To make a successful plan for your Medicare coverage requires an understanding of how much you’ll be expected to pay for your medical care. It also requires you to understand the options that exist to limit your expenses. One of these protective options is Medicare Supplement Insurance. In this article, you can find out how much Medicare could cost you, as well as how you can save money with Medicare Supplement Plans in Tennessee.
As you start making your plan, or as you consider the state of your current coverage, you need to start with a basic understanding of the costs that you’ll be facing when you use your Medicare coverage. These costs go beyond the Part B premium that you’ll have to pay when you enter the program. You will actually be required to pay for part of the cost for your care when you visit the doctor, stay in the hospital, or get other medical services. The amounts that you’ll have to pay vary based on which type of service you receive.
For Part A, you’ll face two different kinds of charges:
You’ll have to pay the Part A deductible when you’re first admitted to the hospital. After you’ve met the deductible, your hospital and skilled nursing home costs are covered for a period of time. If you have a hospital stay longer than 60 days, or a skilled nursing stay longer than 20 days, you’ll then start paying daily co-insurance.
For Part B procedures and services, these are the costs you’ll pay:
The Part B deductible is small; once you meet it, you’ll have to pay co-insurance of 20% for all the Part B services you use the rest of the year. Excess charges can be as high as 15% (which gets added to the standard 20%), but are pretty rare.
There are no caps or limits on your spending. You pay all year long, no matter how much you’ve paid already. Medicare Supplement Insurance was created to protect against these perils.
Medicare Supplement Insurance is a private option that’s designed to help you pay your share of costs when using your Part A and B benefits. This kind of coverage can also be called Medigap. Regardless of what you call it, it works hand in hand with Original Medicare. Instead of directly covering specific services and procedures like other forms of health insurance, Medigap is designed to pay the specific amounts that Medicare doesn’t (the deductibles and co-insurance). By using Medigap coverage, you can limit your out of pocket costs to just a few hundred dollars a year.
Tennessee is one of 47 states that utilize standardized Medigap plans. In these states, there are ten levels of Medicare Supplement Insurance available, plus two high deductible options. These plans are identified by Plan Letter: A, B, C, D, F, G, K, L, M, and N. Every one of these covers a different mix of the gaps (costs) in Medicare. Since these plans are standardized, each one of them offers the same benefits in all of the standardized states. Therefore, Plan D, or K, or any of them provide the exact same benefits from one state to another. This is true no matter which insurance company you use. By standardizing the benefits, finding a plan and comparing prices is super easy.
Using your Medigap coverage is very simple, too. When you see a provider or visit a facility, you’ll give them your Medicare card as well as your Medigap card. The provider will bill Medicare as well as your Medigap plan. As long as you’ve met the deductible, Medicare pays 80%. Your plan will pay most of the remaining 20%, and in some cases all of it (it depends on which Medigap plan you chose). With your Plan paying these costs, you can see how small your out of pocket expenses can be.
Besides the out of pocket spending protection, another useful feature of Medicare Supplement Insurance is that you can see any doctor or provider who takes Medicare. You don’t have to be restricted to a plan network or wait for referrals like you do with some other kinds of plans.
If you know you want a Medigap plan, but you’re having trouble choosing a level of coverage, ask yourself these questions:
Your answers to these questions will guide you to certain Medigap plans. For instance, if you need international coverage, you’ll want to choose from Plans C, D, F, G, M, or N. On the other hand, if you don’t travel internationally, and are not too concerned about developing major health issues, you might consider a less comprehensive plan like Plan B or L.
The eligibility requirements for Medigap plans are set by a combination of federal and state laws. The main requirement is that you have to have both Part A and Part B active. This usually happens when you turn 65. In this case, you’ll have an enrollment period during which you can enter Parts A and B. Once you do that, you can enroll in whichever Medigap plan you choose.
The same is true if you delay taking Medicare past age 65. This could happen because you worked past age 65 and kept your employer coverage. Whenever your coverage ends, you can add Part B and also a Medigap plan.
However, if you enter Medicare before you turn 65, your options for Medigap can be limited. Medicare Supplement Plans in Tennessee are required by state law to cover people under 65 years old. However, these plans typically charge higher premiums for people under 65, so finding an affordable option can be difficult until you reach 65 years of age.
This is an enrollment period during which you can apply for a Medigap plan on a “guaranteed issue” basis. In other words, you can’t be turned down or charged higher rates because of your health. This period lasts for six months and begins when you first enter Part B.
Yes. However, if you try to do so after your open enrollment period ends, your health may be a consideration and your acceptance isn't guaranteed.
No. You can choose to do nothing, or enroll in a Medicare Advantage plan.
Yes. You have the right to do this during the Medicare Annual Enrollment Period each fall.
No. You will need to enroll in a separate, standalone Part D drug plan to get drug coverage.
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