“Medigap” is a form of Medicare supplement insurance policy designed to fill the coverage gaps associated with Original Medicare Parts A & B. While Medicare tries to be comprehensive, there are several healthcare basics which it won’t cover. And if you don’t have any Medigap insurance to pay for those needs, you could potentially find yourself spending thousands in out-of-pocket healthcare expenses. In order to purchase Medigap insurance, you have to first be enrolled in Original Medicare.
Federal Regulations for Medicare Supplements
In order to make sure than a senior citizen in Michigan gets the very same benefits as a senior citizen in Maine, the CMS (Centers for Medicare and Medicaid Services) are in charge of governing the ten obtainable Medigap plans. Plans A, B, C, D, F, G, K, L, M, and N are now available for purchase (E, H, I, and J have already been discontinued). Due to the fact each plan is regulated, the only real distinction between Plan G in Maine and plan G in any other state is selling price, and provider. The benefits are exactly the same across the country.
Medigap Enrollment In Maine
It’s no surprise that more seniors in Maine prefer Plan F to all of the other choices – after all, it is the most popular (and the most comprehensive) plan. Plan C is also fairly popular, with nearly 15,000 members enjoying that particular form of Medigap coverage.
Plan Coverage & Cost
The cost to you for your Medicare supplemental insurance policy is dependent upon several different components. Your overall health is a major issue, and your fee can change depending on things like your tobacco habits, your actual age, and gender. Your premium can also be based upon where you live, right down to your city and zip code.
Not surprisingly, there is no standard rate for Medicare Supplement (Medigap) plans. How much your Medigap plan will cost you depends on a number of underwriting factors. Your current general overall health, your medical history, use of tobacco products, gender, and age will all be considered when developing a premium. What you might find surprising is where you live in Maine, distinct as your zip code also plays a part. The cost of healthcare can vary widely from area to area.
Most Popular Medicare Supplement Plans in Maine
Like many other states, Maine occupants have a preference for Medigap Plan F to all of the other offered plans. The explanation for this is straightforward: Plan F covers each and every gap in Medicare coverage, and all senior citizens must do to safeguard themselves is pay out one affordable monthly premium. Hardly ever is any other action required on their part.
Plan C is a distant runner up, with well over 14,000 members. The only thing Plan C doesn’t cover is excess charges from Medicare Part B. If you happen to live near health facilities which do not charge a premium for their procedures, Plan C might be the more affordable option for you as well.
How do Medicare Plan Ratings Work?
One of the tools you can use to help you evaluate different Medicare plans is the Overall Star Rating report that Medicare publishes each year. Medicare collects data on every company providing Medicare related coverage and puts together a star rating. The more stars the better the overall performance of the company. The areas that Medicare rates include how well a company uses preventive measures like screenings, vaccinations, and imaging to keep you healthy, how well chronic diseases like diabetes is managed, customer experiences with the plan, complaints, and quality of customer service.
Helpful Medigap Tips & Tricks
Doctor/Provider Network Restrictions
Do you wish to travel? Do you migrate yearly as the seasons change? Do you live out in the country, or is there an overall lack of variety in terms of medical service providers in your area? Then you might be better off with a Medicare supplement policy. Sure, there are additional methods to supplement your Medicare coverage gaps, but very few of them supply the versatility that Medigap does. With Medicare supplement insurance, you’re free to get care from any kind of facility and any health care provider which will accept Medicare.
When it comes to doctors, Medigap programs have a major advantage over many other plan types. The trust and relationship you have with your current doctor is not something that is easily or quickly developed. Medigap plans understand that. That’s one of the reasons they don’t limit which physicians or facilities you use so long as they accept Medicare assignment. Other plans use networks and often limit your choice of physicians and facilities that are members of that network. That means you may not be able to keep your doctor and you may have to travel to find one you can and that can be a problem in Maine during winter.
Drug, Vision and Dental Coverage
As you may know, Medicare Part D has become mainly responsible for offering older persons their prescription drug coverage. For this reason, it is no longer necessary for Medicare supplement policies to offer you prescription drug coverage as a possible option. Vision and dental are additional forms of coverage which Medicare supplement and Medicare do not cover. You have the option to either acquire those coverages privately on your own, or to pay out-of-pocket if you find it less costly than private insurance.
Enrollment Options & Best Time To Enroll
There are several approaches to join a Medigap policy. Nevertheless, take into account that all of them ask you to register for Medicare first. For those who enroll at the right time, simply being a Medicare beneficiary will let you purchase Medicare supplement coverage, no strings attached. Other companies might restrict you if you sign up later or if you have serious health issues.
- Initial Enrollment Period: Enrolling in a Medigap policy during your IEP (within 6 months of signing up for Medicare) assures your approval and coverage without the need of health surveys or medical exams.
- Guaranteed Issue: Like the IEP mentioned above, you will be immediately approved without needing to answer unpleasant health questions or endure an exam. Guarantee Issue is typically for senior citizens who don’t enroll during the IEP because they were formerly covered by an employer or group health plan.
- Annual Enrollment Period (AEP): Medigap enrollment isn’t constrained by Annual Enrollment Periods the way in which other insurance plans are, so go ahead and enroll whenever you want.
- Underwritten: Arguably the hardest kind of enrollment. Your insurance provider will ask you personal health questions and perhaps demand a physical exam before they accept you as a beneficiary.
Free Look Period
The free look period helps to protect seniors just like you from being saddled with a Medicare supplemental insurance plan which isn’t going to meet your needs. Within your first 30 days of getting a new plan, you’re free to choose whether or not to keep your coverage, or cancel it without being financially responsible. Any upfront expenses you pay during your first 30 days will be refunded should you elect to end your benefits.
What Medigap Plan Is Best For Me?
If you fully understand your Medigap plan, it provides the coverage you need for your particular health situation, and you can afford it, then you have found the perfect plan for you. The problem of course, is finding it. At Medigap.com we have compiled a comprehensive list of Medicare Supplement (Medigap) plans available in Maine to give you a starting point. We are confident you’ll find the plan that is the best fit for you with our expertise and guidance.