Medicare Supplement Plans - Overview

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Medicare Supplement Plans, also known as Medigap Plans, are designed to help cover some of the medical costs that are not covered by Medicare, and are available to anyone enrolled in part A and B of Medicare. There is an open enrollment period for the first six months after you turn age 65, in which you do not need to qualify.

What Medicare Doesn't Cover

Medicare does not cover all health care costs. Medicare coverage consists of Part A (which covers hospital and skilled nursing facility care), and Part B (which covers doctor bills and other medical expenses).

Even with Medicare Part A and Part B coverage, you're responsible for some out-of-pocket expenses including:

Medicare Supplement Plans are Standardized

By law, Medicare Supplement insurance is standardized into twelve plans (Plans A through L). That means Plan F from one company must include the same benefits as plan F from another company. Since Medicare Supplement insurance plans are standardized and all insurance companies offer the same basic supplemental coverage, your Medicare supplement choice comes down to price and a company's service, reputation and experience with Medicare supplement insurance policies.

The most popular Medicare Supplement insurance plans in Colorado are offered by Anthem Blue Shield Blue Shield of Colorado. To review the available Blue Cross Blue Shield of Colorado Medicare Supplement plans a rates, click here.

Eligibility

To qualify for a Medicare Supplement policy, you must be age 65 or older (may vary by state), enrolled in Medicare parts A and B, and you must reside in the state in which you are applying for supplemental coverage.

When to Enroll

Your open enrollment period is the best time to buy a Medicare Supplement policy because companies must sell you any plan they offer regardless of your pre-existing health conditions. Your open enrollment period lasts for 6 months and begins on the first day of the month in which you are age 65 or older and enrolled in Part A and B of Medicare.

Late Enrollment

To help control rising costs, carriers apply the pre-existing condition clause to newly issued Medicare Supplement plans in most states if you enroll after the open enrollment period. Expenses resulting from a condition existing six months prior to the supplemental policy effective date are not covered unless they are incurred three months after the supplemental policy effective date.

If the supplemental policy replaces another creditable individual or group insurance coverage due to a person's eligibility for Medicare, this Pre-Existing Conditions Limitation will be reduced by the number of months that coverage was in force. If this supplemental policy replaces another Medicare Supplement policy, this Pre-Existing Conditions Limitation will be reduced by the number of months that the coverage was in force.

Medicare Supplement Basic Benefits

Basic benefits included in all plans include:

Medicare Supplement Benefits by Plan

The chart below shows the standard benefits included in each plan.

Plans
A B C D E F* G H I J K** L**
Basic Benefits X X X X X X X X X X 50% 75%
Skilled Nursing Coinsurance - - X X X X X X X X 50% 75%
Part A Deductible - - X X X X X - - - 50% 75%
Part B Deductible - - - - - - - X - - - -
Part B Excess - - - - - 100% 80% - 100% 100% - -
Foreign Travel Emergency - - X X X X X X X X - -
At Home Recovery - - - X - - X - X X - -
Preventive Care - - - - X - - - - X - -

*Plan F and Plan J also have high deductible options, which some companies may offer. These high deductible plans pay the same benefits as Plan F and J after one has paid a calendar year $2,140 deductible. Benefits from high deductible Plans F and J will not begin until out-of-pocket expenses exceed $2140.

**Plan K and Plan L provide for different cost-sharing than plans A-F. Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called "excess charges." You will be responsible for paying excess charges.