If you want maximum peace of mind that you’re protected from high medical costs under Medicare, you need to make a plan for your coverage. One of the strongest and most efficient tools available to limit your medical bills under Medicare is Medicare Supplement Insurance. To help you with your plan, read this article to learn the details of Medicare Supplement Plans in Montana, and learn why one may be a good fit for you.
People often throw the term “Medicare” around in a general way, but what is actually meant by this is the specific benefits provided by the government: Part A, hospital insurance, and Part B, medical insurance. These are the basic benefits that everyone who qualifies for Medicare have. These benefits, while comprehensive and affordable, are not 100% complete. In other words, when you use your Medicare benefits, there are a number of costs that you’ll be required to pay.
These costs apply to both Part A and Part B, and include:
Part B excess charges are fairly rare, but you’ll almost certainly pay Part B co-insurance regularly. If you’re ever hospitalized, you’ll be subject to the Part A deductible. All of the various costs can add up quickly, especially in the case of a major illness. Unfortunately, there is no limit to how much you can be required to pay each year. There is no Out of Pocket Maximum (OOPM) like you’ve had with other health insurance plans.
Medicare Supplement Insurance was created to help minimize or eliminate these out of pocket costs.
Medicare Supplement Insurance is coverage provided by private insurance companies to help you pay for your medical care under Medicare. They only work with Medicare, though; they don’t provide any actual coverage on their own. They simply help you pay the amounts that Medicare doesn’t cover.
Montana is one of the 47 U.S. states that have adopted the Standardized Medicare Supplement (also called Medigap) plans. There are a total of 12 standardized Medigap plans in these states: Plans A, B, C, D, F, G, K, L, M, and N, as well as High Deductible F and High Deductible G. Each one of these Plans provides a unique level of coverage. Some of these plans cover only a few of the gaps (they are basic), and others cover most or all of the gaps (they are comprehensive). As you might expect, the more benefits provided by a Medigap plan, the more expensive the coverage is. In this way, Plans F and G, which are the most comprehensive plans available, have the highest premiums, and Plan A, which is the least comprehensive, has the lowest premium.
Since Medigap plans simply pay expenses associated with your Medicare benefits, they don’t change the terms of your Part A and B benefits. This means that you can continue to see any doctor or facility that takes Medicare patients; there are no network restrictions or referrals needed.This is one of the core features that people appreciate about Medigap plans; they have maximum freedom to see doctors.
Using your Medigap plan is very easy. As you see providers, you’ll give them your Original Medicare care and your Supplement Plan card.Your providers will bill Medicare first. In the case of Part B services like doctor’s visits, Medicare will pay 80% of the cost for your care (after you’ve met the small Part B deductible). Your provider will also bill your Plan for the remaining 20%. Your plan will pay some, or all, of the remaining bill. With some Medigap plans, you might only be responsible for a few hundred dollars of medical costs during an entire year.
Since 2017, the two most popular Medicare Supplement Plans have been Plans G and N. They both offer comprehensive coverage with similar benefits, but they do have some unique differences.
Plan G covers almost all of the gaps in Medicare. The only cost that Plan G doesn’t cover is the Part B deductible. If you use Plan G, you will have to meet the Part B deductible before the Plan begins paying any benefits.Once you’ve met that amount, though, Plan G will pay 100% of your costs for the rest of the year.
Plan N covers nearly everything that Plan G does, with one exception. Plan N does NOT cover Part B excess charges. These are fees that some providers are allowed to charge over and above the standard 20% Part B co-insurance. However, these charges are relatively rare.
The other difference between these plans is that when you have a Part B office visit, you will have a small ($20) co-payment.
Since you have to make those small co-payments and also potentially have to pay the Part B excess charges, the premiums for Plan N are lower than for Plan G. Since excess charges are pretty rare, and premiums for Plan N are lower than for Plan G, Plan N is a good value for many people.
You can enroll in a Medicare Supplement Plan once you’re enrolled in both Part A and B of Original Medicare. Usually, this happens when you turn 65 years old. In this case, you will sign up for Parts A and B during your Initial Election Period (IEP). This enrollment period spans seven months:
You can enroll at any point during this window, but your enrollment may actually be automatic if you’re already receiving Social Security retirement benefits before you turn 65. Once you’re active in Parts A and B, you can enroll in your selected Medigap plan.
You can enroll in your Medigap plan online, over the phone, or with a paper application.
Yes. However, the premiums for people under age 65 can be significantly higher than for people ages 65 and up.
The best time to enroll is during your Open Enrollment Period for Medigap. This window runs for six months and only begins when you are age 65 or older and also active in Part B. Your coverage can’t be declined during this six month period.
It depends. You have the right to apply, but if you’re past your Open Enrollment Period, you could potentially be turned down due to your health condition.
No. If you use Medigap, you’ll also need to enroll in a standalone Part D drug plan.
No. If you need help with those services, you should consider adding supplemental dental, vision, and hearing benefits.
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