Medicare Supplement Insurance

Medicare Supplement Plans, also known as Medigap Plans, are designed to help cover some of the medical costs that are not covered by Medicare, and are available to anyone enrolled in part A and B of Medicare.  There is an open enrollment period for the first six months after you turn age 65, in which you do not need to qualify.

We pride ourselves on helping our clients get into the right Medicare Supplement plan, at the best price we can find, and we'll make the process easy and hassle-free.

How to Compare Medicare Supplement Rates and Apply For Coverage

Since Medicare Supplemental insurance plans are standardized and all insurance companies offer the same basic supplemental coverage, your best strategy is to compare Medigap rates with all three carriers we offer.

The most popular Medicare Supplemental insurance plans are offered by Anthem Blue Cross.  You can also download a copy of the Anthem Medicare Supplement insurance application and brochure Anthem Blue Cross offers Medicare Supplement Plans A, B, F, I, J, and High Deductible Plans F and L.

The 10 Medicare Supplement Plans and
How They Work 

Medicare Supplement insurance can be sold in only ten standard plans: A, B, C, D, E, F, G, H, I, and J.

Plan A:  Basic Benefits

The basic benefits (also known as the "core benefits" or Plan A) are the minimum Medicare Supplement coverage you may buy.  These are the only benefits in Plan A.  Every other plan contains these three Medicare Supplement benefits as the "core" and then adds one or more additional benefits.

1. Hospitalization:  Medicare Part A pays for hospitalizations for the first 60 days, but only pays a portion of the daily costs from the 61st day through the 150th day.  You must pay the coinsurance amounts for those days.  This Medicare Supplement benefit pays the coinsurance amount for those days, and the total Medicare reimbursement amount for an additional 365 lifetime days.
2. Blood:  Medicare pays for all blood that is medically necessary except for the first three pints in each calendar year.  This Medicare Supplement benefit pays for the first three pints of blood not paid for by Medicare.
3. Medical Expenses:  Generally Medicare Part B pays for 80% of a predetermined amount (called the "Medicare approved" amount) for each procedure, supply, or service billed by your doctor or other provider that is not a hospital.  This Medicare Supplement benefit pays the coinsurance (generally 20% of the "Medicare approved" amount) under Medicare Part B.
    

Note:  Plan A contains only these 3 core benefits.  Although Plan A is the least expensive policy, it may not be a good choice for low-income individuals who may not be able to afford the Medicare Part A hospital deductible when they are hospitalized.

Plans B through J

There are seven additional Medicare Supplement benefits that are combined with the basic benefits in various ways to make up the nine remaining plans called Medicare Supplement Plan B through Plan J.  Medicare Supplement plans do not cover Prescription drugs.  For Prescription drug coverage, see Medicare Part D.

1. The Part A Deductible:  The Medicare Part A deductible is the expense for which you are obligated to pay when you are admitted to a hospital as an inpatient.  Medicare pays eligible benefits above that amount.  (The Medicare Part A deductible amount may change yearly, so check the current Medicare brochure).  This Medicare Supplement benefit reimburses you the deductible amount, no matter what the amount may be.  This supplemental benefit is included in Plans B through J.
2. Skilled Nursing Coinsurance:  Medicare Part A pays for the first 20 days of care in a skilled nursing facility following hospitalization, but requires you to pay a coinsurance beginning on the 21st day through the 100th day.  This Medicare Supplement benefit pays the coinsurance amount beginning on the 21st day.  This supplemental benefit is included in Plans C through J.
3. Part B Deductible:  The Medicare Part B deductible is the amount you must pay each year for medical expenses (such as doctor fees) before Medicare begins paying.  (The Part B deductible amount may change per year).  This Medicare Supplement benefit reimburses you the deductible amount.  This supplemental benefit is included in Plan C, Plan F, and Plan J.
4. Part B Excess Charges:  Medicare Part B pays 80% of a predetermined amount (called the "Medicare approved" amount) for each procedure performed by your doctor or other medical care provider.  If your doctor accepts Medicare "assignment," the provider may only bill you for the difference between the amount paid by Medicare and the amount approved by Medicare.
   
   If your doctors do not accept Medicare assignment, they may bill you for the difference between the amount paid by Medicare and the amount they can legally charge you (called the "limiting charge").  If you have a Medicare Supplement Policy with the following:

• If you have a Medicare Supplement Policy with the Part B Excess Charges (100%) benefit, the supplement policy will pay the full amount billed by your doctors or other providers who do not take Medicare assignment subject to the limiting charge.  This supplemental benefit is included in Plan F, Plan I, and Plan J.
• If you have a Medicare Supplement Policy with the Part B Excess Charge (80%) benefit, the supplement policy will pay 80% of the amount you are billed by your doctors or other providers.  This supplemental benefit is only in Plan G.  Theoretically, you should save money on premium costs if you select the 80% benefit rather than the 100% benefit.

(Remember this coinsurance amount is paid by the Medical Expenses part of the Basic Benefits that are part of every Medicare Supplement insurance policy).

