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An Overview of the Different Medicare Supplement Plans

Medicare Supplement plans are purchased to help relieve some of the burden that Medicare part A & B leave behind in the form of out of pocket expenses. Medicare covers only 80 percent of Part B costs and the 20 percent is left for the individual to pay. Even though it is only 20 percent, it can be too much for a retired person to pay. Because of this, insurance companies decided to create Medicare supplemental insurance plans, to pay for that 20 percent difference to help with finances.

There are 10 different standard Medicare Supplement plans that are sold in most states. These 10 Medicare Supplement plans are A, B, C, D, F, G, K, L, M, N, as well as a high-deductible Plan F option. Not all plans cover the same services.

In general, all Medicare Supplement plans cover at least part of:

  • Medicare Part A and Part B deductibles
  • Skilled nursing facility costs (after you run out of Medicare-covered days)
  • Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  • Medicare Part B coinsurance or copayment
  • Part B excess charges
  • Part A hospice care coinsurance or copayment
  • Blood (first 3 pints)

Two Medicare Supplement plans (Plan K and L) include an out-of-pocket limit. This means that once you have reached a certain amount spent on Medicare-covered services, the Medicare Supplement plan will cover 100% of Medicare-covered costs for the rest of the year.

An overview of the different Medicare Supplement plans and what they cover.
An overview of the different Medicare Supplement plans and what they cover.

* There is also a high-deductible version of Plan F.

Some Facts to Know:

  • All insurance companies that sell Medicare Supplement must offer Plan A. A company must also offer either Plan C or Plan F if it offers any other plan besides Plan A.
  • Each standard Medicare Supplement plan option must provide the same basic benefits. For example, a Plan A policy sold by a company in California will have the same basic benefits as a company in Pennsylvania selling the same lettered plan.
  • Plans E, H, I, and J are no longer offered, but if you already have one, you can keep using it until you decide to switch, then you cannot go back.
  • Not all Medicare Supplement plans may be available in your state. In Massachusetts, Minnesota, and Wisconsin, Medicare Supplement policies are standardized differently.
  • Standardized Medicare supplemental plans do not provide coverage for dental care, hearing aids, vision care, prescription drugs or long-term care.
  • You can see any doctor, whether they accept Medicare assignment or not. Medicare assignment is when your doctor or provider accepts the Medicare-approved amount as full payment.
    • If your doctor accepts assignment, then your Medicare Supplement insurance company will pay your doctor directly.
    • If your doctor does not accept Medicare assignment, you will have to pay your doctor yourself and send in claims to your insurance company.

Medicare SELECT

In some states you can purchase Medicare SELECT, which is a type of Medicare Supplement policy. Medicare SELECT can be any standardized Medicare Supplement plan (plans A-N). It requires the policyholder to use hospitals and doctors in their network. If it is an emergency, then you will not have to stay in network. Medicare SELECT plans often have lower premiums.

Medicare Part B bills can become overwhelming, so a Medicare Supplement plan is beneficial to sustain the costs. At EZ.Insure we are trained to be on your side and get you the best plan in your budget. Get an instant quote by typing your zip code in the bar above, or speak with someone now. You can contact one of our highly trained agents through email at Replies@EZ.Insure, or by calling 855-220-1144. At EZ.Insure we want to help you get coverage, not help insurance companies get right. We know how hard it is dealing with a ton of phone calls and agents hounding you, which is why we want to help, we work for you. Let us help you today!

Medicare Coverage VS Medicare Supplement Coverage

Medicare is the federal health insurance program for people who are 65 or older. When you enroll in Medicare, it is important to understand how it works and whether or not you will need a Medicare Supplement plan to go with it. Once you pay your deductible, Medicare covers only 80% of your Part B expenses, leaving you to pay the rest. Medicare Supplement is an insurance plan that is sold by private companies. Medicare Supplement plans help pay for the 20% of the Medicare Part B costs which is left for you to pay.

Original Medicare, and Medicare Supplement plans cover different healthcare. It is important to go over each program, and what they offer in order to determine if a Medicare Supplement plan will benefit you.

