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4 Important Steps To Getting Medicare Supplement Coverage In Colorado


Introduction

If you are to turn 65 within the next year or two, the time to learn about Medicare supplement insurance is right now.  A quality, reliable, Medicare supplement plan is as important a financial piece as any, when it comes to achieving the level of financial stability you're going to want and need in retirement.

Let's go over the basics of Medicare supplement coverage and break down 4 important steps to getting this insurance necessity in the state of Colorado. 


What is Medicare Supplement Coverage (Medigap)?

Before you make the leap to acquiring a Medicare supplement plan, it's important to know what Medicare supplement coverage is, and how it works.  Simply put, Medicare supplement coverage is insurance for medical circumstances that are not covered by Medicare.  While Medicare coverage is quite extensive, it does not cover everything.  If you have the misfortune of suffering a medical incident that requires surgery, or a hospital stay, medical bills can mount rather quickly.  Most people are surprised at the costs associated with even the most modest of medical procedures.  A quality Medicare Supplement plan can be a financial lifesaver.

Medicare Supplement plans (also known as Medigap plans), are offered through private companies.  Keep in mind that Medigap plans are not the same as Medicare Advantage Plans. (For the pros and cons of Medicare Advantage plans, click here.)

Medigap coverage can only be used for one thing: circumstances where traditional Part A and Part B of Medicare does not provide coverage.

In total, there are ten Medigap plan styles that consumers may consider.  We'll discuss these plans in more depth so that you can make the decision that's right for you.

Good to know:  Shop Generic Drugs.  If you're looking to reduce your medical bills and reduce out of control medical spending, you can start by shopping generically.  Consumers tend to think of generic options as less effective or even as harmful.  This is not the case, however, when it comes to generic prescription drugs.  Though these alternatives may not be as flashy as the name-brand drugs advertised on commercials, they treat patient illnesses just as effectively for only a fraction of the cost.  You can increase your drug savings even more by shopping in preferred pharmacies or online at vendors such as GoodRx.  These options allow you access to a wide range of generic and name brand drugs at lower costs.  Preferred pharmacies take the extra step of reducing dispensing fees, saving you even more money on your next drug purchase.  For this reason, it's worth seeing if a preferred pharmacy network is included in your healthcare plan.  If not, you may want to review your options and see if adding such a plan would benefit you.



Who is Eligible for Medicare Supplement Coverage in Colorado?


To be eligible for a Medigap plan in the state of Colorado, you must meet certain requirements.  Let's take a look at the conditions consumers must satisfy in order to be eligible to apply for Medigap insurance.

For starters, you must be enrolled in Medicare Part A and Part B.  If you are not enrolled in Both Part A and Part B of Original Medicare, you will not be able to purchase a Medicare supplement plan.

Secondly, in almost every case, you need to be age 65 or older to be eligible for Medigap insurance.  The state of Colorado requires Medigap insurance companies to provide at least one type of supplemental insurance to individuals who, through specific disabilities, are eligible for early Medicare.



There are a few insurance circumstances in which you cannot be covered by a Medicare supplement plan:

  • Medicare Advantage Plans  If you are covered by a Medicare HMO, PPO, or Private Fee-for-Service Advantage Plan, you are not eligible for Medigap insurance.
  • Medicaid  You cannot augment your Medicaid coverage with a Medicare supplement plan.
  • Veterans' Benefits  Like Medicaid, Veterans' benefit coverage cannot be supplemented by a Medigap plan.

If you have a Medicare Prescription Drug Plan, you will still need Original Medicare to be eligible for a Medicare supplement plan.  Medicare Prescription Drug plans, and Medicare Supplement plans are two distinctly separate coverages.  The benefits do not overlap.  Since 2006, Medigap has been barred from covering the cost of prescription drugs.

Interesting Fact:  In 2015, the Kaiser Family Foundation found that there were 1 million adults who declared medical bankruptcy.  That is more than those going bankrupt for unpaid credit card debt or mortgage defaults.  A 2013 Nerdwallet study found that almost 30 percent maxed out their credit cards, while 8 percent were forced into bankruptcy because the illness cost them their jobs.

