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Do You Need a Medicare Supplemental (Medigap) Policy? 5 Questions to Ask Yourself

Yesterday, we talked about what a Medicare Supplemental Insurance or Medigap policy covers, but I’m sure most of you are wondering about the bigger question: Do I need a Medicare supplemental policy, and if so, which one?

You might be particularly curious about Medicare Supplemental policies this year, since a number of Medicare Advantage plans are being phased out and, as a result, 3.5 million seniors will be forced to switch their coverage.

So if you’re considering a Medicare Supplemental insurance policy, here are 5 questions to ask yourself before you take the plunge:

What Are Your Healthcare Needs?

First, think about what kind of healthcare you need or will likely need. Take a look at what your healthcare needs have been over the last year. Have you been visiting your doctor regularly or do you only see your doctor for annual check-ups? Do you need to see a specialist for any reason? What are your prescription drug needs?

Now, do you think that those needs will change over the next few years? If you started seeing your doctor more often last year, how often do you think you will see him or her next year? Do you have any conditions which will start needing treatment over the next few years?

How Much of Your Healthcare Does Medicare Really Cover?

Most Americans think that Medicare will take care of all their healthcare needs once they turn 65, but that’s not completely true. Going through your list of healthcare needs, traditional Medicare may cover most of it, but how much are you paying out of pocket for deductibles, copays, coinsurance, etc.? These out-of-pocket expenses are the “gaps” that a Medicare Supplemental policy can help you with, so it’s important to get a grip on what they are when you start shopping around for one.

Which Medicare Supplemental Policy Covers the Gaps In My Coverage?

With your list of healthcare needs and out-of-pocket expenses in hand, it’s time to consult a Medigap Benefits Grid. Under federal law, only fourteen standardized plans may be offered as Medicare Supplemental Insurance plans, and all must cover certain services, no matter what state you may live in. These plans have different standardized benefit levels that have been set by the federal government. Because insurance companies that provide Medicare Supplemental insurance plans can only provide one or more of these fourteen standardized benefits, they must and compete on price.

And it is important to compare costs because costs can vary. To make shopping around easier, these fourteen plans are labeled “Plan A” through “Plan N,” with Plan A being the plan with the most basic and Plan N being the plan that is most comprehensive. Each plan, A through N, has a different set of basic and extra benefits, but the benefits of any Medigap Plan A through Plan N are the same for any insurance company. More comprehensive Medicare supplemental insurance policies are likely to cover requirements such as deductibles and services not covered by Medicare such as preventive care. Read the fine print carefully to weigh the coverage and the cost of the plans. (Please note, that not every plan is available in every state.)

How Much Will a Medicare Supplemental Policy Cost?

Medicare supplemental insurance premiums are usually determined using a number of factors, including geographical rating and, depending on when you buy your policy, medical underwriting. It’s important to ask what factors will affect your health insurance premiums as your get older. Some policies increase the premiums as you age. Other’s won’t increase premiums for age, but will for other factors. Find out before you buy.

When Can I Enroll in a Medicare Supplemental Insurance Policy?

The best time to enroll in a Medicare Supplemental insurance policy is during your open enrollment period which generally is when you first six months after you enroll in Medicare Part B. (A few states also require that a limited open enrollment period be offered to Medicare beneficiaries under age 65.) Unlike Medicare Advantage or Medicare Part D prescription drug plans, there’s no yearly open enrollment period to buy a Medicare Supplemental insurance policy, however, so it’s completely up to the Medicare Supplemental insurance companies as to what policies they’re willing to sell you and the prices they charge, depending on your age and health history. A few insurance companies, however, will sell certain Medicare Supplemental insurance policies at any time, regardless of your age or health status.

Are you considering a Medicare Supplemental Insurance plan? Tell us about it!

Related posts:

  1. Medicare Open Enrollment: Are You Considering a Medicare Supplemental (Medigap) Plan?
  2. Filling the Gap-Medicare Supplement (Medigap) Health Insurance Plans
  3. Healthcare Reform: How Will the Medicare Advantage Cuts Affect Me?
  4. Healthcare Reform: Medicare Drug Plans to Go Up As Much as 10%, Is Yours One?
  5. Medicare Open Enrollment Is Here! Are You Ready?

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