How Medicare Works:

Every year, you must pay a set amount, a deductible, for your health care before Medicare pays its share. You can sign up for Part A and/or Part B insurance, but most people have both. You pay a monthly premium for Part B.  Medicare only covers 80 percent of Part B services, leaving you with the other 20 percent to be paid out of pocket. Depending on your medical needs in a given year, that 20 percent gap can become a large financial burden.

For 2017, the Medicare Part A deductible is $1,316 a year, while Medicare Part B’s yearly deductible is $183. Once you have paid your deductible in health bills such as physician visits, outpatient hospital services, and covered medical equipment, then Medicare will pay cover the rest up to 80% for Part B, and 100% for Part A.

Medicare covers wellness visits every month.
Medicare will cover annual wellness visits once a month.

What Medicare covers

Medicare benefits are divided into two parts, Part A and Part B.

  1.   Medicare Part A (Hospital Insurance) — covers inpatient hospital care, skilled nursing facility care, short-term nursing home care, hospice care, and some home health care. (100% of your costs for up to 60 days in a hospital or up to 20 days in a skilled nursing facility.)
  2.   Medicare Part B (Medical Insurance) — covers annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.)

What Medicare does not cover

  •         Annual physical exams except other than one annual wellness visit
  •         Health care you get while traveling outside of the United States (Very limited exceptions)
  •         Hearing aids, and most hearing exams
  •         Long-term nursing home care for more than 100 days
  •         Acupuncture, naturopathy, etc.
  •         Most eyeglasses
  •         Most dental care

Prescription drugs are not covered under Parts A and B, but it will cover some drugs in certain cases like immunosuppressive drugs for transplant patients, and oral anti-cancer drugs. For prescription drug coverage, you should consider signing up for stand-alone Medicare Part D plan.

How Medicare Supplement Works:

There is a monthly premium for your Medicare supplement plan, and in return, the plan pays most of your expenses not covered by Medicare parts A & B. For example, if you have a $4,000 ambulance bill and have already met the yearly Medicare Part B deductible, Medicare Part B will pay 80% of the bill. This leaves you to pay the 20% that us left, $800, out of pocket. But if you have a Medicare Supplement plan that covers Part B copayments and coinsurance costs, then it will pay the $800 remaining.

The Medicare Supplement Open Enrollment period is the six-month period that starts on first day of the month that you are 65 and enrolled in Medicare Part B. During the open enrollment period, you can enroll in any Medicare Supplement plan offered in your service area with guaranteed issue. This means that insurance companies are not allowed to deny you or charge you more due to pre-existing conditions. There are many different types of Medicare Supplement plans to choose from, and they vary in levels of coverage and cost.

What Medicare Supplement covers

Medicare Supplement covers nurse care and Part B excess charges.
Medicare Supplement will cover nursing facility costs after you run out of Medicare-covered days. 

In general, all Medicare Supplement plans cover at least part of:

  •         Medicare Part A and Part B deductibles
  •         Skilled nursing facility costs after you run out of Medicare-covered days
  •         Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  •         Medicare Part B coinsurance or copayment
  •         Part B excess charges
  •         Part A hospice care coinsurance or copayment
  •         Blood (first 3 pints)

Some will cover:

  • Foreign travel emergency (up to plan limits)
  • Part B deductible

Two Medicare Supplement plans (Plan K and L) include an out-of-pocket limit. Once you have reached a certain amount spent on Medicare-covered services, the Medicare Supplement plan will cover 100% of the costs for the rest of the year.

What Medicare Supplement does not cover

Medicare Supplement policies generally do not cover:

  •         Long-term care (care in a nursing home)
  •         Routine vision or dental care
  •         Hearing aids
  •         Eyeglasses
  •         Private-duty nursing.
  •         Prescription drugs

Looking for more details or help?

There are roughly 10 different types of medicare supplement plans on the market, and they all  vary in coverage and cost. Figuring out which plans are best for you can be hard, but we are here to help. If you would like to gather more information on Medicare and Medicare Supplement plans, one or our highly trained agents are ready to help.

