Medicare Supplements and Guaranteed Issue

Federally mandated guaranteed issue periods allow people to enroll in Medicare supplement plans without being denied coverage.

If health problems exist and an individual has been unable to get Medicare supplement plans, there is hope in the form of guaranteed issue periods. These periods are federally mandated by the Centers for Medicare and Medicaid Services and apply to “all” Medicare enrollees. What this specifically means is that the guaranteed issue period lets people apply for a plan without being denied coverage, charging more for any health condition, and excluding any pre-existing conditions.

As a stand-alone product, Medicare pays for roughly 80% of most covered services. This would mean an individual or family would then be responsible for the other 20% of the expenses that are not covered. While this 20% might not sound like much, it definitely adds up if the hospital bill is for things like strokes, heart attacks or cancer. Basically any major medical event will run the meter up and leave many people in a desperate situation financially. For seniors on a limited budget, this is not good news. This is why seniors need to be supplementing Medicare with Medicare supplements. It’s essential.

One reason why it is essential for those over 65 to supplement their Medicare is the fact that anyone needing health insurance needs to consider the monthly premium rate. The coverage itself is standardized, so that means what someone pays for it is critical. Shopping around for better rates makes sense and in the meantime if the insurance company that sold the Medicare supplement plans goes under, those left in the dust are allowed to sign up for a new plan under the guaranteed issue period.

Consider any value added benefits and other possible discounts when sourcing Medicare health insurance. Not a lot of people realize that some insurance outfits offer additional benefits as an attractive value-added part of their plan. If a company offers something worthwhile and it would be used, then it might be the place to buy Medicare insurance.

Take into consideration that waiting might not be a smart idea when it comes to getting Medicare supplements simply because a person might not be able to qualify for it later. Private companies have control over who they accept onto their plans and while some have more lenient underwriting guidelines, they may deny coverage.

The bottom line is shop around, ask questions and read the fine print in any policy purchased. It only makes good sense to know what the policy covers and does not cover.

To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Medicare and Medicare Advantage Differences

Until 2010 when Medicare Advantage is discontinued, it pays to know the differences between Medicare supplement plans and Medicare Advantage.

It’s a fairly straightforward difference between Medicare and Medicare Advantage, and it basically boils down to the majority of an individual’s health care expenses is covered by Medicare. For example, Medicare part A will cover inpatient care at places like a hospice, skilled nursing facility or a hospital.

Medicare part B takes care of doctors and outpatient services, while part D handles prescription drugs. One thing to remember is that parts B and D mean paying a premium. While it looks like Medicare covers a whole lot, it doesn’t cover everything. This is where Medicare supplements or Medicare Advantage steps in if a person or family wants 100% of their health care covered.

If a person opts to buy Medicare supplements, they are purchasing a “gap” policy that fills in the holes in the original Medicare plan, usually referred to as a Medigap policy. With these particular policies, there are various levels of coverage in 12 different plans with alphabet designations A through L. Each one of these letters provides a different kind of supplemental health coverage and the prices are unique, based on the different levels.

Medigap health insurance is offered by private health insurance companies and there is a monthly premium to be paid. Usually the premium is dictated by the level of coverage, age of the insured and their zip code. As with many other things in life, these plans usually have a price increase yearly.

With the Medicare supplement policies there are usually open enrollment periods and a person is able to get guaranteed enrollment. If an application is not made during the open enrollment period, the usual health insurance underwriting routine applies.

Medicare supplements are additional coverage. Medicare Advantage is replacement coverage. To file a claim under a Medicare supplement policy, a person must file a claim with Medicare and the supplemental insurance company. In the case of Medicare Advantage, the claim is processed by the policy provider.

Medicare Advantage also currently provides many choices such as a PPO, FFS or HMO and right now plans are available to suit an individual’s personal preferences and what is still being marketed in the applicable zip code. All this will change when Medicare Advantage is no longer offered in 2010. Now is the time to speak to a local Medicare health insurance provider to find out what other alternatives will be available to replace Medicare Advantage.

To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Medicare Supplement Plans M and N Lower Premiums?

Is the news floating around in cyberspace true, that there will be lower premiums for Medicare supplement plans M and N?

