Questions & Answers
This section of Medicare Insurance Finders will review some of the questions
we have received from our clients. Over the last 5 years we
have received numerous questions because of all the changes to Medicare
( Medicare Part D, Medicare Advantage Plans, 2010 Modernization Act, New Enrollment
Periods, Etc ). This should be a very informative section on the website
dealing with questions that people have had problems with or been
stumped on in the past.
If you have any questions submit them to email@example.com and
we'll be glad to help you with them. Also if we have received
the question before we will post it on our website so that other
people can get help as well.
Q. What is the difference between a Medicare
Supplement and traditional
Supplement Insurance is like regular health
insurance in several ways and differs in several ways, too. Medicare Supplement
Insurance is sold by private insurance companies just like regular health
insurance except you must have Medicare Part A and Part B to be eligible.
Just like regular health insurance, the prices vary depending on the company
you choose to go with. As of now, one of the biggest differences between the
two is the fact that all Medicare Supplement Insurance plans, including the
plan letter), are the same from one insurance company to another. Example:
A Plan F with United of Omaha is identical to a Plan F with Gerber, American
Continental, Family Life, etc…except for the price of the plan and health
All Medicare Supplement Insurance plans are standardized plans and range
from Plan A to Plan N, missing a few letters in between. These plans can be
used anywhere—including hospitals and doctors’ offices—your Medicare
is accepted and cover the majority of what your Medicare Part
A and Part B leaves for you to pay. You are responsible for
paying your Medicare Part B premium and your Medicare Supplement Insurance
premium every month.
Your Medicare Part B premium is usually held out of your
monthly Social Security payment, but you Medicare Supplement Insurance
premium cannot be held out of your Social Security payment. Normally, your
Medicare Supplement Insurance premium will be directly drafted from your bank
account. In some cases, you will be allowed to pay by a monthly bill called
Q. Medicare Pays 80%, What About The Rest?
A. Medicare provides a large amount of coverage
for senior citizens, but it does not cover all of the needs. Generally,
Medicare pays 80% of your doctor and/or hospital bills which leaves
the rest up to the insured. Many people decide to purchase Medigap Insurance
(Medicare Supplement) to fill in the gaps left by Medicare. Medigap Insurance
Policies are sold by private insurance
companies. The coverage ranges depending
on the plan chosen.
Right now, Medigap Insurance Plan F offers the most coverage.
With a Plan
F your coverage includes:
- Medicare Part A Coinsurance and all costs after hospital benefits are
- Medicare Part B Coinsurance or Copayment for other than preventive services
- Blood (First 3 Pints)
- Hospice Care Coinsurance or Copayment
- Skilled Nursing Facility Care Coinsurance
- Medicare Part A Deductible
- Medicare Part B Deductible
- Foreign Travel Emergency (Up to Plan Limits)
Be sure to know all of your options and to explore the benefits of the different
Medigap Insurance Policies.
Q. Why Are Guaranteed Issue Periods Important?
Issue period is the time when
someone who is eligible can sign up for a Medicare Supplement with no
health questions. During this time, you can be declined for any reason.
If a person waits until he/she is out of their guaranteed-issue period, there
is a possibility they will not be approved. Outside of guaranteed-issue periods,
a Medicare Supplement application must go through regular underwriting. Underwriting
will review the answered health questions and prescription medications and
possibly conduct a phone interview to determine if the applicant will be approved
There are many different qualifications for a guaranteed-issue period (see
“Choosing a Medigap Policy” at www.Medicare.gov).
The most popular and well known are the Open
Enrollment Period and the Special
Enrollment Period. It is always important to be informed and knowledgeable
about your guaranteed-issue rights and enrollment periods. For many people
the Open Enrollment Period is a once in a lifetime opportunity, so it is essential
to know and understand your rights and options.
Q. Will Your Medicare Supplement Change Over Time?
A. This is one of the most common questions
we get, and there are good reasons to ask. Group health insurance changed
almost every year that you worked, and even individual health insurance
before 65 could single you out for changes in both price and benefits or to
cancel your coverage outright. Medicare Advantage Plans and Prescription Drug
Plans change both the price and the benefits every January 1.
The benefits of your Medicare Supplement, however, are renewable for life
and have been standardized by law. In short, your benefits for a Plan F, for
example, won’t change from year to year and won’t change even if you switch
No company will ever be able to tell you, “We think we’ve paid enough claims
on you, so we’re cutting you off.” You can never be singled out for
your benefits to end or reduce due to your personal claims or for your rates
to go up individually due to your health status.
Your premium can increase automatically if you have an age-rated plan or
by approval if the company is granted a rate increase by the state insurance
department for all policyholders in your state. In some cases, if you move
to another state or even to another ZIP code within your state, your premium
could go up or down at your anniversary date, based on the prevailing medical
charges in your new location. Your benefits, though, still won’t change.
Q. How Do I Escape From "Rate Increase Island"?
A. Most Medicare beneficiaries purchased their
Medicare Supplements with no health questions asked when they first
turned 65 or first retired and purchased Part B. That single Open
Enrollment period was the only time they could count on a guaranteed-issue
purchase. Even those who were healthy when they first bought their plans have
experienced health problems since then and have found that they can’t change
plans. All they can do is pay the rate increases and the rate increases and
the rate increases with no end in sight. As a result, the plan that started
out under $100 a month may now be $200-$400 a month or more. They are trapped
on Rate Increase Island!
Another reason people can be marooned is that Plans E, H, I, and J were removed
for new sales, also as of June 1, 2010. While people can keep those plans,
the reality is that with no new premiums coming in, you will find yourself
stuck on that Rate Increase Island where everyone gets older and sicker every
day. You can well imagine what that will do for your premiums over the next
For both groups of these fine folks, the answer may also be the new Plan
N. One insurance company is offering Plan N with only one question (no health
questions in some states). These policyholders may well be able to change
from a high-priced Plan F to a very affordable Plan N and still have solid
protection. That’s one way to consider for those who desperately need to escape
from Rate Increase Island.
Does this "escape" mean they’ll have no more rate increases for life?
No, not at all. Premiums will continue to go up on all plans—such is
life—but at least the insured can practically start over with rates
much closer to what they were paying years ago.