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Medicare Supplement plans, also known as Medigap plans, are private insurance policies designed to cover some of the costs that Original Medicare (Parts A and B) doesn’t cover. These gaps might include deductibles, copayments, and coinsurance.
Medicare Supplement plans are offered by private insurance companies and are standardized across most states, meaning the benefits are consistent regardless of the insurer you choose. They are labeled with letters (A through N) and each lettered plan provides a different set of benefits.
Financial Protection: Medigap plans help cover out-of-pocket costs like deductibles, copayments, and coinsurance that Original Medicare doesn’t cover, potentially saving you a significant amount of money.
Predictable Costs: With a Medigap plan, you often have fewer unexpected expenses, which makes budgeting for healthcare costs easier. Some plans cover 100% of the out-of-pocket costs after Medicare pays its share. Medicare Supplements are provided for an additional monthly premium on top of your Medicare Part B.
Nationwide Coverage: Most Medigap plans offer coverage anywhere in the United States, so you have access to a broad network of healthcare providers without worrying about network restrictions.
No Referrals Required: You can visit any doctor or specialist who accepts Medicare without needing a referral, providing more flexibility in choosing your healthcare providers.
Easy Enrollment: During your Medigap Open Enrollment Period, which starts the month you turn 65 and are enrolled in Medicare Part B, you have guaranteed issue rights. This means you can get a Medigap policy without medical underwriting, regardless of your health status.
Peace of Mind: Knowing that many of your healthcare costs are covered can reduce stress and allow you to focus more on your health and well-being.
When considering a Medicare Supplement plan, it’s important to review the specific benefits of each plan letter and compare them to your healthcare needs and financial situation.
In 2024, the standard Medicare Part B premium amount is $174.70/month. If you didn't work long enough and pay Medicare taxes, you could also be required to pay a Part A premium (but most people don't). The Part B premium can be adjusted based on income. Right now they are looking at the 2022 tax return to determine if you will pay the standard amount or if they will charge you IRMAA (Income Related Monthly Adjustment Amount).
If you are still working and covered by your employer group health plan and your employer has 20 or more employees, you are able to delay Medicare enrollment without a penalty for late enrollment. Most people will go ahead and enroll in Part A, which is zero premium if you worked enough time and paid Medicare taxes. The only time you will not want to get Part A is if you have an HSA. Medicare plans don't have a high enough deductible for you to quality for having an HSA account. Find out more info here: https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65. Many people continue to work after 65 but still go on Medicare insurance because it may be less expensive and have more benefits. Contact me to help you compare Medicare costs and benefits to your employer plan.
Seniors can sign up for Medicare during several key periods:
Initial Enrollment Period (IEP): This period starts 3 months before you turn 65, includes the month you turn 65, and ends 3 months after your 65th birthday. This gives you a total of 7 months to enroll without facing any penalties.
Special Enrollment Period (SEP): If you or your spouse are still working and covered by an employer group health plan, you can sign up for Medicare Part B during this period. You have 8 months to enroll after your employment or coverage ends.
General Enrollment Period (GEP): If you miss the IEP and SEP, you can sign up between January 1 and March 31 each year. However, you might face a late enrollment penalty.
If you have any specific circumstances or need more details, feel free to ask!
As independent agents, we don't work for just one insurance company. We represent multiple companies including United HealthCare, Aetna, Humana, Blue Cross Blue Shield, Amerigroup, Cigna, Wellcare, Omaha, and more. Different companies and plans could be a better fit for different people.
We are able to help you by comparing plans available in your area that meet your needs. We will check networks to find out which plans your doctors accept, and will check drug costs to find the best Part D Drug plan for you. There is never any pressure. We are here to help answer your questions you have now and in the future.
We are able to help you get enrolled and help with plan changes in the future. Also, there is never any cost to use for our services and we take your privacy very seriously. Your info is never shared.
To be eligible for health insurance coverage under the Affordable Care Act (ACA), also known as Obamacare, you must meet the following criteria:
Residency: You must lawfully live in the United States.
Citizenship: You must be a U.S. citizen, U.S. national, or lawfully present non-citizen
Incarceration Status: You must not be incarcerated
Medicare Coverage: You must not be covered by Medicare.
Additionally, the ACA provides financial assistance to help reduce the cost of health insurance for individuals and families with incomes between 100% and 400% of the federal poverty level (FPL). Some states have expanded Medicaid under the ACA, making more people eligible for coverage.
If you have any specific questions about your eligibility or need help with the application process, feel free to ask!
Stacey Thomas & Shawn Thomas are licensed and certified representative of Medicare Advantage and Part D Drug Plan organizations. Each of the organizations they represent has a Medicare contract. Enrollment in any plan depends on contract renewal. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not affiliated or endorsed by any government agency.