Medigap Plans, Medicare Advantage, and Part D

*This is Part 3 in a 3-part series designed for people going on Medicare or turning 65. Please
medigapcontact us if you have any questions about this information or fill out a quotes request if you want to get Medigap quotes.*

Medigap plans, Medicare Advantage and Part D are additional coverages that you should be considering if you are going on Medicare. Each of these has their own unique designs and advantages/disadvantages. This article is intended to introduce you to each and give you more information to consider about what is right for you.

First of all, let’s take a look at Medigap plans. Medigap plans are sold through private insurance companies, but they are Federally-standardized. What this means is that each company has to offer one of the standardized plan designs. The chart that shows these standardized plans can be seen here. As you can see, Plan F is the most comprehensive plan – it pays what Medicare Parts A & B do not cover at the doctor and hospital, so you should not have any out of pocket expenses. It is, of course, the most expensive. Other common lower-premium, less-coverage options include Plan G and Plan N. Plan G, in particular, is often a better value than Plan F (Read more about Why Plan G is often better than Plan F).

In addition to the coverage being standardized with Medigap plans, the claim payments and doctor acceptance are also standardized. That is, if a doctor/hospital takes Medicare, he or she will take the standardized Medigap plan that you have, regardless of which company sells you the plan. Additionally, claim payments are processed through the Medicare “crossover” system, so the plans, essentially, “follow” Medicare as a supplement and claims are all handled electronically. For these reasons, it is important to compare the Medigap plans on the basis primarily of cost and company rating. These are the two variables that can differ from one company to the next. You can get a Medigap quotes comparison for you area sent to you by email.

Medicare Advantage is entirely different from Medigap. Many people mistakenly lump them in together or call Medicare Advantage plans “Medicare Supplements”. This is not accurate, as Medicare Advantage plans do not supplement Medicare, but rather take its place in paying claims. These plans have networks, and most are either PPOs or HMOs. Often, premiums are lower than the premiums of Medigap plans, but the coverage is typically also lower. They, in most cases, work more like traditional employer/group type plans. There are some distinct drawbacks to this type of plan, in our experience, and we do not recommend them in most instances. Some of the particular downsides are the network restrictions (which are often based on your county or state) and future plan change issues. If you take a Medicare Advantage plan when first eligible for Medicare, you do have to qualify medically to switch to a Medigap plan at a later time.

Medicare Part D is a part of Medicare, but it is sold through private insurance companies. Part D covers prescription drugs. There are typically 20-40 plans in each county, so it is crucial to compare the plans based on how well they cover your current medications. Co-pays and plan premiums can vary greatly. You can do this on Medicare’s website at: Compare Part D plans.

It is important to sign up for Part D when first eligible unless you have creditable coverage. Medicare imposes a 1% per month penalty if you do not sign up for a Part D plan when you are first eligible (you are exempt from this penalty if you have creditable coverage through an employer-type plan). Premiums for Part D typically range from $15/month to $100/month so it is vital to choose a plan that covers your medications and is the appropriate coverage level for your current medication usage. You can change Part D plans during the annual enrollment period which runs October 15-December 7 each year.

This article explains some of the other coverages that go with Medicare, such as Medigap, Medicare Advantage and Part D. If you still have questions or want to discuss further, please feel free to contact us.

Medigap-Quote.com is one of the nation’s leading independent brokers of Medigap plans. We work with 30+ companies in 40+ states and work exclusively with this type of insurance. As a result, we can provide unbiased, experienced expertise to those going on Medicare and turning 65. Feel free to contact us or request Medigap quotes online.

Online Medigap Quotes – What You Can Get Online and How To Get It

Getting online Medigap quotes is increasingly easy to do. Many people choose this method for comparing and selecting plans, and it is, in most cases, the most advantageous way to “shop around” in an unbiased and low-hassle way. Many insurance companies in the Medicare Supplement marketplace do not allow their rates to be publicly-published online, so the way to see quotes for all of the options in your area is to receive them by email. There are companies out there that promise to offer the rates online; however, keep in mind that you will not be seeing all of the options as many companies have strict regulations against publication of their rates on public-facing computer systems.

So, what are the steps to getting a Medigap quote online? It’s pretty easy to do really. Here are the steps to follow:

  1. The first step is to understand what you are looking for and what the plans cover. There are 10 standardized Medigap plans. All companies are required to offer from this standardized list of plans, although they don’t have to offer all 10. So, comparing plans is relatively easy – an ‘F’ plan with one company is the same as an ‘F’ plan with another. Two important things to note that are common misconceptions and relate to understanding the plans:
    • There is NOT an annual enrollment period for Medigap. You can enroll in, change or disenroll from your Medicare Advantage plan at any time.
    • Medicare Advantage plans are NOT Medicare Supplements. These plans cannot be compared to Medigap plans because they are completely different in how they work, what they cover, etc. (Difference Between Medigap and Medicare Advantage).
  2. After you have a basic understanding of the plans, how they work, etc. you should request the information from an independent brokerage. Whether it is us or someone else, we would strongly recommend using an independent broker. The advantage to doing this versus using a “captive” agent is that you can compare in an unbiased way and make a full comparison of all of the options. To request information, go to a brokerage website and enter accurate information. If the site is asking for information that you do not want to give, simply don’t give it. Keep looking. The only information needed to run and send a quote is date of birth, zip code, gender, and email. Request a quote comparison from us.
  3. Once you have the information, you can compare the plans that are available and make a wise choice from the plans that are offered. Always base your decision primarily on rates and secondarily on other factors such as the rating of the company.

If you have any questions about this information or if we can assist in any way, please contact us by email or call us at 877.506.3378. Alternatively, you can request information on our website at Medigap-Quote.com.

Medigap Questions – I Have …. Can I Get a Medigap Plan?

Medigap plans are plans that are designed to fill in the gaps in Medicare A & B. These plans are sold through private insurance companies. When you first turn 65 or go on Medicare, you have a 6-month open enrollment period, during which you can sign up for a plan without any medical underwriting. In other words, you do not have to answer any health questions at all in order to get a plan. After that time period has passed, however, you do have to answer health questions at any time that you apply for a plan. Contrary to popular belief, Medigap plans do not have an annual enrollment period during which you change plans without underwriting. That only applies to Medicare Advantage and Part D plans.

So, dealing with Medigap plans, how do you know if you can change plans? First of all, it is important to understand that Medigap plans are standardized, so if you have a Plan G now, for example, another Plan G is going to provide the exact same coverage. You can easily compare that way to see if it makes sense to pursue another plan. You do, however, have to answer medical questions to make that change.

Different companies ask different medical questions. In general, companies are looking for the “big stuff” – i.e. heart attack, cancer, stroke, insulin-dependent diabetes, organ replacements, upcoming surgeries, etc. Most all companies ask about (and use as a disqualification) those things. Other things are also asked about on some companies applications. These range widely and any time you are considering a change, you should simply examine the health questions on a companies’ application to see if you would be able to pass underwriting. Most companies do also ask about any medication usage. It is important to note that this applies to most states – there are a few states that have special provisions prohibiting this underwriting at all or during certain times (i.e. your birthday month).

One more implication that must be discussed is that there are also time periods – called “guaranteed issue” – that you can get a plan without medical underwriting. Some of these time periods are losing employer coverage, dropping employer coverage, moving out of your plan’s service area, losing your Medicare Advantage plan, etc.

If you have any questions about Medigap or Medicare, in general, we are happy to help. Reach out to us via our website – Medigap-Quote.com – or call us at 877.506.3378.

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