Connecticut's Medicare Supplement Plans

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What do these "special" medical insurance plans do?

Pay most or all of the 20% MediCare did not pay the provider following an office visit or other outpatient treatment. Plan's also pay the Part A deductible when in a hospital. 


A couple points: 

Supplements are also called MediGap Plans since they generally pay the part - the Gap - of treatment cost MediCare does not. 


  A good way to think about this special kind of insurance   —   it's  a life ring over your money!   

How is a Supplement used?

    You can go to any provider in any state who participates in MediCare and agreed to receive the level of payment. 

     Note: When making an appointment just tell the provider you have MediCare. They do not have to know what Supplement company you have. 


     9 out of 10 people are happy with their Medicare Supplements.


    When you receive treatment:

      + Providers submit their charge for your treatment to the MediCare claims administrator. 

 

      + Your Supplement company, using the approval provided in your plan application, gets your Part B expenses from the MediCare system, and pays your provider.


      + The MediCare system will mail you a coverage summary on a quarterly basis following treatment. 

         Note: The summary has a  - Maximum You May Be Billed column and a code beside the amount which indicates it was sent to the Supplement company.

 

      + The supplement company also mails you an explanation of their payments. 


Supplements have some federal regulation:

    Plans are identified with "lettered' names". A has the least coverage, B, C. etc. have more.  

       [Confusing since the parts of MediCare also have letter names.


     Coverage is standardized so a plan here in CT with the same letter will be the same in most states. 


     A new federal regulation restricts availability of certain Supplement plans to certain people: 

      + Anyone turning 65 in January 2020 or after will not be able to buy a plan that pays Part B's deductible such a Plan F. Individuals enrolled in these Plans can keep them. 


Supplements also have some regulation by the CT Dept of Insurance which: 

    Approves the monthly cost each private company charges for their  plans. When approved the plans can be purchased in any CT County

     Note - the monthly cost charged for a specific Supplement plan: 

       + can vary considerably from what other companies charge for the same plan.

       + will be the same for males and females and whether a person is 65 or 95.


     Allows individuals (normally) to change their plan at any time for coverage the 1st of the next month.


A couple options to think about:

    Plan N - One company offers N for over $100 a month less than their full coverage F. 

     Why does it cost less? With Plan N you share in paying the provider and pay: 

       + Part B's annual deductible at the beginning of each year [$185 for 2019];  

       + a $20 co-pay for each MD office visit

       + a $50 co-pay if any emergency room visits.


    High Deductible Plan F. It's the lowest cost Supplement but only available from a few companies. 

       + Each calendar year an individual pays their providers the first $2,300 (for 2019) of any treatment received. 

       + The Plan then pays all medical related expenses above the deductible.

       + It's a good option for someone who was using a high deductible plan when under 65.


    Note:  High Deductible F will not be available to individuals who turn 65 on Jan 2020 or later.


What about coverage for Prescriptions?

MediCare Part B does not cover any medications you purchase at a local pharmacy. Nor are they paid by a Medicare Supplement Plan. 


What to do?  

    Buy a Medicare Prescription Drug Plan. (PDP) It's MediCare's Part D and will pay part of your outpatient prescription cost.   


    PDPs are purchased from private companies. Buying is voluntary but a penalty is added to the monthly cost if a person did not have "credible"  prescription coverage, such as from an employer, when they sign up. 

 

    Plan availability is based on the plans approved for the County you live in. 

      Note: There are a lot of options in New London County. 

 

When can you purchase a PDP? 

    When turning 65 you are eligible to apply during what is called your Initial Eligibility Period


    Making a change after that is limited to the Oct 15 to Dec 7 Annual Election Period unless a person qualifies for a Special Enrollment Period.


Questions on a Medicare Supplement Plan?

Call John C Parker today for a (no cost to you ) appointment — to:

    Understand your situation and interest and discuss the flexibility of a Supplement! You can receive treatment, if needed, from any provider in any state who accepts MediCare.


    Answer coverage questions, review the monthly cost, and select the plan which is best for your budget. 


    Talk about available Medicare PDP options to help pay for any medications.


You can also send a note with questions to - Learn@JohnCParker.agency