Medicare Supplements are also known as Medi-Gap policies. They are issued by private insurance companies. In exchange for a monthly premium, they help pay the difference of what Medicare pays and what you would be responsible for.

An expense must be covered by Medicare and follow Medicare guidelines to qualify. Policies are standardized and named by certain letters. For example, Plan G offers the same coverage, no matter what insurance company sells it. The main difference would be in the premium that you pay.

Different lettered plans offer different coverage, and generally speaking, the higher the premium, the less you will have to pay out-of-pocket. With some supplements, it is very possible to cover 100% of your responsibility.

Supplement Coverage

With a supplement, it is important to know the different levels of coverage that each plan provides in order to find the one that fits your needs.

When you turn 65, you have a 6-month open enrollment period in which you must be accepted for a policy. However, there are other times when you have what is called a guaranteed issue (GI) right. This means that you are not subject to medical underwriting, i.e. you do not have to answer health related questions, and will be granted coverage. You still may be subject to pre-existing exclusions under certain conditions. If you are not in a GI period, you still may purchase a supplement, but you would have to be approved. You may change a supplement to another one any time of the year.

Supplements only help with medical expenses; they do not cover items such as dental, vision, hearing, or prescription drugs. Because of this, it is necessary to purchase other coverage separately. It is very common to add a PDP (prescription drug plan) for an additional premium.

Supplements are guaranteed to be renewed as long as the supplement premium is paid. Depending on how the rates are structured, you may have a set premium or a premium that has built-in increases due to your age. In addition, supplements are allowed to increase the premium across all their plans due to their cost increase. This is usually just once a year, and at certain predetermined times for some plans. Most plans do not increase your rate in the first year. It is also standard to offer a household discount should more than one person have a supplement with the same company in the same household.

To have a supplement, you must be enrolled in Parts A and B and continue to pay the Part B premium.

Medicare Supplements VS. Medicare Advantage

There are two ways to add additional coverage that can cover gaps your Medicare may not take care of. Learn more about the differences between Medicare Supplements and Medicare Advantage with our helpful guide.

Do you still have questions? Take a look at our Medicare Basics outline, or give us a call at 931-287-0799.

We’d be glad to help you!