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What is a Medicare Supplement Plan? Is it the same as a Medicare Advantage Plan?

Although original Medicare pays a lot of your medical costs, it does not cover them all. A Medicare Supplement Insurance (Medigap) policy can help pay some of your remaining health care costs such as deductibles, copayments & coinsurances.

A Medicare Supplement is extra health insurance that you purchase from a private insurance company to pay health care costs not covered by Original Medicare. Medigap policies do not cover long-term care, dental care, vision care, hearing aid and eyeglasses, and private-duty nursing. They also do not cover prescription drugs.

Medigap policies are only available to people who already have Medicare Part A and Medicare Part B. It is very important to know that people who have a Medicare Advantage plan cannot get a Medigap policy.

When to purchase a Medigap policy?

If you are going to buy a Medigap plan, the open enrollment period is six months from the first day of the month of your 65th birthday, as long as you are also signed up for Medicare part B, or within six months of signing up for Medicare Part B. For example, if you are still working past age 65 and keep your employer insurance until you are 68 or 70, your open enrollment period begins once your employer policy is terminated. During this time, called the Open Enrollment Period, you can buy any Medigap policy without having to go through medical underwriting (guaranteed issue). However, If you try to buy a Medigap policy outside this window, there is no guarantee that you'll be able to get coverage and if you do get covered, your rates might be higher.

Medicare Supplement policies are Standard plans, meaning each specific plan covers the same exact benefits, no matter which insurance company you obtain it from. Standard Medigap plans are labeled A through N and offer different levels of health coverage. Plans E, H, I, and J are no longer available to new subscribers.

How Much does a Medigap policy cost?

While Policy benefits are standardized, the costs are not. For each Medigap plan, you pay a monthly premium to the insurance company in addition to your Medicare Part B premium. The cost of your Medigap policy depends on

The type of plan you buy,

The insurance company,

Your location,

and your age.

A standardized Medigap policy is guaranteed renewable, even if you have health problems, as long as you pay your premiums on time.

As mentioned earlier, people who have a medicare advantage plan cannot get a Medigap policy. If you have Medicare Advantage, you do not need a Medicare Supplement.

Here is the way we generally describe the difference between a Medicare Advantage plan and a Medigap or “MedSup” plan. Medicare Advantage plans are considered ‘pay-as-you-go” plans. Generally, the monthly premium for a Medicare Advantage plan will be much lower than the monthly premium for a Medicare Supplement plan and you will have small copays for services. We describe Medigap plans as “pay in advance” plans. The monthly premiums will be higher, but your plan will cover nearly all of your medical out of pocket costs that are not covered under original medicare (of course your cost will vary depending on which plan you Plan A or Plan G or Plan N, etc). (See the exceptions listed above about what is NOT covered in any Medicare Supplement plan.)

As Independent Insurance Brokers, we are appointed by many of the major insurance carriers that offer Medicare Supplement policies in Virginia and West Virginia. We can help you find the best policy for your individual situation. Contact us today at (540) 662-4432 to speak with one of our Insurance agents or visit our website to obtain more information.

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