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Basic Facts You Need To Understand About Medicare Supplement Plans

  • What Is Medicare Supplement Plans?


Medicare supplement plans or sometimes referred to medigap is a healthcare insurance offered by private companies to take care of your healthcare costs that’s not included in your original Medicare. It is one of the essentials everyone needs to plan for their future. Medicare supplemental policies are sold by insurance companies, this means individuals can choose from various services depending on your budget and the quality of services you want. They offer different benefits and it’s up to you to choose the one that suits your needs.


All Medicare supplemental plans are in compliance with both state and federal legalities, that is to say they’re standardized plans. Whichever plan you choose, the policies are the same for all companies. The difference only lies in the amount you pay. For instance, plan G for company X is the same at company Y.


  • Benefits of Medicare supplement plans


* It will help you cover up your healthcare and other retirement needs.

* It helps in paying off out-of pocket expenses like deductible, coinsurance and co-payment fees.

* Medicare supplement plan helps you make an estimate of your yearly healthcare cost, this will help you save more money throughout the year.


  • Who Is Eligible For Medicare Supplement

You must figure out whether you’re eligible for a Medicare supplement plans or not and the right time to join. Anyone that reached 65 years and has enrolled in part A and part B can buy a supplement plan. You can enroll the very next month after reaching 65 years of age and it only last for six months. This is called the open enrollment period, during this time you can get Medicare supplement without answering any health questions. You’ll get accepted to any policy despite your health condition. When your open period is over you may need to answer health questions before enrolling again.


  • Medicare supplement plan Vs original Medicare plan


The major difference is providers. Supplemental plans work together with original Medicare companies. Any provider that accepts original Medicare will also accept a supplemental plan.


Choosing a Aetna Medicare supplement plans is highly recommended and has lots of benefits but still it has its own downside. It does not cover up prescription drugs, you need a separate plan that will cover up your drug expenses. Other health problems that are related to dental and vision are also not covered in your supplemental plans. It’s not always good idea to enroll with cheap providers, instead go for premium services that will take care of all your healthcare needs.


What Types of Coverage are not Medicare Supplement Plans?

Original Medicare policies help you pay for a selective range of health-care costs. No matter you have Part A or Part B insurance, you will need to have Medicare Supplement plans to get complete coverage.

Actually, Medigap plans supplement the benefits provided by Original Medicare. In order to avail these benefits, you need to enroll in Original Medicare to be eligible for Medigap coverage. You will need to stay enrolled in Original Medicare for your hospital and medical coverage as well. Before buying any supplement plans, you need to understand that these plans do not offer any stand-alone benefits,

As a Medicare beneficiary, you may also need to enroll in other kinds of coverage, either through the Medicare program or other sources, like an employer. When you first enroll in Original Medicare, you will be asked to fill out a form called the Initial enrollment Questionnaire and they will also ask you if you have other types of insurance.

Remember to fill in all types of other coverage you have in that questionnaire. Medicare will use this information to decide who pays first when you receive any health care services. Commonly, people have below types of insurances when apply for Medicare Supplement plans-

  • Medicare Advantage plans such as HMP or PPO
  • Medicare Prescription Drug Plans (Part D
  • Medicaid
  • Employer- or union-sponsored group coverage
  • Veterans’ benefits
  • Long-term care insurance Policies

Medicare Supplement Plans 2018 policies are not good for long-term care. You may not get Medicare Supplement coverage in case you are under 65 and have a Medicare because of disability, end-stage renal disease or any Amyotrophic. So, you should check with state’s insurance department to find out in case you are eligible to enroll in a Medicare Supplement Plan.

Again, keep in mind that Medigap plans do not offer Prescription drug coverage. In case you want help with prescription drug costs, you need to enroll in a stand-alone Medicare Prescription Drug plan. Furthermore, you cannot use your Medicare Supplement plan to pay for costs that you may have with a Medicare Advantage plan. You can only use Medicare Supplement plan to cover costs in Original Medicare.

Disabled Individuals enrolling in Medicare Advantage Plans, is that possible?

Are you looking for disabled people Medicare benefits? Do you want Medicare Advantage plans to receive disability benefits? You may be eligible, if you are disabled even before turning 65, however, you must be first enrolled in the Medicare federal program. Florida Blue Medicare is great coverage for Seniors.

Disabled and Medicare eligible, is that possible?

Medicare can be availed for under age 65 people even with disabilities. Typically, there should be the social security benefits of disability or some benefits of disability for a period of 24 months continuously to be Medicare qualified. This benefit of disability can also be from RRB, the Railroad Retire Board. Generally, you become enrolled automatically in Medicare.


You may qualify even on getting diagnosed with any of these conditions even being under 65 years:

  • ESRD referring to the End-stage renal disease. This is a kidney failure that requires a kidney transplant or regular dialysis. In such cases, you do not get enrolled automatically, but your may be Medicare qualified. You must contact Social Security.
  • ALS referring to Amyotrophic lateral sclerosis. In this, you are automatically Medicare enrolled from the month you receive the benefits of disability.


