Medicare Supplement Insurance Plans


Medicare Supplement Insurance Plans:
What are they and How do they Work?‚Äč

Medicare Supplement plans, sometimes called Medigap Plans, are sold by private insurance companies and help pay for some or all of the costs for Medicare covered health care services and supplies. Medicare is the primary insurance and determines what benefits are covered. Medicare is billed first and pays its portion of the bill and the Medicare Supplement plan is billed secondarily. Depending on the level of supplement plan that you choose, the supplement may pay for the Part A and B deductibles and the 20% coinsurance for Part B services. (If you turned 65 after January 1, 2020, you will not be able to purchase a plan that covers the Part B deductible.) The most popular plan in Massachusetts is called “Supplement 1A”, and in 47 of the remaining states, they refer to it as “Supplement Plan G”.

In every state, there may be many companies that offer Medicare Supplement plans. All supplement plans of the same type must offer the same coverage for Medicare covered benefits, but they will differ in premium, discounts offered and some additional benefits. We can help you choose the plan that is right for you.

Medicare Supplement Insurance Gives You Access to All Doctors and Hospitals that Accept Medicare. That means that NO Physician REFERRALS are required.

If you plan to travel domestically or live in another part of the country part of the year, you may want the enhanced flexibility to choose your medical providers and hospitals. A Medicare supplement gives you that flexibility without having to be concerned with PCP referrals or staying within a network of providers to keep costs down. Most Medicare Supplements will also cover you worldwide for emergency care.

Medicare Supplement Insurance is an individual choice, but one that can save you money in the long run and help you to budget expenses. It’s an important decision that impacts your access to medical care and your financial planning. We would be happy to discuss this with you in detail.

Prescriptions covered by Part D plan

One important fact to understand is that no Individual (Non-Group) Medicare Supplement plan includes coverage for prescriptions. For that, you will need a separate “stand-alone” Part D plan. Part D plans are offered by private insurance companies and most states offer many options, which can be overwhelming. We work with our clients to determine which option is most cost effective for them by analyzing their medications using a variety of tools. We can provide reporting that shows estimated monthly costs and how those costs change during the 4 stages of the Part D benefit. For example, will your prescriptions trigger the “Deductible” phase, or will you enter the “Coverage Gap”, sometimes referred to as the “Donut Hole”. Once enrolled, In most cases, you will need to keep the same Part D plan for that calendar year.

Since a person’s medications may change or the drug plan itself makes changes, we recommend that you request a review each year during the Annual Election Period, which runs from October 15 - December 7 for a January 1 effective date. That service is provided at no charge and helps ensure that you are enrolled in the most appropriate plan for the following year.