MEDICARE SUPPLEMENTS

What are Medicare Supplement Plans?

   Like it's name suggests, a Medicare Supplement does not replace Medicare. Instead, it works in unison with it Medicare. 

   With a Medicare Supplement, Medicare is still primary. What this means is that your doctor and hospital bills first go to Medicare. Medicare processes the bill and makes payments directly to your provider. Medicare then sends the rest of the bill to your Medicare Supplement company, who also processes the bill and pays directly to your provider.

What Can a Medicare supplement do for me?

    Well, many Medicare Supplement plans are able to offer you basically Full Coverage for your doctor and hospital bills. What this means is that people who turned 65 after January 1st of 2020 are required to pay a small, 1-time, annual deductible on their Part B (Doctor) bills. For 2023, this deductible is $226. After this one time deductible, you would pay NOTHING for both your doctor and hospital bills.

   Some Medicare Supplement plans also offer you full freedom. What this means is that, as long as you are going to a doctor or hospital that accepts Medicare and you are participating in a Medicare approved service, you pay the same price regardless of what provider you go to. So for example, a blood test at your local hospital would cost you the same as a blood test at the Mayo clinic.

Wow! So what's the downside?   

    Well, with Full Coverage and Full Freedom comes Full Premiums. Prices for a Medicare Supplement vary, depending on your age, marital status, zip code etc. But for a 65 year old in Wisconsin, the premium would be in the neighborhood of $120 a month. The premium does not stay constant either, but it normally rises as the enrollee ages.

Additionally, Medicare Supplements do not include Part D Prescription Drug coverage. What this means is that when someone has a Medicare Supplement Plan, they also need a seperate Prescription Drug Plan that covers their prescription medications.

How do I enroll in a Medicare Supplement Plan?

   Well, the easiest way to enroll in a Medicare Supplement is to do so when your Medicare Part B coverage begins.

    The reason for this is that when you are first enrolled in Medicare Part B, you have what is called an Initial Enrollment Period. This period lasts from 3 months before the month your Part B starts until three months after your Part B start date. So, for example, if your Part B coverage started on April 1st, your Initial Enrollment Period would last from January 1st through July 1st.

   The Initial Enrollment Period guarantees you to be accepted into the Medicare Supplement plan of your choice. In other words, Medicare Supplement companies cannot deny your application for a Medicare Supplement plan due to health history in this 7 month period around your Part B start date.

   If you choose not to enroll in a Medicare Supplement plan during your Initial Enrollment Period, but decide later on that you would like to have a Medicare Supplement plan, you can submit an application for a Supplement at a later date. However-unless you are in a Guaranteed Issue period (for instance if you are losing group coverage or leaving a Medicare Advantage plan's service area)-you will have to go through Medical Underwritting. Underwritting is a process where the Supplement company asks you a series of questions about your health history, your medications, list of Drs you visit, recent surgeries, trips to the ER etc. and can accept or reject your application based on your answers.

   So, to summarize, Medicare Supplements work in conjunction with Medicare. Some of them offer you the freedom to see any doctor or hospital you chose-as long as they accept Medicare-or the luxury of having no deductibles or copayments for Medicare approved doctor and hospital services. You can use the Initial Enrollment Period to have guaranteed acceptance of your application, otherwise you most likely will have to pass through Medical Underwriting in order to be enrolled in the plan of your choice.

Thanks for reading! If you are interested in learning more about Medicare Supplements in Wisconsin, please give insurance brokers Paul or Vincent Vanderscheuren a call!                                                                                                                 Paul Vanderscheuren: 608-843-3118                                                                                                                                     Vincent Vanderscheuren: 920-960-9961