You can start by simply entering your zip code in the bar above to get a quote, or you can contact us by email at Replies@Ez.Insure or call 855-220-1144. There is no hassle and no obligation. We will help you answer any questions, go over all of your plan options, find the Medicare Supplement plan most suited for your needs and budget, and even help you sign up if you’re ready. No hassle necessary! We work on your time and do not hound you with calls like the other guys.

Medicare Advantage Plans Have A $0 Premium For Most

When it is time to consider Medicare, usually around the time you turn 65 years old, it would be wise to take a look at different Medicare Advantage plans. Medicare Advantage plans, also known as Medicare Part C, usually offer more benefits than Original Medicare for a lower cost. About one-third of Medicare beneficiaries have chosen to go with a Medicare Advantage plan, and it is projected to be almost 34% more in the upcoming years. The reason for this estimated rise and popularity is due to how many benefits you get at such a low cost, in fact, many plans have a $0 premium.

prescription drug bottles
Medicare Advantage Plans will cover things that Original Medicare does not, such as prescription drug coverage. 

How Medicare Advantage Works

Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. MA plans include both Medicare Part A and Part B. When you enroll, you continue to pay your Part B premiums, and you have a separate monthly premium for having the Medicare Advantage plan (Part C plan). The Part C plan offers the same benefits offered by Original Medicare along with medically necessary procedures, prescription drug coverage and other benefits like vision and dental.

You must have Medicare Parts A and B to join an MA plan. You must also live in the plan’s service area, and you must not have End-Stage Renal Disease (ESRD).

Different Medicare Advantage plans:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-for-Service (PFFS)
  • Special Needs Plans (SNPs)
  • HMO Point-Of-Service (HMOPOS)
  • Medical Savings Account (MSA)

How Cheap Medicare Advantage Costs

hundred dollar bills inside a glass jar.
Medicare Advantage Plans will help you save money, especially since most plans have a $0 premium.

If you worked for at least 10 years and paid Medicare taxes, then your Part A premiums are free, if not you will pay a monthly premium. The standard Part B monthly premiums for 2018 is $134, but may be higher depending on your income. For a Medicare Advantage plan (Part C), you pay very little. Around 81% of Medicare enrollees have the option of a $0 premium plan. If you do end up paying $0, you may be responsible for paying higher cost sharing such as copays, coinsurance, or deductibles (which is determinant on the plan you choose).

The average Medicare Advantage plan premium in 2018 will be around $30, and can range anywhere from $0 to $200 a month. An example of how affordable these plans are, are the estimated monthly premiums of different Advantage plans in 2017. HMO monthly rate was around $28, the Regional PPO plan was $41, and the Local PPO was around $55.

All Medicare Advantage plans include a yearly Maximum Out-of-Pocket amount. This amount is the maximum you will pay out of pocket for covered services within a year. When this limit is met, your plan will cover 100% of the costs for the rest of the year.

Need Help?

Medicare’s Open Enrollment is October 15-December 7 every year, which is when you can enroll into a Medicare Advantage plan. EZ.Insure will answer any questions you might have regarding the different plans, and guide you through the process. Start saving on Medicare costs with a low costing, or $0 premium Medicare Advantage plan! Our agents are trained and knowledgeable on the plans in your area. To start saving, contact an agent by entering your zip code in the bar above, email replies@ez.insure, and call 855-220-1144. What’s even better, is you get all this help from our agents free of charge. Our goal is to help you save and provide you with the best customer service possible.

Is There A Difference Between Medicare & MedSup?

Medicare is the federal health insurance program for people who are 65 or older. When you enroll in Medicare, it is important to understand how it works and whether or not you will need a Medicare Supplement plan to go with it. Once you pay your deductible, Medicare covers only 80% of your Part B expenses, leaving you to pay the rest. Medicare Supplement is an insurance plan that is sold by private companies. Medicare Supplements plans help pay for the 20% of the Medicare Part B costs which is left for you to pay. Original Medicare, and Medicare Supplement plans cover different healthcare. It is important to go over each program, and what they offer in order to determine if a Medicare Supplement plan will benefit you.

