these cover fewer of the costs, and your out of pocket spending would potentially be higher. You can choose the level of coverage you want, and also compare the costs for the coverage, because the plans are standardized.
If you’ve been researching Medicare Supplement Plans in Kentucky, you’ve likely encountered Medigap Plan G. This is the most comprehensive Plan available to people who become Medicare-eligible after December 31, 2019. Plan G offers coverage for every Medicare cost except for the Part B deductible. With Plan G, you will have to meet this small deductible ($233 for 2022) before your coverage kicks in. But, once you’ve met the deductible, Plan G will cover 100% of your costs for the rest of the year. Plan G even provides emergency coverage when you’re outside the United States. Because of these benefits, Plan G is one of the most popular Medigap Plans in the country.
You can generally enroll in a Medicare Supplement plan when you enter Medicare. For most people, this happens when you turn 65, although it’s possible to delay taking your Medicare benefits if you’re still working and covered by an employer plan. Whether you enter at 65 or later, you can get Medigap coverage once you’re active in both Parts A and B of Original Medicare. However, if you get Medicare before turning 65, due to disability or illness, the rules are a little more complicated. Federal law doesn’t require insurance companies to give Medigap coverage to people under 65. This provision is left up to the states. Kentucky doesn’t require insurers to make any standardized Medigap Plans available to people under 65. While some insurance companies voluntarily offer it, the prices tend to be much higher than for people who are 65 and older. For people with Medicare before age 65, Medicare Advantage may be a more affordable option for coverage until they turn 65. Once you turn 65, you will have access to your Medigap Open Enrollment Period, which will allow you to enroll in a Medigap plan at the standard, more affordable, rates. When it comes time to enroll in your Medigap plan, you can enroll online, by phone, or with a paper application. By using a licensed insurance agent, you can easily compare quotes for multiple plans, and enroll in the plan of your choice.
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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