Health Exchange Agency – Frequently Asked Questions

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What’s Medicare supplement insurance?

Medicare supplement insurance plans by private insurance companies can assist in paying for a portion of the out-of-pocket costs not covered by Medicare Parts A and B. These are standard plans associated with letters like “F” and “N” that have core benefits that remain unchanged between company to company; however, plan availability can vary by state and insurer.

Do Medicare supplement plans replace Medicare Parts A and B?

The answer is no. Medicare supplement insurance plans work in tandem with Medicare Parts A and B to ad in covering a portion of out-of-pocket health care expenses. For example, Medicare Part B typically covers 80% of costs, and the rest is up to the insured. Buying Medicare supplement plans to go along with your existing Medicare Parts and B coverage can assist you in paying for medical expenses not taken care of by Medicare.

What sort of out-of-pocket expenses are covered by a Medicare supplement plan?

A Medicare supplement plan will differ between plans offered by different insurers; however, they each offer the same standard benefits. Typically these plans offer coinsurance for Medicare Part A hospitalization expenses and cover 20% of Medicare-approved costs. Standard benefits usually cover the initial 3 pints of blood each year and provide Part A coinsurance for hospice care.

Are “Medicare supplement” and “Medicare Advantage plans” interchangeable?

Negative. Medicare supplement and Medicare Advantage* plans aren’t the same. A Medicare supplement plan can be bought in additional to Medicare Parts A and B coverage, while Medicare Advantage plans (aka Medicare Part C) provides Medicare-approved standalone coverage combining hospital costs, doctors’ visits, outpatient care and occasionally prescription drug benefits into a single plan.

You can’t acquire both a Medicare Advantage plan and a Medicare supplement plan simultaneously but are both offered via private insurance companies.

*Please note that Medicare Advantage may not be offered in all states/territories in the USA.

How to Medicare supplement plans differ across different insurance companies?

Regarding standard benefits, Medicare supplement insurance plans never change. However, there are differences, such as added benefits provided by a particular insurance company, as well as the quality of customer service offered.

When am I able to apply for Medicare supplement insurance?

When you are enrolled in Medicare Parts A and B, you may always opt for Medicare supplement insurance plans.

Should you apply for Medicare supplement plans within 6 months of your 65th birthday and Medicare Part B enrollment, you are virtually guaranteed for approval. In certain states, you will be guaranteed regardless of the timeframe in which you apply.

Can my plan be cancelled due to new health conditions?

A Medicare supplement insurance plan is lifetime-guaranteed – age and health are not a factor – provided that you are fully paid up on your premium payments and there is no material misrepresentation on your application.

Do I have to choose a specific doctor with my Medicare supplement plan?

Thankfully, with Medicare supplement plans, you are given the choice of any doctor, specialist or hospital provided they accept Medicare patients.

Do Medicare supplement plans cover Rx drugs?

Currently, Medicare supplement insurance plans do not cover Rx drugs, which are available under a separate plan, Medicare Part D, which is available by way of private Medicare-approved insurance companies. However, there is a choice of different plans available, and these plans will vary depending upon the insurer.

What is the cost of a Medicare supplement plan?

Monthly premiums vary based on the amount of coverage you desire and the insurance company chosen.

When researching Medicare supplement plans, take into account how much you will be expected to pay for hospital stays, visits to the doctor, as well as how much you are comfortable spending on monthly plan premiums and out-of-pocket expenses.

Being educated about your personal needs and how you will utilize Medicare supplement insurance plans will aid you in choosing the best plan with the ideal cost and benefit structure for your needs.

How much Medicare supplement insurance coverage will I need?

You can choose between higher-benefit plans (which cost more), or you can opt for lower premiums with minimal benefits.

Plans with higher benefits offer the greatest amount of supplement coverage and may pay up to 100% of your out-of-pocket expenses for a wide variety of services.

Should you choose a lower-benefit plan, you can expect to pay a lower premium month to month but will pay more out-of-pocket for covered services

Can you help me choose a plan suitable for my needs?

It’s important to do your own research, because choosing Medicare coverage is not a simple task. We suggest reaching out to an insurance company’s customer service, contacting a local insurance agent, or even asking a friend. When considering plans, take into account how much coverage you will need and how much you’re comfortable paying on a monthly basis. This helps you to narrow down your options.

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