If you want help paying for the costs that you’ll face when using your Medicare benefits, you need to consider Medicare Supplement Insurance. While there are other options for limiting your costs, Medicare Supplement Plans in Washington offer some compelling benefits and features that are worthy of your consideration. Read this quick guide to learn more about the costs of Medicare and how Medicare Supplement Insurance can protect you from them.
When you think of the cost for Medicare, you might think about the Part B premium that you pay each month. Or about the payroll taxes that you paid all of your working life that funded your Part A benefits. While those costs are significant, you have more exposure than just those to worry about. Besides these costs for coverage, there are also out of pocket costs you’ll experience when you actually use your benefits.
There are costs for both aspects of Original Medicare - Part A and Part B. For Part A, you will experience out of pocket expenses when you need to stay in a hospital or skilled nursing facility. In this case, you must pay the Part A deductible before Medicare will start picking up the tab. In some cases, if your stay is long enough, you might have to start paying daily co-payments.
Part B costs tend to occur more frequently, but for smaller dollar amounts. You’ll pay the Part B deductible at the start of the year. After you’ve done that, Medicare will start paying 80% of the cost for your Part B services. You are responsible for the remaining 20%. While Part B costs tend to be smaller, one exception is for cancer treatments. Many of these, like chemotherapy, are covered by Part B; 20% of these costs can be a large amount.
Your costs are potentially unlimited with Medicare, because there’s no cap or yearly limit to your spending like there is with other kinds of health insurance. It is for this reason that people consider using Medicare Supplement Insurance.
Medicare Supplement,or, Medigap Insurance, is a private addition to your base Medicare benefits. These private plans are designed to pay many of the costs that you would ordinarily have to pay. These plans don’t alter your Part A or B coverage, they just protect your wallet from runaway costs for medical care.
In most of the country (47 of the 50 states, plus Washington, D.C.), Medigap plans operate under a standardized framework of benefits. In each of these states, there are ten standardized plans available. The Plans are: A, B, C, D, F, G, K, L, M, and N. Besides these, there are two high deductible versions, making a total of 12. Each one of the letters represents a plan with a different range of benefits. The individual plans (A, B, C, etc.) each have the same benefits in all of the states (i.e. they are standardized). Since the plans themselves offer exactly the same benefits in each of the 47 standardized states, it is easy to shop for and compare plans offered from the insurance companies in your area.
There may be 12 plans to choose from, but some are more popular than others. Insurance companies aren’t required to offer all of the plans. Instead, Plans A, F, G, and N tend to be the most popular. Plan F (as well as High Deductible F, and Plan C) are not available to anyone who becomes eligible for Medicare after December 31, 2019.
Plan A is the most basic and least expensive plan.This plan covers:
You remain responsible for all the other costs of your care.
Plan G is much more comprehensive, and therefore the most expensive option available. Plan G will pay every expense for you except for the Part B deductible. You pay the Part B deductible, and you’re done spending money on medical care for the rest of the year. Because of this, it is one of the most popular plans, despite the higher cost for coverage.
When you have Medigap coverage, you will pay for your medical care with both of your insurance cards - your Original Medicare card and your Medigap plan card. As long as you’ve already met your deductible, Medicare will pay the first 80% of the cost for your Part B services. Your plan will pay for most, or all, of the remaining 20%. If you haven’t met the deductible yet, you’ll have to pay that first, then Medicare and your Plan will start paying claims. Since Medigap plans all cover the Part B co-insurance in full or in part, your medical expenses will be very limited.
You can enroll when you are covered by both Part A and Part B. You have to have both active, so if you delay taking Part B, you have to wait until you add Part B coverage in order to get your Medigap plan. When you enter Parts A and B at age 65, you have the chance to add Medigap during your Initial Enrollment Period. You can apply for your plan as soon as you have your Medicare number and Part A and B start dates.
If you get into Medicare early (before age 65), the situation is a little more complicated. Federal regulations don't require Medicare Supplement Plans to give coverage to people under age 65. This rule is set at the state level, and the states all have unique laws when it comes to people under 65 and Medigap coverage. Medicare Supplement Plans in Washington are not required to give coverage to people under 65. However, some insurance companies voluntarily do so. Despite this fact, the premiums can be very expensive because Washington does not limit how much Plans can charge people under 65.
During your Open Enrollment Period for Medigap coverage. This six month window starts when you are age 65 or older and also enrolled in Part B. During this time, you can’t be denied coverage or charged higher premiums because of your health status.
Yes. Washington has very consumer-friendly laws about this. You can switch plans once per year without difficulty.
Yes. This can be done during the annual Medicare enrollment period from October 15th to December 7th each year.
No. You will need to add standalone Part D drug coverage to get help with your prescriptions.
Not all of them. But, Plans C, D, F, G, M, and N do.
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