Do you dream of retirement, even though you’re still in your working years? Unfortunately, more and more people have discovered a disconcerting truth about retirement: Neither Social Security nor Medicare will cover every cost associated with living out your golden years.
Last posted by Sarah Horvath | benzinga
Baby boomers have run into a unique problem — advancements in medical technology and prescription drugs mean that people are living longer than ever before and have vastly underestimated how much money they’ll need for retirement. Suddenly, the cost of a monthly prescription or copay for an unexpected doctor’s appointment can put a major strain on your budget.
Medicare supplement plans (sometimes referred to as “Medigap plans”) can help you cover some of the costs that your Medicare plan does not, including deductibles and copays.
Medicare supplement plans are provided by private health insurance companies and are not offered by the federal government like standard Medicare plans. In addition to routine costs, the best health insurance plans that offer supplemental Medicare coverage also may offer coverage for circumstances and conditions not covered by your Medicare plan, such as healthcare and hospital stays outside the United States.
If you have Medicare Part A or Part B and you’re considering supplementing your plan with a Medigap policy, make sure you read our comprehensive guide to choosing a plan as well as our suggestions for reliable providers.
Overview: What’s Medicare Supplemental Insurance?
If you have Medicare, you probably have Medicare Part A (hospital insurance), Part B (medical insurance), or most commonly, both. When you choose a supplemental plan, you’ll need to make sure that you’re choosing a plan that supplements your Medicare plan, as Parts A and B rarely overlap when it comes to coverage.
Most people will not need a Medigap policy if they only have Medicare Part A because if you or your spouse worked and paid taxes for at least 10 years (or 40 quarters), you will likely qualify for premium-free Medicare Part A.
If you have Medicare Part B, you probably have to pay a monthly premium, a deductible and a co-pay of about 20%. This schedule can cause serious financial problems for senior citizens, especially if you’re on a fixed income or you have not saved enough for retirement independently through a 401(k) or IRA. Medicare supplemental insurance can help you to cover some of these costs, which lessens the financial burden on you and your family. Supplemental plans are often also automatically renewed, except in the event that you don’t pay your premium or the health insurance provider discovered that you’ve somehow misrepresented yourself when signing on for a policy.
Most supplement plans dictate that you must pay a monthly premium in addition to the premium you pay for Medicare Part B. Most supplement plans also dictate that they’re for single-users only. If you and your spouse each need a supplement plan, you’ll usually have to purchase two separate plans regardless of whether or not you were on the same employer-sponsored health insurance policy while you were working.
It’s important to note that you can only purchase a Medicare supplement plan if you are already enrolled in original Medicare. You cannot purchase a plan to supplement a Medicare Advantage Plan (Part C). Additionally, not everyone will qualify to enroll in Medicare; you must be over the age of 65, have been receiving Social Security disability insurance for at least 24 months or have been diagnosed with a qualifying need for certain end-of-life care. If you don’t qualify for Medicare, don’t panic — the Affordable Care Act has made it significantly easier to get health insurance coverage.
Check out our guide on how to get health insurance to determine if you qualify for a special enrollment period.
Illegal Medicare Policies
There are laws surrounding Medicare supplement policies that are intended to protect consumers from unfair business practices or marketing techniques. The following practices are illegal according to the U.S. government site for Medicare:
- A company or representative that sells you a policy when they know that you already have an existing Medigap policy. You cannot have two supplemental policies simultaneously. The company may only sell you a second policy if you state in writing that you intend to cancel your original Medicare supplement insurance before signing on with a new company.
- A company or representative that sells you a Medigap policy while claiming to be associated with or a partner of Medicare or the federal government. Medicare supplement policies are only offered by private corporations. No Medicare supplement plan is “approved,” “suggested,” or “supported” by the federal government or Medicare in any way, and a company that claims to be is breaking the law.
- A company or representative that sells you a Medicare Advantage Plan and claims that it’s a Medicare supplement plan. A Medicare Advantage Plan (Part C) cannot be combined with a supplement plan. However, you may purchase a Medicare supplement plan only if the date of the plan’s benefits begins after your Medicare Advantage Plan runs out or expires.
- Anyone using high-pressure sales tactics to coerce you to buy a Medigap policy or switch from your current supplement plan to a different supplement plan.
If you believe that you have been a victim of one of these illegal practices while searching for your Medicare supplement plan, contact the Inspector General through Medicare.gov’s contact form.
What Makes a Great Medicare Supplemental Insurance Company?
Individual states may limit the types of Medicare supplement policies that may be sold, and not every plan will be available in every state. Before you invest in a policy, check with your state’s insurance department to ensure that the company is legally allowed to operate and issue plans where you live. Other characteristics of a great plan include:
- International coverage. One of the major benefits of maintaining a Medicare supplement plan is that these plans are allowed to provide benefits and coverage types that are not offered by Medicare Parts A and B. If you frequently travel outside of the country for vacation or to visit members of your family living abroad, choosing a Medigap policy with coverage for international hospital stays and emergency medical treatment is a smart idea.
- Affordable premiums. The purpose of a Medicare supplement plan is to help you cover some of the costs that aren’t included in your Medicare plan. Choose a plan with a low and reasonable premium to help you save more money and ensure that your health is covered.
