Medicare Supplement

Medicare Supplement Insurance in Terre Haute and the Wabash Valley

Crapo Insurance Agency helps individuals in Terre Haute and the surrounding Wabash Valley understand Medicare Supplement choices and compare available options. Our goal is to explain the differences clearly so you can make a more informed decision about your coverage.

What Is Medicare Supplement Insurance?

Medicare Supplement Insurance works alongside Original Medicare Parts A and B. It can help pay certain costs that Original Medicare does not pay completely, such as copayments, coinsurance, and some deductibles.

Medigap policies are sold by private insurance companies, but the benefits are standardized by plan letter. That means the medical benefits provided by a particular standardized plan, such as Plan G, are the same regardless of which insurance company sells that plan. Premiums can still vary among companies.

Why Consider a Medicare Supplement Plan?

Original Medicare provides broad healthcare coverage, but it does not place a simple annual cap on every beneficiary's out-of-pocket medical costs.

A Medicare Supplement policy may help make those expenses more predictable by covering some of the cost-sharing that would otherwise be your responsibility.

Depending on the standardized plan selected, Medigap benefits can include protection for items such as:

• Medicare Part A hospital coinsurance
• Medicare Part B coinsurance or copayments
• the first three pints of blood
• hospice coinsurance or copayments
• skilled nursing facility coinsurance
• the Medicare Part A deductible
• certain foreign-travel emergency expenses

The exact benefits depend upon the standardized Medigap plan you choose.

Understanding Standardized Medigap Plans

In most states, Medicare Supplement plans are identified by letters.

Because the benefits within each lettered plan are standardized, comparing Medigap coverage is different from comparing many other types of insurance. Once you determine which standardized plan fits your needs, you can compare companies offering that plan based on factors such as premium, pricing method, availability, and service.

Indiana SHIP notes that insurers may use different methods to calculate Medicare Supplement premiums, including issue-age, attained-age, and no-age-rating approaches. Understanding how a company prices its policy can therefore be an important part of the decision.

Plan G and Plan N

Two plans frequently considered by people who are newly eligible for Medicare are Plan G and Plan N.

Medicare Supplement Plan G

Plan G provides broad standardized benefits. After you satisfy the Medicare Part B annual deductible, Plan G covers the standardized Plan G benefits, including Part B coinsurance and Part B excess charges.

Plan G does not pay the Medicare Part B deductible.

Medicare Supplement Plan N

Plan N provides many of the same standardized benefits as Plan G, but it uses some additional cost sharing.

Under Plan N, you may be responsible for copayments of up to $20 for certain office visits and up to $50 for certain emergency-room visits that do not result in an inpatient admission. Plan N also does not cover Medicare Part B excess charges.

Which plan is more appropriate depends on factors such as your healthcare usage, budget, preference for predictable expenses, and the premiums available from insurers in your area.

Your Medigap Open Enrollment Period

Timing can be especially important when purchasing Medicare Supplement insurance.

Your federal Medigap Open Enrollment Period lasts for six months and begins the first month you are both:

During this one-time period, an insurance company generally cannot deny you a Medigap policy it sells because of pre-existing health problems or use medical underwriting to charge you more because of your health.

After that period ends, your choices may become more limited. An insurer may be permitted to use medical underwriting, charge more, or deny an application unless you qualify for a specific guaranteed-issue right or other protection.

Medicare Supplement Is Not Medicare Advantage

Medicare Supplement and Medicare Advantage are different ways of handling Medicare coverage.

A Medigap policy supplements Original Medicare. It does not replace Original Medicare and generally cannot be used together with a Medicare Advantage plan.

One benefit of Original Medicare with a Medigap policy is that you generally may see doctors and other providers throughout the United States who accept Medicare, rather than using a Medicare Advantage plan's provider network.

What Medicare Supplement Does Not Cover

Medicare Supplement insurance is designed primarily to help with cost sharing under Original Medicare. It is not intended to cover every healthcare expense.

Standard Medigap policies sold today generally do not provide coverage for:

• retail prescription drugs
• routine dental care
• routine vision care
• hearing aids
• long-term custodial care
• private-duty nursing

People who want prescription-drug coverage generally need to consider a separate Medicare Part D prescription-drug plan.

Comparing Medicare Supplement Companies

Because standardized plans provide the same core benefits for a given plan letter, price and company considerations become especially important when comparing policies.

When reviewing available Medicare Supplement policies, it can be useful to consider:

• the standardized plan benefits
• monthly premium
• how the insurer determines premiums
• whether premiums can increase as you age
• household discounts, if offered
• the company's service and administrative experience
• your anticipated healthcare needs and budget

The Indiana Department of Insurance reviews Medicare Supplement premium rates in Indiana, but premiums can still vary considerably among insurers.

Medicare Costs Change Over Time

Medicare premiums, deductibles, coinsurance amounts, and certain Medigap limits can change from year to year.

For that reason, we recommend verifying current Medicare amounts rather than relying on figures from an older article, brochure, or website. CMS publishes updated Medicare cost information each year.

This is one reason speaking with an agent before making a Medicare Supplement decision can be helpful.

When Should You Review Your Medicare Supplement Coverage?

Your Medigap policy is generally guaranteed renewable as long as required premiums are paid, but that does not mean you should assume another policy will always be available later under the same conditions.

If you are considering changing coverage after your initial Medigap Open Enrollment Period, underwriting or eligibility rules may apply unless you qualify for a guaranteed-issue situation.

Before cancelling an existing Medicare Supplement policy, make sure you understand whether you can obtain the replacement coverage you want.

Help Understanding Your Medicare Supplement Options

Medicare terminology, enrollment periods, standardized plan letters, and insurance-company pricing can make the process difficult to navigate alone.

Crapo Insurance Agency can help Terre Haute and Wabash Valley residents review Medicare Supplement options and better understand the differences among available plans.