A Medicare Supplement Insurance plan in Delaware helps pay for a variety of healthcare costs. Also known as Medigap, these policies may cover hospital and hospice care, doctor visits, and more. This page describes how Medigap plans work and when is the best time to apply.
What is Medigap in Delaware?
Medigap plans help pay your out-of-pocket costs under Original Medicare, which includes Part A, hospital insurance, and Part B, medical insurance. Unlike Medicare Advantage (also known as Medicare Part C), there is no yearly out-of-pocket maximum with Original Medicare. This can leave you with significant healthcare costs, particularly if you have one or more chronic conditions or a lengthy hospital stay.
Which services the plan pays for depends on which plan you choose. There are 10, each represented by a letter (A, B, C, D, F, G, K, L, M, and N). In addition, some insurers offer high-deductible versions of one or more Medigap plans.
Medicare Supplement plans are standardized, meaning the benefits of each plan do not change no matter which insurance company you choose.
Please note that Medicare Supplement plans are not standalone health insurance such as you get with an Advantage plan.
Who qualifies for Medicare Supplement Insurance in Delaware?
You qualify for Medicare Supplement Insurance in Delaware if you are age 65 or older and enrolled in Original Medicare.
Beneficiaries who are younger than 65 and qualify for Medicare due to a disability or illness may also enroll in a Medigap plan. However, they face significantly higher rates. For example, if you are under 65 and qualify for Medicare due to a disability, expect to pay around four times what an over-65 enrollee pays. And if you have end-stage renal disease (ESRD), your rates may be up to 20 times what an over-65 Medicare beneficiary pays.
What does Medigap cover?
Supplement plans help pay for a variety of healthcare services covered by Original Medicare. The following table details what each Medigap plan covers:
The important note is that Medigap only covers services provided by Original Medicare. If you need prescription drug coverage, you get that by joining either a standalone Medicare Part D plan or a Medicare Advantage Prescription Drug plan (MA-PD).
You cannot have both Medigap and an Advantage plan.
Medigap Plan C and Medigap Plan F in Delaware
As of January 1, 2020, Medigap Plan C and Medigap Plan F are no longer available to new Medicare beneficiaries. If you qualified for Medicare before 2020, you may still join one of the plans. We do not recommend this, though, as premiums tend to rise sharply on discontinued Medigap plans.
With the exception of the Medicare Part B deductible, you can get the same coverage with Medigap Plan D (instead of C) or Medigap Plan G (instead of F). In addition, the lower monthly premiums for these plans typically leads to a lower annual out-of-pocket, despite beneficiaries having to pay their Part B deductible.
When is the best time to join a Medicare Supplement plan in Delaware?
The best time to sign up for a Delaware Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP). This begins the day you are both age 65 or older AND enrolled in Original Medicare.
Your Medigap OEP is one of the rare instances that you have a guaranteed issue right. This means that your application cannot be denied due to age or medical history. Guaranteed issue rights also mean that you cannot be charged more for the policy.
If you do not have guaranteed issue rights, your Medigap application goes through a process known as medical underwriting, whereby the insurer reviews your medical history and decides whether to offer you a policy and at what rate.
How to choose a Medigap plan in Delaware
When deciding how much coverage you need, it's always a good idea to plan for your future healthcare needs so you can avoid the risk of being denied coverage due to medical underwriting.
Since plans are standardized, your next concern is cost. Medigap insurers use one of three rating systems:
- Attained-age rated: Premiums start out low but rise as you age. These policies are usually the most expensive option over time.
- Community rated: Plans charge the same premium regardless of age. Over time, these Medigap plans cost the least.
- Issue-age rated: Premiums are based on your age upon joining the plan. They won't go up due to your age but they may rise over time due to inflation.
Attained-age rating is the most common method used by Delaware Medigap insurers, but some offer community rated plans.
Our Find a Plan tool makes it easy to compare Medigap plans in Delaware. Just enter your location information and coverage start date to review Medicare plan options in your area.
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