Best Medical Supplemental Insurance Companies
Our top 5 picks for medical supplemental insurance.
One of the most well-known specialty insurance providers in the United States, Cigna’s Medicare supplement policies are top-notch and widely available.
Cigna offers competitive premiums and policies are currently offered in 38 states (though some states limit supplement benefits available if you qualify for Medicare because of a disability). You can even get a discount through Cigna’s Household Premium Discount plan if you and your spouse both sign on with a policy.
Cigna’s supplement policies don’t sacrifice quality for low prices; the company offers policies that complement Medicare Parts A, B, and D (prescription drug coverage), as well as a few other less common Medicare benefit plans. Some of Cigna’s higher plans also include international coverage for emergencies. In most cases, you’re free to keep your own primary care physician so long as he or she accepts Medicare coverage without worrying about whether his or her practice is considered in Cigna’s network.
Cigna’s policies are also guaranteed renewable for life except under extenuating circumstances — so you won’t have to worry about suddenly being dropped from your plan. With wide availability and affordable rates, Cigna is a great supplemental insurance choice for those who qualify for Medicare.
Humana is a rock-solid supplemental insurance provider that offers plans throughout the country. Humana offers supplementary policies for nine out of 10 Medicare plans and some of Humana’s plans also offer international coverage as well.
Humana’s easy-to-use search function will introduce you to plan options in your state just by entering a zip code, and in most states, you also have the option to meet up with a local agent to discuss your plan options and sign on without making a commitment online.
Humana’s website is a great tool if you’re just beginning your search for a Medigap plan, as its pages are packed with information and tools that you can use to learn more about the differences between Medicare plans as well as estimate how much you’ll pay and how you can lower your premium. Humana also allows policyholders to chat with a nurse over the phone and around the clock if you’re concerned about some facet of your health but aren’t sure if you should see a specialist or go to the emergency room. If you’re overwhelmed with supplemental plan options and you’d like to learn more about Medicare itself before you begin thinking about which plan is right for you, Humana’s comprehensive site and human-assisted planning is a great choice to get started.
3. Blue Cross Blue Shield
Blue Cross Blue Shield is an umbrella corporation that provides insurance by working through over 30 established healthcare providers. An estimated 95 percent of hospitals and independent healthcare practices work with or contract services from Blue Cross Blue Shield, and plans are available in all 50 states. If you live in a state that places restrictions on Medicare supplemental policies and you’re having a difficult time finding a plan offered in your state, Blue Cross Blue Shield will more than likely have a coverage option that suits your needs.
Like other providers, you can quickly search for quotes and plan options online through Blue Cross Blue Shield’s site. Blue Cross Blue Shield’s extensive network options also mean that you won’t need to switch physicians or primary care providers to use your benefits as long as your current provider already accepts Medicare. Plans purchased through Blue Cross Blue Shield renew automatically so you don’t have to worry about losing coverage because you missed the annual enrollment date.
There are a number of ways to save through Blue Shield Blue Cross, including quitting smoking, setting up electronic payments for your premium costs and lowering your cholesterol level through diet and exercise. With a simple shopping system and easy-to-use online quote calculations, Blue Cross Blue Shield has quickly established itself as the star player in the Medigap arena.
Aetna’s Medicare supplement coverage options are somewhat limited when it comes to signing on. You cannot apply for coverage online; instead, you’ll need to call or see an in-person representative. Aetna’s plan offerings are also little less expansive than some competitors, with choices to supplement five out of the 10 Medicare plans. If you want to cancel your plan with Aetna, you’ll also have to write a letter, which is an unusual restriction that may make it more difficult to cancel your coverage if you want to switch plans.
However, Aetna’s plans also cover more than many competitors, with 100% coverage for most costs on Medicare Plan A & B and even up to 80% coverage for travel emergencies. Many of Aetna’s plans also cover skilled nursing expenses, which is usually excluded from standard Medicare supplement plans. If you’re a big international traveler, Aetna’s plans might save you money in the long-term by helping protect you against high emergency bills abroad.
Still totally lost on Medicare supplement policies? Gotten quotes from a number of plan providers but you’re still not sure which is right for you? LHENetwork may be able to help take some of the confusion out of the enrollment process.
LHENetwork is not an insurance provider, but it can show you a comprehensive list of every policy provider that serves your area, helping you quickly compare policy options at a glance. LHENetwork has connections with over 27 Medicare supplement insurance policy providers, and its system works in 45 states.
After supplying a little personal information about yourself, you can view a list of supplement policies available to you, costs and a list of inclusions and exclusions. LHENetwork’s online database of insurance agents can help you get coverage soon, eliminating hours spent calling for plan options — and save you money in the process.
Medicare can be confusing — and understanding exactly what type of supplemental coverage you need can be even more frustrating and time-consuming. However, like most other types of insurance, the best way to make sure that you’re getting the best rate possible is to request as many quotes as you can. Every health insurance company uses its own unique formula to determine how much you’ll pay in monthly premiums, so it’s possible to get five totally different quotes from five different insurance companies.
Don’t be afraid to “shop around” for coverage and ask any agents you speak to how you can lower your premium — health insurance providers have a hefty financial incentive to sign on qualified users, so there’s usually a few discounts that can be found for you if you’re debating between two providers.