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Tuesday, May 14, 2002
S HIIP - Senior Health
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on Medicare, Medicare supplement insurance, long term care insurance,
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If you have friends or relatives in other
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Medicare Supplement Insurance - Simply Sterling Health Insurance for Life
Welcome!
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and hospitals of your choice. And, you are allowed to move between the Sterling plans should your healthcare needs change
(subject to federal limitations on Medicare+Choice plans). As you navigate our site, please feel
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Find a Sterling Plan that fits your needs. Determine plan availability,
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Medicare Supplement, "Medigap"
Because Medicare won't cover all
your health-care costs during retirement, you may want to consider purchasing
a supplemental medical insurance policy called Medigap. Medigap is specifically
designed to fill some of the gaps in your Medicare coverage.
Where can you buy a Medigap policy?
Medigap policies are sold through private insurance companies. However, they
are standardized and regulated by federal and state law.
When's the best time to buy a
Medigap policy?
The best time to buy a Medigap policy is during your open enrollment period,
since you can't be turned down or charged more because you are in poor health.
If you are age 65 or older, your open enrollment period starts when you first
enroll in Medicare Part B. Or, if you are not yet 65, your open enrollment period
starts when you turn 65, and then lasts for six months. A few states also require
that a limited open enrollment period be offered to Medicare beneficiaries under
age 65.
If you don't buy a Medigap policy
during your open enrollment period, you may not be able to buy the policy you
want later. You may find yourself having to settle for whatever type of policy
an insurance company is willing to sell you.
Note: If you are currently age 62 or younger (i.e., you
were born in 1938 or later), you should be aware that your eligibility for Medicare may be
affected by the increase in the normal retirement age for Social Security. Starting in 2000,
the age for collecting full Social Security benefits will gradually increase from age 65 to
age 67 over a 22-year period. This means that the age at which you can begin receiving Medicare
benefits may be greater than 65 (if current law still applies) because the date you become
eligible for Medicare is the date you reach normal retirement age. However, neither the Social
Security Administration nor the Health Care Financing Administration has yet published
information on how the change in normal retirement age will affect Medicare eligibility.
What does a Medigap policy cover?
Under federal law, only ten standardized plans can be offered as Medigap plans.
All ten must cover certain services, no matter in which state you live. Medigap
policies pay most, if not all, Medicare coinsurance amounts. Some also provide
coverage for deductibles and services that are not covered by Medicare such
as prescription drugs and preventive care.
Each Medigap policy is labeled with
the letter "A" through "J". You can buy the Medigap plan
that best suits your needs. Plan "A" is the basic benefit plan, while
Plan "J" offers the most coverage. However, it is important to note
that not all ten plans are available in every state.
How do I compare Medigap policies?
You don't have to compare the policy offered by one insurance company to
the policy offered by another insurance company. Because Medigap policies are
standardized, there are no variations. Plan "B" purchased through
an insurance company in New York will offer the same coverage as Plan "B"
purchased through an insurance company in Minnesota. All you have to do is decide
which plan you want to buy.
However, even though the plans offered
by insurance companies are identical, no two insurance companies are alike.
So, look closely at the company's reputation and customer service standards.
And check out what you'll pay for Medigap coverage--Medigap premiums vary widely,
both from company to company and from state to state.
What is Medicare SELECT?
Medicare SELECT is another Medicare supplemental health insurance product. It's
almost identical to standard Medigap insurance. When you buy a Medicare SELECT
policy, you are buying a standard Medigap plan. The only difference between
a Medicare SELECT plan and a Medigap plan is that Medicare SELECT is a managed
care plan. In order to be eligible for full benefits, you must use specific
hospitals, and sometimes specific doctors. That's why Medicare SELECT premiums
are usually lower than premiums for Medigap policies that do not require the
use of managed care.
Does everyone need Medigap?
No. In fact, it's illegal for an insurance company to sell you a Medigap
policy that substantially duplicates any existing coverage you have, including
Medicare coverage.
You may not need to buy a Medigap
policy if you work past age 65 and have employer-sponsored health insurance.
You can still enroll in Medicare, but your employer-sponsored insurance will
be your primary payer, so you'll submit claims to them first. Medicare will
be the secondary payer, paying costs covered by Medicare, but not covered by
your employer's plan. If you find yourself in this situation, you may want to
enroll in Medicare Part A (since it's free). However, remember that if you enroll
in Medicare Part B, your open enrollment period for Medigap starts. If you won't
be buying a Medigap policy within six months, you may be denied coverage later
or charged a higher premium.
In addition, you may not need to
buy a Medigap policy if you are covered by an employer-sponsored health plan
after you retire. In this case, your employer plan will be your primary payer,
and Medicare will be your secondary payer. However, if you wish, you can convert
your employer-provided plan into a Medigap policy. In fact, some insurance policies
automatically change coverage when you reach age 65 because they assume you
will sign up for Medicare.
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