Medicare Supplement or Medigap, helps pay the “gap” between what Original Medicare (Medicare Parts A and B) pays and what you pay out of your own pocket. There are 10 different Medicare Supplement basic benefits options to choose from. Plans are labeled A, B, C, D, F, G, K, L, M, and N.
Take note: Medigap plan types offered by insurers have the same basic benefits but may vary in price. We suggest that you shop for the best price with a credible carrier.
Plans are standard, so different companies all offer the same benefits, but the premiums do vary based on a number of factors. Consider these facts in deciding if Medicare Supplement insurance for hospital and medical coverage is right for you:
- The policies may cover all of your co-insurance, co-pays and deductibles.
- The policies may cover health care bills not covered by Medicare.
- Premium may start from $85/month.
What you should know about Medicare Supplement:
Every company offering Medicare Supplement insurance must offer Plan A. In addition, companies may have some, all, or none of the other plans. Plans are standardized, so different companies all offer the same benefits, but the premiums do vary based on a number of factors. Although private insurance companies are required to offer the same benefits for each lettered plan, they do have the ability to charge higher out-of-pocket costs for this coverage.
- Medicare Supplemental plans are STANDARDIZED and serve people with chronic health conditions well.
- The top 3 Medicare Supplemental Plans are Plan F, G, and N.
- People who enroll with Medicare Supplement Plan pays most of their healthcare cost in advance, but generally lesser than Original Medicare or Medicare Advantage Plan.
Medicare Supplement for People with Disability under 65
If you are under 65 and qualified for Medicare due to disability or End Renal Stage (ESRD), your eligibility for Medicare Supplement Plans depends on your location. Rules governing the availability of Medicare Supplements vary from every state. Though the federal law states Medicare supplement guaranteed-issue proper protection for beneficiaries, it is not required that Medicare Insurance carriers must sell Medigap plans to people under 65. Mainly, due to higher posted risk and lesser competition, the cost of the plans may be higher, and there are chances for coverage to be denied due to pre-existing conditions. It is better to visit first the insurance board’s website to review your rights as a beneficiary.
Oregon is among the 29 states that require insurers to sell Medicare Supplement plans to anyone, regardless of age, as long as they are eligible for Medicare.
Is it possible to switch my Medicare Supplement Policy?
Yes. People with Medicare Supplemental Plans may switch anytime but may face some restrictions if one doesn’t have guaranteed-issue-right outside One time Enrolment period (OEP). To change policy, one must apply for a new plan. Once accepted, your present insurance company must be notified to cancel the current coverage.
Oregon Birthday Rule on Medicare Supplement
In Oregon, there is a birthday rule for Medicare Supplement or Medigap Policies. The state allows 31 days to change your Medigap policy, skipping the underwriting process. This rule starts on your birthday each year and gives you a chance for open enrollment for the next 30 days. During this time, you’re able to switch your Medicare supplement to another carrier with either the same exact Medicare Supplement or lower plan option. For example, you can switch from Plan F to Plan F or Plan F to Plan G to save money on your premium. This requires an ACTIVE Medicare Supplement plan. For an individual with Medicare Advantage plans, still need to undergo the underwriting process when applying for Medigap (given that they don’t qualify for guaranteed- issues).
Therefore, beneficiaries shop around to find a Supplement plan that is right for both their medical and financial needs. Since Jan. 1, 2013, Medicare beneficiaries also have a yearly opportunity to compare supplement prices and switch companies. They must keep the same plan type or choose one with lesser benefits. Out-of-pocket costs with Medicare Supplement plans may also include monthly premiums and yearly deductibles.
What to do next?
To most people, Medicare is very confusing and hard to understand. Don’t worry, we got your back. Give us a call at 503-928-6918. Our assistance is at no cost to you.
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*By completing this form, you agree that an authorized representative or licensed insurance agent may contact you by phone, email, text, mail or face to face to answer your questions or provide additional information about your Medicare plan options. Not affiliated or endorsed by Medicare or any state or federal governmental agency.
Health Plans in Oregon is a website owned and operated by Insurance Marketplace Agency, Inc., a licensed health insurance agency doing business as Health Plans in Oregon. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. Health Plans in Oregon and our licensed agents are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877)486-2048), 24 hours a day/7 days a week or go to: medicare.gov