If you’re getting close to entering Medicare, or if you’re already enrolled, you’ve surely seen a lot of advertising for Medicare plans. There’s so much information available that it can be hard to know what is truly important when it comes to your Medicare benefits. However, in this brief guide, we’ll review the basics of Original Medicare, so that you have a clear understanding of how much your Medicare coverage may actually cost you. We will also review one of the best tools available to help protect yourself against high spending on Medicare - Medicare Supplement Insurance. By the time you’re finished reading, you’ll know what you need to know about Medicare Supplement Insurance Plans in Nebraska.
Before we can examine how Medicare Supplement plans work, it’s important to review how Medicare works, especially to understand when and how much you’ll be expected to pay. As you likely know, Medicare is split into two different “Parts.” Part A helps with your hospital expenses and other forms of institutional care. Part B provides medical coverage, and will help you pay for all the various forms of non-hospital medical care you might need on a day to day basis.
Each of the Parts require you to pay out of pocket for services. You are exposed to these out of pocket costs:
While the Part B deductible is pretty small and Part B excess charges are fairly rare, the Part A deductible and Part B co-insurance can add up to large out of pocket expenses. This is especially true if you need a lot of medical care, either because of a serious illness like cancer, or if you should require multiple hospital stays in one year.
This kind of medical care can be especially pricey because Medicare doesn’t limit your spending like other health insurance you’ve probably had in the past. Instead, you keep paying the co-insurances and deductibles all year long, no matter how much you’ve spent. This potentially unlimited medical expense concerns many people, and is the chief reason that some of them consider Medicare Supplement Insurance.
Medicare Supplement plans are a secondary coverage that work with your Original Medicare benefits. These plans, which are also called Medigap plans, are designed to pay some, most, or all of your out of pocket costs when you receive medical care under Medicare. Medigap plans are issued and administered by private insurance companies. They are not actually Medicare products, because they simply supplement Medicare, but they are regulated by the Medicare program.
Medicare Supplement Insurance is jointly regulated by the federal government, through legislation and oversight by the Centers for Medicare & Medicaid Services (CMS), and the individual state governments.
47 of the states, along with Washington, D.C., have implemented standardized Medigap Plans. Nebraska is one of these standardized states. This means that each of these states require Medigap insurers to offer benefits that conform to the standard. There are ten standard Medigap plans: Plans A, B, C, D, F, G, K, L, M, and N. Besides these, there are high deductible versions of Plans F and G. Every Plan that is sold as “Plan A” must provide the exact same benefits, and so on for all of the standardized plans.
Each one of the standardized plans gives a slightly different level of coverage. Since these plans are standardized, you are able to very easily choose a coverage level and then compare the costs for coverage between insurance companies.
Medicare Supplement Insurance works nationwide; it is accepted by almost all providers who take Medicare patients. There are no networks or referral requirements; you can see any provider, anywhere in the country, that takes Medicare as a payment. This portability and physician freedom is one of the most popular features of Medigap plans.
Medicare Supplement Insurance is an excellent coverage for many people, but it’s not right for everyone. Your circumstances can dictate whether you should consider Medigap coverage. There are two primary considerations for determining whether Medigap is something you should consider:
Medicare Supplement Insurance is usually chosen by people who are worried about needing lots of medical care. If you’re worried about paying a steady torrent of co-payments and co-insurance, then Medigap could be a good fit.
Your budget also comes into play. There is no question that Medigap is almost always more expensive than Medicare Advantage plans. It might not be a good idea to commit to the higher premiums of Medigap if you can’t afford them. Conversely, if the premium is affordable to you, give Medigap strong consideration.
You can enroll in a Medicare Supplement Plan just as soon as you enter both Part A and Part B of Original Medicare. Typically, this occurs when you turn 65, but can be both earlier than this, or later, depending on your circumstances.
When you enter Medicare at age 65 or older, enrolling in a Medigap plan is relatively straightforward. As soon as you have your Medicare card you can sign up for your chosen plan.
It’s more complicated when you enter Medicare before turning 65. Federal rules and regulations don’t require Medigap plans to cover people under 65. This rule is left up to the individual states. Medicare Supplement Plans in Nebraska are not required to offer coverage to people under 65. While some of them voluntarily offer it, the premiums tend to be much higher than they are for people aged 65 and older. For these people, a different plan, like Medicare Advantage, may be a more viable option budget-wise. Once you turn 65, you will have the chance to get a Medigap plan on a more affordable basis.
No, this is optional coverage.
This enrollment period is your best chance to get Medigap coverage. It starts only when you’re active in Part B and 65 years old, or older. It lasts for six months. During this six month period, you are guaranteed enrollment into any Medigap plan available to you. You can’t be declined or charged higher than normal premiums.
You may be able to; it depends on your circumstances. If you’re outside of your Open Enrollment Period, you may be subject to underwriting. This means that your health history may be investigated and you can potentially be declined for coverage.
No. You will have to add a Part D drug plan in order to get drug coverage.
No. You will need to consider adding standalone coverage to get help with dental services.
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