Medicare Supplement Insurance, more commonly known as Medigap, automatically renews each year.
Medicare Supplement plans are a useful way to make sure that you’re covered under a wide variety of circumstances. But, many people worry about these plans because they’re offered by private health insurance companies. This makes them a bit more complicated than Original Medicare in some key respects.
Luckily, Medicare Supplement plans are guaranteed renewable each year. We’ll go over what exactly this means, as well as many other details regarding these plans. Whether you’re new to Medicare Supplement plans or just want to know the details going into a new year of coverage, we’ll go over everything.
What Are Medicare Supplement Plans?
If you’re new to Medicare Supplement plans or are shopping for one for the first time, then it’s important to understand the general details first. Medicare Supplement plans, also known as Medigap plans, are a type of insurance plan that helps pay for your out-of-pocket costs under Original Medicare. This includes things like your deductible, coinsurance, and copayment.
The way that these plans work is that you pay a monthly premium to the insurance company, and then they pay for your out-of-pocket costs. Different plans cover different out-of-pocket costs, but the overall structure will be the same.
For example, your plan may cover your Part A deductible. This means that whenever you are charged an amount that falls under your Part A deductible, you will not pay it. Instead, your Medicare Supplement plan will pay it for you.
Except for having blood drawn, Medicare Supplement plans don’t actually cover health care directly. As the name states, they are intended to supplement your Original Medicare coverage, not provide you with more medical insurance.
Medicare Supplement plans only apply to Original Medicare. If you have a Medicare Advantage plan, you won’t be able to purchase a Medicare Supplement plan to help pay for your out-of-pocket costs. Medicare Supplement also doesn’t cover out-of-pocket costs associated with Medicare Part D prescription drug plans. If you’re looking into a Medigap plan, remember that it will only apply to Medicare Part A and Medicare Part B.
Which Medigap Policy Should I Choose?
Understanding which Medigap plan is best for you is a personal choice and will involve looking at your own unique needs and costs. But, we can give an overview of some popular plans as well as some notes on how to decide if a plan is right for you. Medicare.gov contains a full comparison of every plan available.
The most popular Medigap plans are Plan F and Plan G. These are the most comprehensive plans available and cover most out-of-pocket costs. Plan G differs only in that it doesn’t cover the Part B deductible, whereas Plan F does.
Because these plans are so popular, it will usually be easier to buy them at a competitive price. Other plans may cost less but offer less value, but most plans are a good fit for someone out there. Because Medigap is offered privately, it’s hard to say what the details will look like without knowing your specific situation.
How to Decide if a Medicare Supplement Insurance Plan is Worth It
To decide if a Medigap plan is financially viable, you can do a simple calculation. Look at the full list of costs that the plan covers, i.e. the coinsurance, copay, etc. Add up the amount that you expect to pay for all of those costs together, and then compare it to the annual premium amount for a given Medigap plan.
If the annual premium amount is higher, that plan will not be worth it. Although it will provide coverage, your premiums will end up costing more, meaning that it would be better to just pay the out-of-pocket costs or find another plan. If the annual premium amount is lower, then you will end up saving money with that plan.
When Can I Enroll in a Medigap Plan?
You can enroll in Medigap plans at any time that you can enroll in Medicare. This includes your Initial Enrollment Period, the Medicare Open Enrollment Period, and the Special Enrollment Period.
However, enrolling in Medigap is easiest during the designated Medigap Open Enrollment Period. This begins the month that you turn 65, and only happens once. The period lasts for 6 months. During this time, you can enroll in any Medigap plan that you choose.
Outside of this time, Medigap plans may use underwriting and can therefore reject your application. But, during your 6-month Medigap Open Enrollment Period, they must allow you to purchase any plan.
Understanding Plan Renewals Under Medicare
When discussing insurance more generally, some plans will include automatic renewal. This means that even if you do nothing, your plan will continue into another year once you reach a certain point in the year.
Medicare can be split into four parts, which can be further split into two categories. Part A and Part B constitute Original Medicare, while Part C Medicare Advantage plans and Part D plans, which offer prescription drug coverage, are private. Medigap plans supplement Medicare, and function in a unique way compared to these four parts.
Original Medicare will always automatically renew. If you have Original Medicare, you will never have to worry about losing your coverage. The Medicare program is standardized in such a way that this will always be the case. Although there are often slight changes in costs each year, the coverage itself will always be available.
Medicare Advantage and Medicare Part D drug coverage plans are both offered by private insurance companies. These plans will usually automatically renew, but not always. The way that these plans work involves contracting with Medicare, and if their agreement expires or isn’t renewed, the plan may no longer be available.
Annual Notice of Change Forms
When you enroll in a Medicare plan of any kind, you'll receive an annual notice of change form each year. This will be true whether you have Original Medicare, a Medicare prescription drug plan, or Medicare Advantage.
Your current plan insurer will notify you of any changes that will affect you in the next year with this form. This includes things like changes to a drug formulary or service area. Make sure to always look at these forms in detail so that you know what to expect in the coming year.
What Are the Options with Medigap Plans?
When it comes to Medigap plans, the situation is a bit different. Every Medigap plan is guaranteed renewable. This means that the plan will be available for you to stay on even if that company is no longer working with Medicare.
This can result in some unusual scenarios. For example, you may be able to keep your plan from a specific company, even if they don’t sell that plan anymore. If you then change your plan or choose to not renew it, it may not be available to you again if you want to purchase it later on.
This makes Medigap plans very easy to deal with. Medigap plans do change, but not in a way that will result in unavailability. Your premiums may go up, and Medicare may issue new requirements about Medicare Supplement plans at large. But, if you have your plan now, you will be able to renew it for another year.
Things to Remember About Medigap Renewal
Remember: although Medigap plans will be available for renewal, the plan may cost more or other plans may become available to you. Even if you do intend to renew your plan, you should always look at the plan details each year to see if anything has changed. You can always talk to an independent insurance agent for help getting quotes.
It’s also a good idea to look at the overall structure of Medigap plans and to get some quotes every year to see if any new plan options are available that works better for you. But, when it comes to renewal, they will always be easily available.
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