Medicare Supplement Insurance is a tool that can help you save money on medical care while you have Medicare coverage. This coverage has been used by millions of Americans since the beginning of the Medicare program. This article will help you understand the need for Medicare Supplement insurance. It will also help you know how Medicare Supplement Plans in Ohio work.
Before you can appreciate the benefits of Medicare Supplement Insurance, you need to be familiar with how Original Medicare works, especially the costs that you’ll be exposed to with this coverage.
Your basic, traditional Medicare benefits (Parts A and B) absolutely provide strong coverage. Unfortunately, Medicare doesn’t cover 100% of the costs for your care. You must pay for part of the costs out of your own pocket. These costs that you’re required to pay are frequently referred to as gaps in your coverage. Covering the gaps in Medicare is the primary goal of any private Medicare insurance coverage. The gaps in Medicare include:
The Part B deductible is the only expense that you pay once per year. All of the other gaps, including the Part A deductible, can be charged to you multiple times throughout the year. The Part A deductible and Part B co-insurance charges are likely to be the most expensive costs you’ll encounter. Of these, Part B co-insurance is the most common cost; you will pay this out of pocket cost whenever you use Part B services like seeing a doctor or having lab work done. The cost for Part B co-insurance is 20%. You pay 20% of the cost for all Part B services you receive throughout the entire year. For the most part these costs are minimal, but some treatments like chemotherapy can be very expensive, and your 20% share can add up to thousands of dollars.
With Original Medicare, you don’t have any limitations on your spending. You pay the same all year long, regardless of how much you’ve paid during the year. This is a major difference between Original Medicare and other kinds of health insurance you’ve had in the past. Medicare Supplement Insurance protects against the potential for high out of pocket costs for health care.
Medicare Supplement Insurance is a private coverage that’s designed to work with Original Medicare as a secondary payer. This means that Medicare Supplement Insurance pays part of the costs that you’d normally pay (the gaps in Medicare), but only after Medicare has paid its share. As a private insurance coverage, it’s offered by insurance companies; you can choose to add it, or not. It’s completely optional.
Ohio is one of the 47 states that have adopted a framework of standardized Medicare Supplement Plans. This means that most of the rules and regulations for these plans, which are alternatively called Medigap Plans, are the same in all of the standardized states. In these 47 states, there are ten standardized Medigap plans plus two high deductible plans: A, B, C, D, F, G, K, L, M, and N. Plans F and G have high deductible versions. After December 31, 2019, Plans C, F, and high deductible F are not available to people newly eligible for Medicare. Anyone eligible before that date remains eligible for those three plans.
The fact that these plans are standardized means that the benefits provided by them are the same in all of the standardized states. Each one of these Medigap plans covers a different number and combination of the gaps in Medicare. Some are minimally comprehensive (they provide only basic benefits, and you will pay more out of pocket for care), others much more comprehensive (you’ll pay very little out of pocket for care), and others are in-between. Since there are so many options available, you can choose a level of coverage that meets your unique needs. But, since they are uniform in all of the standardized states,you can very easily compare the costs for plans in your area.
As mentioned earlier, Medigap is a secondary coverage. When you get medical care, you will use both your Original Medicare benefits and your Medigap plan to pay your bill. Original Medicare is the primary payer; for Part B, they’ll pay the first 80% of your costs, as long as you’ve already met the Part B deductible. Your Medigap plan will help pay for some, or all, of the remaining 20% of your bill. This coverage very effectively reduces the amount that you pay out of pocket, protecting you from the possibility of very high medical bills.
You have the right to enroll in a Medigap plan when you first enter Original Medicare. Most people have the opportunity to do this when they turn 65 years old. If you are one of these people, your Initial Election Period (IEP) will start three months before your 65th birth month. This enrollment window lasts for seven months; it ends on the last day of the third month following your 65th birth month. You can enroll in Parts A and B at any point in this window. Once you’ve done that, you can enroll in your Medigap plan.
Some people qualify for Medicare before they turn 65 years old. It can be difficult for these people to get Medicare Supplement Plans in Ohio when they first enter Medicare. Federal laws don’t require Medigap Plans to cover people under 65 years old. This decision is left up to the individual states. Ohio does not require plans to cover people under 65. People who enter Medicare before turning 65 in Ohio will likely choose a Medicare Advantage plan, at least until they turn 65. Once they turn 65, they will have the chance to add Medigap coverage.
This is a six month window during which you are guaranteed acceptance into any Medigap plan in your area. It only starts when you are age 65 or older, AND enrolled in Part B.
You might be able to, but it can depend on your health history in some cases. If you apply for a new plan after your Open Enrollment Period, Plans can take your health into account; you could be declined or charged higher premiums based on your health.
Yes. You can do this during Medicare’s Annual Enrollment Period (October 15 to December 7).
No. If you choose Medigap, you should also enroll in a Part D drug plan.
No. You’ll need to consider adding separate coverage for those services.
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