Pay the providers of a person's outpatient treatment or professional service most or all the 20% MediCare did not pay. A couple points:
● Generally pay the part - the Gap - of treatment cost MediCare does not thus are also called MediGap plans.
● Think of this special kind of insurance as — a life ring over your money!
● Individuals can receive treatment from any provider in any state who agreed to participate and accept MediCare.
Note: When making an appointment a person tells the provider they have MediCare but does not have to say what Supplement company they have.
● When treatment is received providers submit their charge to the MediCare claims administrator.
● The Supplement company, based on your approval in the application, is able to get your Part B expenses from the MediCare system and pay your provider.
● The MediCare system mails a quarterly coverage summary following receiving treatment. The supplement company also sends an explanation of their payments.
● 9 out of 10 people are happy with their Medicare Supplements.
Some information on federal regulation of Supplements:
● Plans are identified with "lettered' names" and coverage is the same in most states. A has the least coverage, B, C. etc. have more.
[Confusing since the parts of MediCare also have letter names. ]
● Any plan in CT with the same letter from any company will have identical coverage.
Some information on state regulation of Supplements The CT Dept of Insurance:
● Approves the monthly cost of each private companies plan and when approved it can for purchased in any CT County
Note - the monthly cost of a specific Supplement plan:
+ can vary considerably between what companies charge for their 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 new federal regulation restricts availability of certain Supplement plans:
Any person turning 65 in January 2020 or after will not be able to buy full coverage Plan F. Individuals enrolled in Plan F at that time can keep it.
● Plan N - One company offers N for over $100 a month less than their full coverage F.
Why does it cost less? A person with Plan N shares in what the company pays the provider. When treatment is received they 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 the first $2,300 (for 2019) of any treatment they receive.
+ The Plan then pays all medical related expenses above the deductible.
+ It's a good option for someone who was using an under 65 high deductible plan.
● Note: High Deductible F will not be available to individuals who turn 65 on Jan 2020 or later.
MediCare Part B does not cover medications purchased at a local pharmacy nor are they included in a Medicare Supplement Plan. What to do?
● Buy a Medicare Prescription Drug Plans (PDP), which is MeddiCare's Par D, to pay part of the cost of outpatient prescriptions.
● Buying PDPs are purchased from private companies on a voluntary basis. But a penalty would be added to the monthly cost if a person does not have "credible" prescription coverage, such as from an employer, when they do sign up.
● There are a lot of PDP options in New London County.
When can a PDP be purchased?
● A person is eligible to apply for a PDP during their Initial Eligibility Period when they turn 65.
● 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.
Call or Text John C Parker's Google Voice # — (860) 451-9793 — today for an appointment. We can have a discussion (no cost to you ), to:
● Understand your interest and situation and discuss the flexibility plans provide to receive treatment from any provider in any state who accepts MediCare.
● Answer coverage questions, review plan monthly cost, and select one 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
The Medicare-Health-Plans-Southeastern-CT content is copyrighted © 2018 to 2019 by John C Parker, RHU, LTCP - All Rights Reserved.