5. Foreign Travel Emergency:  The original Medicare plan does not pay for medical care outside of the United States, but some Medicare managed care plans, private Fee-for-Service plans, and some Medicare Supplement plans do.  This Medicare Supplement benefit will pay 80% of your expenses for most emergency medical care in a foreign country during the first 60 days of a trip abroad after you pay a $250 deductible.  There is a lifetime maximum benefit, so check the current Medicare brochure for the dollar amount.  This supplemental benefit is in Plan C through Plan J.  Check your insurance coverage before you travel.
6. At-Home Recovery:  Under the home health care benefit, Medicare pays for intermittent visits by a nurse or other skilled care provider in your home during recovery from an acute illness.  Medicare does not pay for custodial care in your home such as homemaker services (such as help with bathing, dressing, laundry, or shopping).  This Medicare Supplement benefit pays per home visit.  Check the Medicare brochure for current benefits for medically necessary custodial care while you are recovering from an illness, injury, or surgery.  An insurance company may limit the number of visits to equal the number of Medicare home health care visits.  This supplemental benefit is in Plan D, Plan G, Plan I, and Plan J.

Preventive Care:  Medicare pays for some testing for diagnostic purposes.  This Medicare Supplement benefit pays up to $120 per year for certain tests done for screening purposes, routine physical exams, patient education, and other medically appropriate tests or preventive measures not covered by Medicare.  This supplemental benefit is included in Plan E and Plan J.  There are eight additional benefits that are combined with the basic benefits in various ways to make up the nine remaining plans called Plan B through Plan J.

The chart below shows the benefits included in each plan.

Features	A	B	C	D	E	F*	G	H	I	J*
Basic Benefits
Skilled Nursing Coinsurance	-	-								-
Part A Deductible	-
Part B Deductible	-	-		-	-		-	-	-
Part B Excess	-	-	-	-	-	100%	80%	-	100%	100%
Foreign Travel Emergency	-	-
At-Home Recovery	-	-	-		-	-		-
Preventive Care	-	-	-	-		-	-	-	-

* Plan F and Plan J also have high deductible options, which some companies may offer.  These high deductible plans pay the same benefits as Plan F and J after one has paid a calendar year $1900 deductible.  Benefits from high deductible Plans F and J will not begin until out-of-pocket expenses exceed $1900.

After the Medicare Supplement policy is mailed or delivered, you have a 30-day free look to examine the policy and to decide if you want to keep it.  If you return the policy within 30 days, all of your money must be refunded.

How to Qualify for
Medicare Supplement Plans 

To qualify for a Medicare Supplement policy, you must be age 65 or older (may vary by state), enrolled in Medicare parts A and B, and you must reside in the state in which you are applying for supplemental coverage.

Open Enrollment:  Your open enrollment period that lasts for 6 months and begins on the first day of the month in which you are age 65 or older and enrolled in Part A and B of Medicare.  Some states have additional open enrollment periods.  There are no other qualifying questions during open enrollment, insurance companies can not use medical underwriting, and pre-existing health conditions do not matter.  This is great news for anyone desiring to enroll in a Medicare Supplement plan.  During this time, an insurance company must sell you any Medicare Supplement plan they offer, they can not make you wait for coverage to begin (even for pre-existing conditions) and they can not add extra charges because of any health problems, past or present.

IMPORTANT:  If you do not apply during your open enrollment period, your application will be subject to an approval process called “underwriting.”  Because health insurance is designed primarily to cover you for the unexpected, a company may put an exclusion on pre-existing health conditions.  If you have cancer, heart disease, or other serious health conditions you will likely be declined.  Some companies also reserve the right to rate the premium up (charge more) to cover the cost of current medications.  IT IS VERY IMPORTANT THAT YOU APPLY DURING YOUR OPEN ENROLLMENT PERIOD IF POSSIBLE, at which time your application will NOT be subject to this underwriting process.  This means the insurance company must accept your application, and can not raise your premium or exclude coverage because of any pre-existing conditions you may have.

After Open Enrollment:  To help control rising costs, carriers apply the pre-existing condition clause to newly issued Medicare Supplement plans in most states.  Expenses resulting from a condition existing six months prior to the supplemental policy effective date are not covered unless they are incurred three months after the supplemental policy effective date.

If the supplemental policy replaces another creditable individual or group insurance coverage due to a person's eligibility for Medicare, this Pre-Existing Conditions Limitation will be reduced by the number of months that coverage was in force.  If this supplemental policy replaces another Medicare Supplement policy, this Pre-Existing Conditions Limitation will be reduced by the number of months that the coverage was in force.

The medical questions on the supplemental enrollment application address health conditions that would result in a rejected application.  If you have one of these conditions or have been advised by a doctor to treat these conditions using medications, X-rays, a surgical procedure (in-patient or outpatient), therapy, rehabilitation or doctor's visits, you should not apply for a Medicare Supplement plan until your next open enrollment period.