Medicare Advantage

Medicare Advantage plans is another way of receiving Part A and B Medicare coverage, regardless of whether you are disabled or not. The plan of Medicare Advantage are provided by the private insurance companies as approved by Medicare that offers Part A Medicare coverage for the hospital insurance and Medical insurance as per Part B coverage except for the Part A covered hospice care.


Precisely, on being qualified for Medicare owing to disability, the benefits of Medicare will be same as any other beneficiary.


Bear in mind that having the renal disease at the end stages alone may not be considered eligible for the Medicare Advantage plans. Yet, you are allowed to enroll in Medicare Advantage types of plans that feature Special Needs Plan and it is tailored with the ESRD for beneficiaries.


SNP refers to special needs plan. These are limited to chronic condition beneficiaries where people require Medicare and Medicaid or are people who are living already in certain facilities. These plans may be inclusive of the coverage for prescription drug.


What Medicare coverage is given for disabled people?

Medicare coverage is for all disabled qualified is the same as people qualifying as per their age. Of course, you have the enrolling option in the Advantage plan or you can consider Part D as stand-alone for prescription drug.

When does a person enroll automatically in Medicare part B in 2019

You can just wake up and decide to join Medicare Supplement Plans 2019, there are some rules that restricts some people to join any plan. At some point, the Medicare plan enrollment might occur automatically if only;

  1. You are getting the retirement benefits

This happens when you turn 65 and that is the time you will be able to enroll automatically without any struggles. It will be possible for you to join the Medicare part A which is hospital insurance and Medicare part B which is medical insurance. Rules differ according to your state and it is true that if you live in D.C or some other states in the list you will have to manually enroll for medical insurance (part B) but automatically get enrolled for hospital insurance.

  1. You are getting disability benefits

If you are not yet 65 and you are receiving any disability benefits from any social security, you definitely be enrolled automatically to the original Medicare that is part A and part B. This is only done after receiving the disability benefits for 24 months. In situations where you have ESRD (End-stage Renal Disease) and require regular kidney dialysis or kidney transplant you can actually apply for Medicare advantage plans manually.

On the other hand, if you have a certain condition known as amyotrophic lateral sclerosis it is clear that you definitely be automatically enrolled in an original Medicare in the month that you start to receive the disability benefits.

  1. You do not want Medicare Part B

In this matter you are already enrolled to Medicare part B but you are not willing to continue with it, you have some options that will enable you be in a position where you can drop the coverage. The moment you get the card and feel that you don’t want the plan anymore you will just return your card and follow the required instructions. If you stay with the card, you will keep the Medicare plan and premiums must be paid. For more information on that, visit your nearby offices or make contact with them.

Remember that there are different rules depending on the Medicare advantage plan. The plans are offered through the private insurance companies and you can simply purchase from eHealth insurance who acts as brokers. This is done online as the name suggests. If you may need some clarities contact the plan administrator.




Different eligibility criteria for Medicare Supplement Plans

If you are thinking of getting Medicare Supplement Plans then you must first look into the various eligibility criteria involved in the said purchases. You will not be able to purchase Medigap policies whenever you feel like. There are certain time periods when you will be allowed to make such a purchase.

There are also other criteria which you need to look after. Your medical condition is also very crucial in this regard. If you are diagnosed with certain types of ailments then the insurance company may choose not to sell you Medigap policy. However, once sold to you, the company will not be able to dismantle the policy even if you are ill at any point of time after such purchase is made.

Various eligibility criteria

The most important eligibility criteria for purchasing Medicare Supplement Plans are as follows:-

  • In order to purchase Medigap policy, you must first enrol into Part A and Part B of the original Medicare plan.
  • You also need to remain enrolled in your original Medicare policy as far as hospital and medical coverage is concerned. Medigap policy cannot function alone.
  • You need to attain an age of sixty five years in order to become eligible for this policy.
  • If you are under the age of sixty five and have a Medicare policy because of some disability then the company may offer you Medigap policy depending on your current state.
  • You should remember one thing about this policy that it does not include the prescription drugs coverage. There were certain policy that did in the past but the policy of today’s time does not provide any such benefit.
  • You must enrol into Medigap policy during the open enrolment period when the company will not be able to reject your application.
  • However, the company may ask you to wait for a period of six months before it will start covering your pre existing medical conditions.

Do Medicare Supplement Plan and Medicare Advantage Plan work together?

The answer to this question is a plain no. The Medigap policy does not work with the advantage plan. You will have to drop one of these. The reason for this is simple. There are certain coverage in the Medigap policy that are beyond the Advantage Plan so even though you will be paying for such benefits but at the time of claim you will not be compensated because the Medicare Advantage Plan will prevail over Medicare Supplement Plans.

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