Medicare supplement plans are sometimes called Medigap plans. These plans cover costs that you would normally pay out of your own pocket, like deductibles and co-pays. Medicare supplement plans also cover unusual expenses like emergency care in foreign countries. It’s possible to use Medicare supplement plans to totally eliminate costs that Medicare doesn’t pay. Most consumers opt for insurance that costs less than 100-percent coverage, but still keeps their out-of-pocket costs predictable and under control.
Understanding the Plans
California health insurance consumers should be aware of the difference between Medicare supplement plans and other re-insurance products. Many people add riders to their insurance policies to cover losses that aren’t covered by their regular insurance policies. That’s not how most Medicare supplement plans work. If Medicare doesn’t cover the healthcare, medicine, or therapy that you need, a Medigap plan probably won’t either.
Medicare supplement plans don’t normally pay for things like hearing tests, vision care, and dental care. Medicare supplement plans don’t cover prescription medicines. Consumers can take advantage of other insurance policies like Medicare Advantage plans or Medicare Part D plans to extend their coverage. Your California health insurance agent has more information.
Who Accepts Medicare Supplement Insurance?
If your doctor, clinic, or hospital accepts Medicare, it will also accept supplement insurance. Some Medicare plans limit coverage to a limited network of providers. Once again, if your provider accepts your Medicare insurance, they’ll also accept your supplement plan. Even consumers with a limited network of providers can use almost any provider if there’s an emergency that requires urgent care.
How Does California Health Insurance Compare?
California residents can choose from one of ten Medicare Supplement plans. The plans are identified by letters. For instance, Medicare Supplement Plan A has different coverage than Plan B. Except for the 3 states we mentioned, all the other states offer the same benefits for each plan.
Common Plan Coverage
Medigap coverage plans can be confusing. However, here are some of the benefits you’ll find in all of the most popular Medicare supplement plans:
- Adds up to one year of coinsurance after Medicare benefits are exhausted
- Adds coinsurance for hospice care
Setting an Upper Limit
Many consumers want to limit the total out-of-pocket expenses they pay if they need a lot of medical care. The formulas for calculating Medicare coverage can be complex. That can make it difficult to figure your potential bills in advance. There are two different Medigap plans that might help.
Plan K and Plan L set out-of-pocket limits on medical care. They don’t kick in until after your Medicare Part B deductible is satisfied. After that, they pay up to 100 percent of your medical expenses. That offers a lot of peace of mind to seniors. The original Medicare plan didn’t have any sort of limit on the total amount of out-of-pocket expenses. If you suffer a serious health emergency that requires a lot of emergency care, you’ll be glad you have an upper limit on the amount of money you have to pay.
Who Can Enroll?
Consumers who already have Medicare Part A and B are eligible for Medicare supplement plans. Medigap has an open enrollment period that begins when you turn 65. This period last for 6 months. Your preexisting conditions won’t affect your application for Medigap insurance during this period. You can apply for supplemental insurance after the open enrollment period. Acceptance is not guaranteed, however.
Understanding the Fine Print
Medicare supplement plans are a great way to enjoy good healthcare without constantly worrying about costs. Your health insurance broker can tailor a plan for your lifestyle and your budget. Contact Harmony Health Insurance Services in Santa Monica to find out more about Medicare supplement plans. They’ll guide you through the alphabet soup of plans. You’ll enjoy better coverage and lower costs. Because of limited open enrollment periods, it’s smart to plan ahead. Call today for more information!
Health Maintenance Organization (HMO) Plan
In most HMO Plans, you can only go to doctors, other health care providers, or hospitals on the plan’s list except in an emergency. You may also need to get a referral from your primary care doctor. In most cases, prescription drugs are covered in HMO Plans. It’s important that you follow the plan’s rules, like getting prior approval for a certain service when needed.
Please call us at (855) 545-5858 for free assistance and evaluation of your Medicare options.