For those of you that don’t know what Medicare supplementary plans are, they are meant to bridge the gap between the policy coverage of the original Medicare and the actual bill, when it arrives in the mail later.This “gapping” became necessary when it was discovered that the original Medicare plan didn’t pay for every medical service actually needed, and you were dealing with a medical disaster.

If you stop to think about that explanation, it will make a great deal of sense to find out that there is more than one “gap” between the original plan and your bill. In order to do something about that gap, you do need to have Medicare to begin with, and then supplement it with other plans to fill the gaps. This analogy is a bit like filling teeth in that the dentist takes the existing original tooth and fills in the gaps with supplemental material to make it whole again.

Notice the use of the term “gap” and it will come as no surprise that the plans to fill in the original Medicare are referred to as Medigap policies. Medigap policies are run by private insurance companies who sell them to the public for varying prices. While the plans themselves are standardized, meaning they are the same in every state, the prices tend to be different depending on what the insurance company wishes to charge for them.

Despite the fact that Medigap policies are controlled by private health insurance companies, they still must have common rules to be followed when it comes to actually selling the Medigap policies. First and foremost is there are only 12 standard policies running from plan A to L. Each of their policies has its own set of benefits as well.

What is often not clearly understood by many people is that most of the Medigap policies give consumers the basic benefits of plans A and B, and in addition to the basic benefits, they also have their own advantages.

The 12 plans (A-L) have been around since 1992, but now there may be two “new” plans introduced in June 2010, plans M and N. The main feature of these two plans will be that they are supposedly going to provide lower premium rates as an alternative to the existing Medicare Supplement plans. While it isn’t entirely clear what M and N may offer, it is predicted that they should sell well because of the lower premiums.
With any change in Medicare or Medicare supplements, make sure you take the time to read each policy you decide to buy so you “know” just precisely what health coverage you actually have.

Richard Cantu is with Medicare supplements resource, GoMedigap.com. To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.

Seniors Supplement to Boost Medicare Expenses for 2010

If all goes well in Washington, it looks like seniors getting social security will get a check for $250 next year instead of a cost of living increase.

Whether or not this will truly come to pass depends a great deal on what happens in Congress over the remainder of the year and into the first part of 2010. However, having said that, the Social Security Administration has already served notice that is won’t be giving recipients a cost of living adjustment in 2010.

For the first time in 35 years there will be no cost of living adjustment, simply because there has been no inflation; a shocking bit of information by itself, but when combined with the news that seniors will not get the adjustment, the news becomes dismaying and financially upsetting for seniors. This is one of the reasons why Washington may step in and try and make a difference.

The truth here is that any extra money that seniors may have is going to buy prescription drugs and pay for Medicare and Medicare supplements, both of which have increased in cost quite substantially. In light of that particular revelation, politicians have seen a chance to make a difference and are lobbying for extra funds to be given to seniors in 2010.

This “supplement” of sorts won’t come without a cost of roughly $14 billion, which makes one wonder where on Earth the money will come from during this recession. Apparently it will be gleaned from slapping Social Security payroll taxes on earnings between $250,000 and $359,000 a year. Currently workers only pay Social Security taxes on the first $106,800 of their incomes.

While it’s obvious that this tax will not go over well with the people who have to pay it, it’s equally as obvious that something needs to be done to assist seniors in 2010, thanks to the absence of the cost of living adjustment. The theory behind the supplement payment is that seniors will spend it and help stimulate the economy.

There is no doubt seniors will spend it, and likely spend it on health care needs that would include medications and topping off their Medicare supplements for better health coverage. If you follow the news, you’ll likely appreciate that this kind of an economic boost for seniors will be a welcome relief as Medicare Part B costs are slated to increase as much as 9% in 2010 with Part D costs following along with an increase of about 11.1% for next year.

This extra help for seniors is timely and in light of bailouts for banks and other businesses, it only seems fair to provide funds for those most in need of decent health coverage.

Richard Cantu is with Medicare supplements resource, GoMedigap.com. To learn more about Medicare, Medicare supplements, or Medicare supplement insurance visit GoMedigap.com.