Medicare Supplemental Insurance Options in Maryland
Most retired individuals in the U.S. qualify for Medicare, however, there are numerous gaps in basic Medicare coverage, leaving patients with significant out-of-pocket costs after they receive medical care. To help fill in these gaps, individuals can purchase a Medicare supplement policy through a private insurer.
Medicare supplements, also known as “Medigap” plans, are designed to fill in the holes in Medicare coverage, allowing patients to have some or all of their copayments, coinsurance, and deductibles paid by the plan. There are several different Medicare supplement options, and they vary widely in price and level of coverage. Reviewing all the available Medicare supplement insurance choices can be complicated and confusing, and different insurers have different rates for these plans. Balderson Insurance Agency is here to help you make sense of your options. We have access to many of the top insurers in Maryland, and we work closely with you to identify your specific needs and budget and to find the plan that is right for you.
Call us today at (301) 874-0772 for further information on Medicare supplement/Medigap plans and to get a free quote.
Understanding Medicare and Medicare Supplements In order to obtain a Medigap plan, you must have the basic parts of Medicare, known as Medicare Part A and Medicare Part B. Part A is free for most Americans, provided you (or your spouse) have met the minimum work requirement of 10 years. It covers hospital stays, hospice care, and skilled nursing care.
For Part B, there is a monthly base rate that is adjusted annually for inflation, and those in higher income brackets pay more than the base rate. Part B covers doctor visits, diagnostic tests, surgeries and other medical procedures, outpatient care, and some preventative services.
There are also two optional parts of Medicare that can be obtained through private health insurance companies, known as Part C and Part D. Part C includes Medicare Advantage, which is similar to a Medigap plan in that it provides additional coverage for many of the out-of-pocket expenses that are not paid by Part A or Part B. Part C also includes a Medicare Advantage prescription drug (MAPD) plan.
Part D is one of the more recent additions to the Medicare program, and it is designed to provide more comprehensive prescription drug coverage for seniors. Individuals must sign up for Part D as soon as they become eligible for Medicare. If they want to sign up later, they will need to pay a penalty to do so.
Medicare supplement/Medigap plans can be purchased to help supplement the coverage provided by Medicare parts A and B. These plans are divided into 10 standardized categories, which are grouped by letter. The categories are A, B, C, D, F, G, K, L, M, and N. Plans C and F have been suspended by Congress for new Medicare recipients, but individuals who already had one of these plans are allowed to continue on them until they cancel.
Coverages for Medigap plans vary depending on which plan you choose, and prices vary by plan and by which insurer you purchase the plan through. All of the plans pay for Medicare Part A coinsurance for an additional 365 days after Medicare benefits are exhausted. Most of them also cover copayments and coinsurance for Medicare Part B preventative care and basic benefits. However, plans C and F provided more comprehensive coverage that included Part B deductibles.
Here are some important things to know about Medicare supplement/Medigap plans:
• Benefits are standardized based on the category, so consumers can shop insurers to pick the carrier that offers the plan they want at the lowest price.
• The time to apply to be guaranteed the issue of a policy is the 3 months before you turn 65, the month you turn 65, and the 3 months following turning 65. For example, if you turn 65 in April, you can apply in January, February, March, the month of birth (April) May, June, and July of that year.
• Most plans pay for up to 80% of “medically necessary” emergency care in a foreign country.
• Consumers can purchase Medicare supplement plans from any insurer that is licensed to sell them in their state.
As we touched on previously, Medicare supplement plans have some similarities with Medicare Advantage (Part C). Both are purchased through private health insurers, and both provide additional coverages above and beyond what is covered by Medicare parts A and B. One of the main differences is that Medicare Advantage essentially replaces the basic parts of Medicare and wraps everything into one plan, while a Medigap plan supplements what is provided by basic Medicare.
In general, the premiums for Medicare Advantage plans are lower than for Medicare supplement/Medigap plans, but patients can also end up with higher out-of-pocket costs with Medicare Advantage. Medigap plans also provide significantly more choices of doctors and facilities, while Medicare Advantage plans are usually limited to HMOs and preferred provider (PPO) networks within a local region.
Your Independent Agent for Medicare Supplement Coverage in Frederick, MD
When it comes time to choose your Medicare plans and supplements, there is a lot to think about. Going over each plan and analyzing how it might affect you (based on your specific circumstances) can be exhausting and time-consuming, and unless you are familiar with how Medicare works, you may have difficulty sorting everything out.
At Balderson Insurance Agency, we understand the frustration seniors have to deal with when they are looking at Medicare options. We have in-depth knowledge of this program, and we have helped countless individuals find the right Medicare supplement or Medicare Advantage plan that is right for them. We take the time to listen and understand your unique needs, and because we are not captive to any one particular carrier, we are able to shop freely to find the plan that is right for you.
Call us today at (301) 874-0772 to speak with one of our Medicare supplement experts.