Medicare Supplement plan or in other words, Medigap, is a type of insurance that, as its name says, fills some gaps in original medicare, and whose providers are private companies. We all understand how medicare requires some costs that can be high, and therefore extremely significant when taking our budget into consideration. Those costs are covered into such categories as copayments, coinsurance, and deductibles, and there’s also an option that allows covering medical care for traveling abroad.
Medigap is completely different from the Medicare Advantage Plan in terms of offering only supplements for your original medicare while the latter offers some additional benefits. Having in mind these distinctions, the payments for each of the programs differ. To be able to use Medigap, you need to have Medicare Part A and Part B, and the monthly payments are just an add up to the Part B premium that’s being paid to Medicare.
The providers for Medigap policy can be any company that has a government-issued license to sell it. Their plans vary and switching from one to another carries its pros and cons that are of utmost importance to have in mind before you decide about the one you’ll choose. The plans are divided into groups marked with letters from A to N. The costs that are included also vary from one to another and the amount that’s covered can be either 0%, 50%, 75%, 80%, or 100% with certain exceptions for those like K or L.
Important steps in selection process
At some point, you might want to change the plan you’re using and this process can (to some extent) look like the car-buying one or house-building one. Of course, the importance is incomparable between those, yet the algorithm you follow might be similar. Let’s see some crucial steps:
- Plan type decision making – you are certainly interested to know more of the benefits that each of them includes (the above-mentioned A to N) and the costs they cover. Once you review the options, you can understand your main needs or at least anticipated needs and make the basic selection for the one that suits your pocket/necessities leverage.
- Policy type decision making – make sure to be aware of the offer in your particular areas, since different companies offer different prices for each of the letter-marked policies. This can be done using a zip code search.
- Getting in touch with the insurance company – once you found the one you prefer, you can contact them and get the exact official offer which can vary depending on some subcriteria (other than policy type) – your health state, time of the year when you purchase it, and many more.
Things to consider when changing the plan
The chosen policy isn’t carved in stone. As a client, you can choose to change the plan according to some circumstances that have appeared in your life more or less expectedly. Knowing what’s crucial in this process can save you both time and money, and probably nerves.
1. Timing when to cancel the current one
Without any doubt, the Open Enrollment Period is the far best time to make the switch you want. Regardless of this, it’s good to know that canceling the current one before knowing if you will or will not be accepted into the new program you’re interested in isn’t a good option. Just like when you’re buying a new car, you don’t want to be left without a vehicle and sell the old car before you find the new one to buy and arrange the purchase.
When you recognize the necessity for the change, your next step should be to gather as much information as possible from the new insurance company and the one you want. There’s a slight chance they won’t be accepting your application. If they do accept – you should leave it up to them to get in touch with your current company and request the current policy cancellation. Also, it isn’t advisable to cancel the current policy until you’re positive about the wish to go on with the new policy program.
2. Restrictions in the plan switch and exceptions to it
There is the above-mentioned so-called Open Enrollment Period, which is a particular period during which the person can enroll for insurance coverage. It usually lasts from October 15 to December 7 each year, which means the insurers might not accept selling the (other) policy after this period ends or they can charge you a higher premium if you come with some high-risk health issue.
Like with any other rule, there are exceptions to this one too. Even though you might be required to pay more if you decide to go with this method, it’s good to know your rights. The exceptions might be more beneficial to know than the rule:
- If you are within your 6-month Medigap Open Enrollment Period, you can switch from one to another or buy a new one
- You already have a Medicare Advantage plan and the company is no longer offering services in the field
- The one you have been using is no longer offered or isn’t in the Medicare package
- You have moved out of the area where the particular one has been offered and in the new one it’s no longer available
- Your employer stops paying the Original Medicare coverage for you
- You lose the insurance plan due to the bankruptcy of the insurance company
- Your coverage is lost due to law-questionable activities and false leading by the insurance company.
3. Regulation change from January 1, 2020
There has been a major change in the regulation of insurance starting from the beginning of the current year, which reflected the Medigap policies. For new ones to buy the policy, there was no Part B deductible included which as a result caused plans C and F not to be available to newbies in insurance.
This change didn’t reflect ones already having the plan C or F, or who’d been covered by any of them before the start of the current year.
4. The coverage you get with the change
It’s more than natural that your cost coverage is one of the main reasons that urged you to change the policy. The insurance companies consider altering their part D and Medicare Advantage plans yearly. This implies the service additions or removals yearly. So, if you get informed of the upcoming change that they’re obliged by law to send you in the form of a letter, you should be careful in reviewing this.
Usual changes refer to the following – removing certain medications from one level to another (part D), new pre-authorization or other therapy requirements, health benefits removal or addition, etc.
5. The cost of the change
Based on the above-mentioned or other law-implied changes, the costs might change every year. The change might come from premiums or other costs that come with it. The basic way to make the calculation is to deduct the prices from the last year from the anticipated ones for the upcoming year having in mind the costs that the new one will include.
In case it includes a deductible, you’re the one to cover the cost up to the insured amount. Copays and coinsurance are the charges you pay after receiving the service. If you estimate the expenses and make a simple comparison you’ll be able to decide which one to go with. Some people might need a little help to decide here, which is probably why medisupps.com has decided to make a handy overview for the best deals in 2021.
There’s not a single way to make the best decision. Your financial and health condition change from year to year and even every month.
The things to consider in the process of change must include the service features you certainly can guess will be needed in the upcoming year. If you add the deductibles, copays, and coinsurance alongside the annual premium price you’ll be able to make a good decision that’ll ensure your safety, which is the main goal of insurance in general.