What Medicare Supplemental Insurance Do I Need?

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what medicare supplemental insurance do i need

When it comes to health insurance, you want to know for sure you’re covered for all of life’s big and small problems.

When you’re looking forward to retirement and reaching 65 years old, you may be thinking ahead to using Medicare to cover your health.

According to Medicare.gov, Medicare is the federal health insurance program for people age 65 and older. It also can include certain people with disabilities and people with End-Stage-Renal-Disease.

If you’re on Medicare, you may think you’re all set. But that might not actually be the case.

While Medicare is a helpful resource, it may not be the all-encompassing solution for you and your family.

Here, we’ll explore what Medicare covers and help you determine which health insurance options best fit you and your lifestyle.

What does Medicare cover?

Before you know whether you need to add supplemental insurance, you should understand what is already covered by Medicare.

An article from Medicare.gov outlines three decisions to make as you choose your health care plan through Medicare. First, choose between Original Medicare or a Medicare Advantage Plan.

Original Medicare includes Part A and B. Part A covers hospital insurance such as hospital stays and hospice care. Part B incorporates health insurance in covering things such as doctor’s visits and medical supplies.

A Medicare Advantage Plan is a plan offered through a private party. These plans cover services and care offered through Medicare Part A and Part B. They include Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).

After you’ve chosen either Original Medicare or a Medicare Advantage Plan, you’ll also choose if you want Medicare Part D. This part is prescription drug coverage. This service is an add-on to your first plan.

With those previous two steps in place, you’ll need to determine whether you need supplemental coverage.

Who needs Medicare supplemental insurance?

So if you have either Original Medicare or a Medicare Advantage Plan, what benefit does a supplemental insurance plan bring?

A Medicare Supplement Plan helps in covering out-of-pocket costs, according to an article by the Wisconsin Medicare Solutions Team, who offers Wisconsin Medicare supplement plans. This coverage helps in costs such as copayments, coinsurance, and deductibles.

These plans typically have out-of-pocket maximum amounts. This means that when you reach that maximum, you generally do not have to pay any additional amount for care for the rest of that year. This policy differs from Medicare Part A and Part B, which do not have out-of-pocket maximum amounts.

This maximum amount brings a great benefit. Those with prolonged hospitalization or need extensive care may find relief with a Medicare Supplemental Insurance program.

Depending on your situation, supplemental insurance can save you a lot of money on health costs.

What insurance options do I have?

Medicare Supplemental Insurance offered through Medicare is called Medigap.

You purchase this policy through a private insurance company licensed in your state. Keep in mind that this policy is different than your Medicare Part A or Part B and does not include prescription drug coverage.

There are various options of plans for Medigap. Each plan incorporates different amounts of coverage, notes an article from eHealthInsurance. In fact, there are 10 different plans.

For example, eHealthInsurance says that Plan F is the most comprehensive. This plan includes more benefits such as a Medicare Part A and Part B deductible. It may also include Part B excess charges and preventative care coinsurance.

Some insurance companies charge higher premiums for coverage. Some companies base premiums off your age when you enroll in the program. The older you are, the greater likelihood of a higher premium you’ll have to pay.

When determining which plan is best for you and your lifestyle, look at which coverage options you currently need or expect to need. Such choices can help save you a lot of money later on.

What are the requirements for Medicare Supplemental Insurance?

Before you jump in and enroll in Medigap, be sure you meet the requirements of the program. To get Medigap, you must be on Medicare Part A and Part B, notes Medicare.gov. That means you typically are 65 or older or have a special circumstance. You must also pay the private insurance company a monthly premium for your coverage.

It’s important to remember that Medigap doesn’t cover everything. Medicare.gov notes that these supplemental plans don’t include care such as vision, dental or hearing aids.

In determining if a Medicare Supplemental Insurance program is right for you – and which plan to go with – there are several things to consider. Your health condition and age should be good indicators of what plans are best to make sure you’re well taken care of.

If you choose to supplement your Medicare, check out the various Medigap plans and find one that’s right for you.

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