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3 Key Tips to Getting Medicare Supplement Insurance In Illinois


Are you to turn sixty-five within the next year or so?  If so, it's time that you looked into Medicare supplement insurance.  Finding the right Medicare supplement plan could go a long way to providing you with the stability you need in your retirement.
Knowing this, let's go over the basics of Medicare supplement coverage and break down 3 key tips to acquiring this valuable insurance in the state of Illinois. 

Chicago, Illinois

What is Medicare Supplement Coverage (Medigap)?

Before you make the leap to acquiring a Medicare supplement plan, it's important to know what this coverage is and what it could mean for you and your family.  Simply put, Medicare supplement coverage is additional insurance not offered in traditional Medicare plans.  Alternatively known as "Medigap," these supplement plans help pay medical costs that are not included in a consumer's base Medicare plan.
What does this mean for you?  Basically, it means that Medigap coverage could help bear costs in the following areas: insurance deductibles, copayments, and coinsurance.
If you feel your traditional Medicare plan does not offer you the coverage you need, it may be time to see what Medigap options are available for you.
It's important to know that 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.)
Remember that because Medigap is used to supplement Original Medicare plans, it can be used in situations where your traditional Part A and Part B plans don't provide coverage.
In total, there are ten Medigap plans that potential consumers should consider.  We'll discuss these plans in more depth so that you can make the decision that's right for you. 

Good to know:  Want to really know the particulars concerning a health care plan?  Request the "evidence of coverage" document associated with the plan.  The evidence of coverage document is what you need if you want to understand in perfect detail, exactly what a health care plan covers.  You will find a thorough explanation of benefits, exceptions, and exclusions.  The evidence of coverage document provides details that may not be listed in that glossy plan brochure, or any online verbiage detailing plan benefits.  In most circumstances, this document is legally required to be associated with most any health plan policy.  It is available to consumers.  You need only to ask.

Who is Eligible for Medicare Supplement Coverage in Illinois? 

To be eligible for a Medigap plan in the state of Illinois, you must meet certain requirements.  Let's take a look at the requisite conditions consumers must satisfy to successfully apply for Medigap insurance.
For starters, you must be enrolled in Medicare Part A and Part B.  If you don't have Original Medicare coverage, you will not be able to buy a supplemental plan.  Because Medigap contains only supplemental policies that you can add onto traditional Medicare coverage, you must first be enrolled in Medicare Part A and Part B to qualify.
This means that you will likely need to be age 65 or older to apply for Medigap insurance in the state of Illinois (as this is the age when most Medicare plans start).  Despite this, the state of Illinois requires Medigap insurance companies to provide at least one type of supplemental insurance to individuals who—through disability or poor health—are eligible for early Medicare. 

Knowing this, who isn't eligible for Medigap insurance?  You may think that your Medicare Advantage Plan qualifies you for Medigap.  Unfortunately, only holders of Original Medicare insurance are eligible for Medigap.  This means that if you are seeking supplemental insurance, you will have to switch your Medicare plan.
Let's take a brief look at a few insurance plans that don't offer supplemental Medigap coverage:

  • Medicare Advantage Plans—If you hold a Medicare HMO, PPO, or Private Fee-for-Service Plan, you are not eligible for Medigap insurance. 
  • Medicaid—Medicaid does not provide access to Medigap plans. 
  • Veterans' Benefits—Like Medicaid, Veterans' benefits do not give you access to supplemental Medicare coverage. 
  • —If you have a Medicare Prescription Drug Plan, keep in mind that you will need Original Medicare to be eligible for Medigap.  Unfortunately, Medigap acquisition does not mean that you can drop your Medicare Prescription Drug Plan.  Since 2006, Medigap has been barred from covering the cost of prescription drugs.  

Keeping these eligibility requirements in mind can help you decide if Medigap insurance is right for you.

Good to know:  When it comes to medical services, shop around for a better deals.  Patients often think that medical fees are set, but just like any other business, costs for goods and services can vary widely.  Shop the cost of exams, tests, procedures, medications, nursing facilities, and imaging centers before non-emergency events.  The price of an MRI on one side of Main Street can be $500, and $2,500 on the other.  Healthcare pricing, as a rule, is arbitrary.  Even the pharmacy you choose can be the difference in hundred of dollars annually.

How Does Medigap Work in the State of Illinois?

If you meet the eligibility requirements for Medigap insurance in Illinois, 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 works differently than Original Medicare, it's important you understand the differences between the two plans.
If you enroll in a Medigap plan, you will be forced to pay an additional premium on top of your existing Part B premium.  Additionally, this premium will be payed on a monthly basis.  Furthermore, these plans cover only one individual.  If you are seeking supplemental coverage for both you and your spouse, keep in mind that each member of the relationship must apply for his or her own policy.
What's more, Medigap coverage in the state of Illinois must be 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.
In the event that you need to use your health insurance, your Part A or Part B plan will cover the cost of anything included in your Original Medicare coverage.  After this, your Medigap insurance will kick in to help cover expenses not covered in your Original Medicare plan.
As long as you continue to pay your monthly Medigap premiums, you will be in no 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.
If you plan on applying for Medigap coverage, understanding these basics on how Medigap works is crucial to getting the most out of your plan.

Steps to Finding the Right Medicare Supplement Plan for You
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 can painlessly find the perfect plan.
Keep the following information in mind as you start applying for Medigap coverage. 

  • Tip #1:  Research and Choose a Medigap Plan
Northwestern Memorial Hospital - health insurance
Northwestern Memorial Hospital
251 E Huron St
Chicago, IL 60611
Telephone: (312) 926-2000
Plus Code: V9VH+VF Chicago, Illinois
Website: click here

First, you'll need to research the different Medicare Supplement plans available.  Currently, there are ten different supplement plans available: A – N.
By understanding these different plans, you can choose the one that best fits your situation. 


  • Tip #2:  Find Out the Price of Your Plan

Once you've chosen the plan that's right for you, it's time to start looking for an insurance company.  Though this may sound complicated, the good news is that the state of Illinois has made it exceptionally easy to find Medigap insurers in your area.

  • Visit the Illinois Department of Insurance.

Access the Illinois Department of Insurance website.  Here, you will find a wealth of information pertaining to a variety of different insurance options in the state of Illinois.  Use this resource for official, in-depth, insurance information.

  • Tip #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.

The Bottom Line

By taking the right precautions, you can increase your chances of being approved for a Medigap plan.  This includes researching different plans available and finding the right insurance provider in your area.
By staying informed, you can increase your approval odds, as well as choose the plan that best suits your needs.
To start applying for Medigap insurance, consider the first three steps above.  By taking advantage of this information, you can streamline your application process.  You'll also be able to enjoy a sounder peace of mind in knowing that you've chosen the plan right for you.
To do this, make sure to research different plans, find the right insurance provider, and contact them before applying.  By doing so, you can be sure to apply for Medicare Supplement plans in Illinois the right way. 

Good to know:  Just because a hospital or office is "in-network" doesn't mean all its doctors are.  Think you're covered because you took the time to make sure your hospital or doctor's office was approved as being in your network?  Think again.  It's just not that simple. Individual providers, labs, tests, specialists, and others that work within the facility may still be out of network.  Yes, exasperating, but true.  It's tedious but important to, when possible, ask everyone involved in your treatment if they are an "in network" provider.

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

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