How Medicare Works:

Every year, you must pay a set amount, a deductible, for your health care before Medicare pays its share. You can sign up for Part A and/or Part B insurance, but most people have both. You pay a monthly premium for Part B.  Medicare only covers 80 percent of Part B services, leaving you with the other 20 percent to be paid out of pocket. Depending on your medical needs in a given year, that 20 percent gap can become a large financial burden.

For 2017, the Medicare Part A deductible is $1,316 a year, while Medicare Part B’s yearly deductible is $183. Once you have paid your deductible in health bills such as physician visits, outpatient hospital services, and covered medical equipment, then Medicare will pay cover the rest up to 80% for Part B, and 100% for Part A.

What Medicare covers

Medicare benefits are divided into two parts, Part A and Part B.

  1.   Medicare Part A (Hospital Insurance) — covers inpatient hospital care, skilled nursing facility care, short-term nursing home care, hospice care, and some home health care. (100% of your costs for up to 60 days in a hospital or up to 20 days in a skilled nursing facility.)
  2.   Medicare Part B (Medical Insurance) — covers annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.)

What Medicare does not cover

  •         Annual physical exams except other than one annual wellness visit
  •         Health care you get while traveling outside of the United States (Very limited exceptions)
  •         Hearing aids, and most hearing exams
  •         Long-term nursing home care for more than 100 days
  •         Acupuncture, naturopathy, etc.
  •         Most eyeglasses
  •         Most dental care

Prescription drugs are not covered under Parts A and B, but it will cover some drugs in certain cases like immunosuppressive drugs for transplant patients, and oral anti-cancer drugs. For prescription drug coverage, you should consider signing up for stand-alone Medicare Part D plan.

How Medicare Supplement Works:

There is a monthly premium for your Medicare supplement plan, and in return, the plan pays most of your expenses not covered by Medicare parts A & B. For example, if you have a $4,000 ambulance bill and have already met the yearly Medicare Part B deductible, Medicare Part B will pay 80% of the bill. This leaves you to pay the 20% that us left, $800, out of pocket. But if you have a Medicare Supplement plan that covers Part B copayments and coinsurance costs, then it will pay the $800 remaining.

The Medicare Supplement Open Enrollment period is the six-month period that starts on first day of the month that you are 65 and enrolled in Medicare Part B. During the open enrollment period, you can enroll in any Medicare Supplement plan offered in your service area with guaranteed issue. This means that insurance companies are not allowed to deny you or charge you more due to pre-existing conditions. There are many different types of Medicare Supplement plans to choose from, and they vary in levels of coverage and cost.

What Medicare Supplement covers

In general, all Medicare Supplement plans cover at least part of:

  •         Medicare Part A and Part B deductibles
  •         Skilled nursing facility costs after you run out of Medicare-covered days
  •         Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  •         Medicare Part B coinsurance or copayment
  •         Part B excess charges
  •         Part A hospice care coinsurance or copayment
  •         Blood (first 3 pints)

Some will cover:

    • Foreign travel emergency (up to plan limits)
  • Part B deductible

Two Medicare Supplement plans (Plan K and L) include an out-of-pocket limit. Once you have reached a certain amount spent on Medicare-covered services, the Medicare Supplement plan will cover 100% of the costs for the rest of the year.

What Medicare Supplement does not cover

Medicare Supplement policies generally do not cover:

  •         Long-term care (care in a nursing home)
  •         Routine vision or dental care,
  •         Hearing aids
  •         Eyeglasses
  •         Private-duty nursing.
  •         Prescription drugs

Looking for more details or help?