How Does Medigap Work in the State of Colorado?

If you meet the eligibility requirements for Medigap insurance in Colorado, you may be wondering how exactly Medigap insurance works.  Is the payment rolled up into one bulk Medicare cost, or will you be forced to pay two different premiums?  Additionally, does Medigap insurance offer spousal coverage, or is it just for one person?

Let's take a look at these questions and break down the answers.  Because Medigap plans work differently than Original Medicare, it's important you understand the differences between the two plans.

If you enroll in a Medigap plan, you will need to pay an additional premium on top of your existing Part B premium.  This premium will be paid on a monthly basis.  These plans cover only one individual.  If you are seeking supplement coverage for both you and your spouse, each member must apply for his or her own policy.

Medigap coverage is purchased through private insurance companies.  You'll find that different insurance companies have different premium structures (and therefore different prices) when it comes to their Medigap plans.

If you suffer a medical incident, you can expect Medicare to cover any medical costs according to the Medicare coverage plan benefits.  Your Medigap insurance is designed to help cover expenses not covered in your Original Medicare plan.

As long as you continue to pay your monthly Medicare supplement premiums, you are never in danger of losing your coverage.  Because Medigap is guaranteed-renewable, you can keep your coverage even if you fall ill or have a downward turn in your health.


Steps to Finding the Right Medicare Supplement Plan

Finding the right Medigap plan for your situation doesn't have to be difficult.  Though it can be overwhelming at first, by following the steps below, you should be able to painlessly find an ideal plan. 

  • Step #1: Research Medicare Supplement plan styles.

First, you'll need to research the different Medicare Supplement plans available.  Currently, there are ten different supplement plans available: A – N.


Medicare Supplement Plan Comparison

Benefits Medicare Supplement Plans
  A B C D F* G K L M N
                     
Medicare Part A Deductible No 100% 100% 100% 100% 100% 50% 75% 50% 100%
Medicare Part B Deductible No No 100% No 100% No No No No No
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Medicare Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%**
First three pints of blood 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part A hospice coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Skilled Nursing Facility (SNF) coinsurance No No 100% 100% 100% 100% 50% 75% 100% 100%
Medicare Part B Excess Charges No No No No 100% 100% No No No No
Foreign Travel Emergency (Up to Plan Limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-Pocket Limit*** None None None None None None $5,240 $2,620 None None

*Plan F is also has a high-deductible option.  The F high deductible plan pays for all Medicare-covered expenses after you meet a $2240 annual deductible.
**Office copay exceptions: Some office visits may require a copayment of up to $20.  Emergency room visits may require a copayment of up to $50.
***Plan pays 100% of covered Medicare costs for the remainder of the calendar year once the out-of-Pocket limit is reached.



Good to know:  Know the basics of health insurance.  According to a recent study, only 4% of Americans were capable of defining four of the basic health insurance terms.  Know your stuff when it comes to health insurance.  Knowing the difference between co-payments and coinsurance will be invaluable when shopping for the right plan.  It will also come in handy when figuring out costs once you've started using your health insurance plan for medical care.



  • Step #2:  Research Medicare Supplement Plan Pricing

Once you've chosen the plan type that fits your needs, you should begin looking at insurance companies that offer that plan.

Visit the Colorado Department of Regulatory Agencies website.  Here, you will find a wealth of information pertaining to the insurance companies who offer Medigap coverage in the state of Colorado.  Use this resource for official, in-depth, insurance information.

  • Step #3:  Contact Insurance Companies In Your Area

Don't be afraid to make some phone calls.  Be sure to verify plan details directly with the insurance carrier, before applying for any plan.  This can prevent costly mistakes, delays, and even denials in the future.
Also, be sure ask as many questions as you need in order to feel comfortable about selecting a plan.

  • Step #4:  Speak With A Professional
Purchasing a Medicare supplement plan is an important decision.  There is no reason to go it alone.  Please give us a call.  We are experienced, Medicare insurance specialists and are happy to help.



Other articles:
Is Short-Term Health Insurance Right For You?
Medicare Supplement vs Medicare Advantage plans in Colorado.
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