Medicare Supplements

Braking Down Medicare Supplement Talk

The Medicare Supplement marketplace is difficult for many seniors to understand, and many choose the Medicare Advantage route due mainly to a lower or no monthly premium and extra benefits.

Supplement in English means in addition to so the Medicare Supplement is a plan you add on to your Medicare. Meaning that Medicare pays first, and your supplemental plan pays second and the plan name or letter determines how much your plan pays.

Medicare supplements are considered private insurance meaning the government is not in control of the pricing, but they do control the benefits. This is difficult for the average senior to understand so this blog will hopefully answer many questions. If there are still questions, please feel free to call or email me. My contact information is listed below.

The Barend Agency Inc. Las Vegas NV
Medicare Supplement Professional – The Barend Agency Inc. Las Vegas NV

Medicare supplement benefits are standard throughout America meaning that all plans A, B C, F, G, etc. have the same benefits by letter. All plan G’s have the same benefits designed specifically for that plan. Same with all the other supplements. So, if you bought a plan G in New York, Georgia, or California the plan design will be the same. The pricing differs by region and insurance carrier. Pricing also changes by state or even county.

Those seniors aging into Medicare can purchase a Medicare Supplement with guaranteed issue. Meaning, regardless of your health, the plan issues your policy at their best rate. You could literally be on your death bed and the insurance company must issue you the policy with no medical questions asked. Once your initial enrollment period of 8 months following your 65th birthday expires, these plans can underwrite you and raise the premium or decline you based on your medical conditions.

Special Circumstances

There are other special circumstances where guaranteed issue is available regardless of age and that usually means you continued working and had coverage from your employer with more than 20 employees. In those cases, you still get guaranteed issues regardless of your age. If your employer has less than 20 employees, you are required by law to go onto Medicare.

Supplements Are Considered Private Insurance

Medicare Supplements are considered private insurance and have different rules and regulations. The one I particularly like is the ability to go to any doctor, any hospital if they take Medicare. The flexibility to go to the Mayo Clinic, Sloane Kettering, Debakey in Houston or other world-famous healthcare institutes makes the supplement more appealing to those that can afford the monthly supplemental premiums.

Realizing these sets of rules is very confusing for the average senior with no insurance background so suggest you seek out an experienced Medicare insurance broker or agent and seek help. These professionals cannot charge you a fee so you pay the same rate you would by going directly to the insurance carrier. The difference is these insurance brokers or agents offer many different plans while insurance companies will only offer you their plans, thus limiting your options.

There are significant differences between the Medicare Supplement and Medicare Advantage plans. The supplement allows you to go to any doctor, or any hospital anywhere in the US if they take Medicare.

The Medicare Advantage plans usually have a network of doctors in your area and nationwide that you can see but, in some plans, you still cannot go out of network. Supplements do not have networks, and that flexibility is one of the main reasons why seniors choose a supplement over an Advantage plan.

Personally, as many of you know from reading my blogs that I have Rheumatoid Arthritis and have a supplement because of the doctor’s choice and how the insurance pays. I get a shot once a month for the disease which costs $4000 per month. Between Medicare and my supplement, that bill is covered, and I pay nothing other than the monthly premium for the supplement. If I had an advantage plan, I’d pay 20% of the cost of the medication or $800 per month. My supplement is less than ½ of that cost, so I have the choice and freedom and get the needed medication as well.

As you can see, there are many reasons to choose a supplement over a Medicare Advantage plan for seniors who want the freedom of choice of doctors anywhere in the US, specific medications, or other more personal reasons. That’s the benefit of choice.

Speak To Medicare Broker

My suggestion is to speak with a Medicare broker or several if you feel the necessity and get an understanding of each plan and the benefits and downsides of each plan and choose wisely. Remember, regarding the supplements you have a guaranteed issue for 8 months and then you must go through underwriting.

The other thought most seniors are thinking I get my supplement but what happens several years down the road the cost is more than I can pay.

Well, here in Nevada there are two choices. We have a law called the birthday rule (which I wrote with another broker and got it passed and signed into law). It allows you to change your supplement plan during your birthday month and the month after to another supplement without underwriting so it’s a guaranteed issue. Only 6 states have this rule, so it is a very significant benefit for Nevada residents.

The other option is to go onto a Medicare Advantage plan. In Clark County Nevada there are 84 different plans. The average senior with little or no understanding of insurance will get lost in reviewing their options. That’s why a licensed Medicare broker is your best option.

Remember, we cannot charge for our services as the insurance company pays us directly. By the way, you cannot buy these plans and pay less by going directly to the insurance company. Same monthly premium either way.

Closing Summary

In summary, Medicare Supplements are an excellent choice for those seniors who have specific medical needs or those with the ability to pay those monthly premiums. It is not for everyone so choose carefully and get the assistance needed to make the best choice for yourself.

I hope this information is useful and if anyone has questions, please contact me via phone or email and I will respond quickly.

Also, take a look at Medicare 2023 Information.

The Barend Agency

The Barend Agency Inc.

Len Barend, Broker