There are roughly 10 different types of medicare supplement plans on the market, and they all  vary in coverage and cost. Figuring out which plans are best for you can be hard, but we are here to help. If you would like to gather more information on Medicare and Medicare Supplement plans, one or our highly trained agents are ready to help. You can start by simply entering your zip code in the bar above to get a quote, or you can contact us by email at Replies@Ez.Insure or call 855-220-1144. There is no hassle and no obligation. We will help you answer any questions, go over all of your plan options, find the Medicare Supplement plan most suited for your needs and budget, and even help you sign up if you’re ready. No hassle necessary! We work on your time and do not hound you with calls like the other guys.

Medicare Enrollment Expanded by the Federal Government

The Federal Government has extended the time to sign up for Medicare, mainly the relief period, also known as the Special Enrollment Period (SEP), for people through September 30.

Normally the annual open enrollment for Medicare is January 1st through March 31st. This time is when people who missed signing up for Medicare Part B at the time they were supposed to. Generally the time to sign up is three months before you turn 65, the month of when you turn 65 and the 3 months after that month. For example, if your 65th birthday falls in February, you can sign up November through May. If you miss this period you must enroll during the Special Enrollment Period.

During the January 1-May 31st Special Enrollment, people will have to pay a late fee based on how many years you delayed signing up from your eligibility. Also, your coverage will not start until July 1st.

The federal government expanded the special enrollment period until September 30th. The time expansion is mainly for those who enrolled in marketplace insurance when they could have enrolled in Medicare after losing their spouse’s job-based insurance or their own plan. The fees that would normally be charged for late enrollment will be waived through this relief process. There will also be no gaps in coverage when enrolling late.

“CMS’ decision to expand equitable relief will help even more people hampered by costly penalties and those going without needed health care,” said Joe Baker, president of Medicare Rights. “We applaud CMS for doing right by people new to Medicare, and we look forward to working with our agency partners, State Health Insurance Assistance Programs (SHIPs), local Social Security Offices, and others to help people access this critical relief.

If you qualify for the time-limited equitable relief, or have questions, you can go online and even apply at www.medicareinteractive.org.

New Medicare Open Enrollment Dates

The Centers for Medicare and Medicaid Services, CMS, has announced that beginning in 2019, there will be a continuous Medicare Open Enrollment Period which will now be January 1- March 31st. During this time, Medicare beneficiaries will be able to to make a one time change of plans.

In 2011, the Affordable Care Act changed the Annual Election Period (AEP) to October 15 through December 7 every year and changed the Open Enrollment Period (OEP) into a Medicare Advantage Disenrollment Period (MADP) which was January 1-February 14. During the Disenrollment Period, you can drop your current Medicare Advantage plan and can return to Medicare and purchase Medicare Supplement. You can purchase Part D plan but only if you drop your Medicare Advantage Prescription Drug Plan, MAPD.

 

The 21st Century Cure Act that just passed and signed into law is bringing back the Open Enrollment Period dates. During the AEP, beneficiaries can change switch as much as they want but a final decision will be by December 7.  The AEP will still during October 15- December 7 every year where beneficiaries can:

  • Switch from Original Medicare to Medicare Advantage Plan
  • Switch from Medicare Advantage Plan back to Original Medicare
  • Change Medicare Advantage Plans
  • Enroll in a Part D plan
  • Drop prescription drug coverage
  • Switch or purchase Medicare Supplement Plan

 

During the 2019 OEP, January 1-March 31st, beneficiaries can make a one time change to:

  • Medicare Advantage Prescription Drug Plan to another MAPD
  • Switch a MAPD to Original Medicare and a Part D
  • Switch Original Medicare and Part D to a MAPD.
  • Change Medicare Advantage Plans
  • Switch from Original Medicare to Medicare Advantage Plan
  • Switch Medicare Advantage Plan to Original Medicare
  • Purchase Medicare Supplement Plan when switching to Original Medicare*

*When purchasing a Medicare Supplement Plan during OEP, you will not have guaranteed issue and subject to underwriting.

The AEP can be a hectic time for many Medicare beneficiaries because it falls during the holidays. Some people will wait until the holidays are over to try and change plans and find out they cannot do it until the next AEP in a year. Now, with this new OEP, from January 1-March 31st, beneficiaries can help those that missed the deadline to have another chance to make changes.

 

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