If you’re concerned about how much Medicare will cost you, you should consider adding Medicare Supplement Insurance to your coverage. To help you understand and plan for your Medicare coverage, read this short but thorough guide to Medicare Supplement Plans in Nevada.
People consider Medicare Supplement Insurance because of the potential for high out of pocket spending on medical care under Medicare. Original Medicare, the health insurance program that most Americans qualify for at age 65, is designed to pay most, but not all, of the cost for your medical care. There are a number of expenses that you are required to pay; you share in the cost, in other words.
The costs that you have to pay are often referred to as gaps, and include:
Of these costs, the Part A deductible and Part B co-insurance are the most expensive.
You’ll pay the Part A deductible, which is $1,556 in 2022, before Medicare will begin paying for your hospital stay. One of the more unfortunate quirks of Original Medicare is that you can actually have to pay the Part A deductible more than once in a year, which is very different from most other health insurance coverages.
You’ll pay Part B co-insurance after you’ve met the small Part B deductible ($233 for 2022). Once you’ve satisfied the Part B deductible, you’ll have to pay co-insurance of 20% on all Part B services for the rest of the year. You’ll pay 20% of the Medicare-approved cost for services and procedures.
There is no cap on your spending during the year; you keep paying as you need medical care. Because your costs are potentially unlimited, many people look for a way to limit their spending.
Medicare Supplement Insurance is a private insurance coverage that was designed to offset or eliminate the out of pocket costs under Medicare. People use Medicare Supplement, or Medigap coverage, as it is also called, to protect against the possibility of large medical bills due to major illness or hospitalization. Medicare Supplement Insurance has been around as long as the Medicare program itself.
Medigap functions as a supplement coverage, as the name implies. It doesn’t provide any medical benefits on its own. Instead, Medigap plans pay the costs that you’d normally have to pay. Technically, Medicare Supplement Insurance is what’s called a secondary payer, and you’ll often hear doctor’s offices simply refer to it as a “secondary.” This means that Medigap plans only pay benefits after a primary insurance coverage has paid claims; it doesn’t provide any benefits on its own.
The benefits and coverage provided by Medicare Supplement Plans are standardized in 47 of the U.S. States, including Nevada. In these states there are ten standardized Medigap plans, each one identified by letter: A, B, C, D, F, G, K, L, M, and N.
Every one of the ten standardized plans offers a different level of coverage, or protection from the gaps in Medicare. You choose your level of coverage by enrolling in the standardized plan that best fits your needs.
Medicare Supplement plans provide coverage nationwide. There are no networks of providers to worry about, and you don’t need referrals from a primary care physician to see specialists. You can go anywhere you want, as long as the provider accepts Medicare patients.
It’s very simple to use your Medicare Supplement plan. When you go to the doctor, you’ll give them your Original Medicare card and your Medigap Plan card. Your provider will bill both Medicare, who will pay most of the cost, and your Plan. Your Plan will pick up some or all of the rest of the cost, depending on which Medigap option you chose.
Medigap coverage is an excellent choice for many people worried about out of pocket costs in retirement. But, it’s not right for everyone. You may want to consider Medicare Supplement Insurance in these cases:
Medicare Supplement Insurance can provide maximum protection against medical costs. However, if you don’t need such comprehensive protection, or can’t afford it, you might consider an alternative, like Medicare Advantage coverage.
Enrolling in a Medigap plan occurs in two steps. In the first step, you have to qualify for enrollment. You are eligible to enroll in a Medigap plan if you are actively enrolled in Part A and Part B of Original Medicare. You can’t get Medigap coverage if you don’t have both.
The majority of Americans are able to enter Medicare when they turn 65 years old. If you are already receiving Social Security retirement benefits, you will be automatically enrolled in Parts A and B when you turn 65.
If you’re not taking Social Security by that time, you’ll have to manually enroll during your Initial Election Period (IEP). This enrollment period lasts for seven months and begins on the first day of the month that’s three months before the month of your 65th birthday. For example, if you turn 65 in August, your IEP will begin on May 1st.
Once you are enrolled in Original Medicare, you can enroll in a Medigap plan. You can do this online, by paper application, or over the phone. Note that if you’re under 65 years old and on Medicare, you may find it difficult to enroll in a Medigap plan. Federal rules don’t require Plans to give coverage to people under 65 years old.
During your Open Enrollment Period for Medigap coverage. This window usually coincides with your initial Medicare eligibility; it begins once you are 65 or older and also enrolled in Part B. Your enrollment window lasts for six months. During this time, your acceptance is guaranteed, regardless of your health condition.
Yes. It is easier to switch Medigap plans in Nevada than in many other states.
Yes. You can do this during the Medicare Annual Election Period which runs from October 15th to December 7th of each year.
No. You must also enroll in a Part D drug plan to get drug coverage.
No. You’ll need to consider adding separate insurance coverage to get help with those services.
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Participating sales agencies do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.
Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP]organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.
Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a special enrollment period.