If you are enrolled in Original Medicare – which is another name for Medicare Part A and Part B – then you are likely well aware that even with this extensive coverage, you can still end up having to pay a long list of out-of-pocket costs. These can include deductibles, copayments, and coinsurance.
In order to help with reducing, or possibly even eliminating, these expenses, you could purchase a Medicare Supplement insurance policy. This type of insurance fills in many of Medicare’s coverage “gaps,” which is why it is oftentimes referred to as Medigap insurance.
While Medicare Supplement insurance can be helpful in keeping your health care costs in check, though, there are some things that you should know about the Medigap application process before you move forward with the purchase of any plan.
There are ten different Medicare Supplement insurance plans currently available in the market. These plans can range from offering a basic set of “core” benefits, to having a wide array of different coverage options. So, be sure that you have a good idea regarding what your health care coverage needs may be.
Also, even though the Medicare Supplement plans’ benefits are the same, regardless of which insurance carrier they are purchased from (in other words, all companies’ Plan A offer the same set of coverage options), the premium that is charged can differ – sometimes substantially – from one insurance company to another. With that in mind, you need to be sure that you shop and compare several companies’ plans prior to making a purchase. This could end up saving you hundreds of dollars per year, or more.
In addition to choosing – and indicating to the insurance carrier – the best Medicare Supplement insurance plan for you, there is also some additional information that you will have to provide on the application for this coverage.
This includes your:
Name (First, Last, and Middle Initial)
Date of Birth
Medicare Claim Number
You’ll also need to have your Medicare Part A and Part B Effective Dates (this information can be found on your Medicare ID card)
The insurance carrier will also need to know whether or not you currently have a Medicare Supplement insurance plan, and likewise, if you intend to replace a current Medigap plan with a new one.
Also, by asking you on the application whether you have turned age 65 within the past six months, and if you have enrolled in Medicare Part B within the past six months, the insurer will know if you are eligible for a guarantee issue plan. This means that you may not need to go through the underwriting process in order to qualify for the coverage you are applying for.
Even though you can typically apply for Medicare Supplement insurance at any time you are eligible (i.e., if you are age 65 or over, and you are enrolled in Original Medicare coverage), the best time to apply for this type of coverage is during your Medicare Supplement insurance open enrollment period.
That’s because during this period of time, you cannot be turned down for coverage – or even charged a higher amount of premium for your policy – even if you have a pre-existing health condition.
If, however, you wait until your open enrollment period has ended before you apply for a Medicare Supplement insurance plan, you run the risk of having to pay a higher amount of premium, or even of being denied for the coverage altogether.
Your Medicare Supplement insurance open enrollment period is a six month window of time that starts on the first day of the month in which you are age 65 or over and that you are also enrolled in Medicare Part B.
As an example, if you turn age 65 on April 4th, but you do not enroll in your Medicare benefits until May 23rd, then your six-month Medicare Supplement open enrollment period will begin on June 1st. That’s because June 1st is the first day of the month following your turning age 65 AND being enrolled in Original Medicare.
If you are not still within your open enrollment period when you apply for Medicare Supplement insurance, you will likely be required to answer a list of health-related questions so that the insurance underwriters can evaluate whether or not you will pose a risk to the carrier if they approve you for the coverage.
In this case, the application will typically have questions regarding whether or not you have been diagnosed with various health conditions, such as the following:
Leukemia or Hodgkin’s disease
Stroke / TIA (Transient Ischemic Attack)
Alzheimer’s disease / dementia / senility / brain disorder
Heart attack / Carotid artery disease
Congestive heart failure
Kidney failure / Nephritis
Cirrhosis of the liver or Hepatitis C
ALS / Lou Gehrig’s disease
Respiratory or lung disease that requires the use of oxygen
HIV / AIDS or AIDS Related Complex
On the application for Medicare Supplement insurance coverage, there may also be additional questions that ask you whether you have, in the past two years, had surgery and / or been hospitalized for any other reason(s).
Likewise, the insurance carrier will want to know if you are currently confined – or if confinement has been recommended for you – in a hospital or nursing home facility, as well as whether or not you require assistance from another individual to perform basic activities of daily living, such as bathing, dressing, toileting, and / or getting in and out of bed or chairs.
If any of the above mentioned information is left out, your Medicare Supplement insurance application will be considered incomplete, and it will likely be returned to you for completion, and without your coverage being approved.
Depending on your answers to these questions, the insurance company’s underwriters can determine whether or not you will be able to qualify for the plan you’re applying for, and if so, the amount of the premium to be charged.
In any case, if you are approved for coverage, you will have a 30-day “free look” period in which to review your new Medicare Supplement insurance policy – and if you decide for any reason not to keep it, you can return it for a full refund of your premium.
It is important to note that, even though their names sound very similar, Medicare Supplement insurance is not the same thing as Medicare Advantage. As its name implies, Medicare Supplement is a type of insurance that supplements the benefits that are already offered by Medicare Part A and Part B.
Conversely, Medicare Advantage – which is oftentimes also referred to as Medicare Part C – is an alternative method of obtaining your Original Medicare benefits. With Medicare Advantage, you will have the same coverage that you would get with Original Medicare. You may also get additional coverage, such as vision, dental, and / or wellness.
Many Medicare Advantage plans will also automatically include Medicare Part D prescription drug coverage (although this is not always the case). If you have a Medicare Advantage plan, you may not also have Medicare Supplement coverage.
If you are – or you soon will be – ready to purchase a Medicare Supplement insurance plan, but you have more questions and / or need any additional information prior to moving forward, there are several ways that you can proceed.
First, there is a lot of information about Medicare Supplement insurance that can be found directly on Medicare’s website. Go to: www.Medicare.gov, and then click on the “Supplements and Other Insurance” tab at the top of the page.
Here you will find a plethora of details regarding what Medicare Supplement insurance is, and how it works. There is also information here about how you can compare Medicare Supplement (Medigap) insurance policies. This can be helpful in determining which of the Medigap plans will pay for what benefits.
You can also be directed to find a Medicare Supplement insurance policy, based on your state of residence and your zip code. To do so, just simply click on “Find a Medigap Policy” near the bottom of the When Can I Buy Medigap page on Medicare’s website.
It can also be beneficial to discuss your Medicare Supplement insurance questions with an insurance professional who specializes in this type of coverage. If you are ready to apply for a Medicare Supplement insurance plan, working with a Medicare insurance professional can point you in the right direction.
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Author Bio: Ben started Prepare for Medicare in 2014 to help people help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in product development, sales, marketing and strategy for over 20 years.