Medigap - Medicare Supplement
What is Medigap Insurance?
Medigap, also known as Medicare Supplement, is insurance designed to fill the "gaps" in original Medicare coverage. It is a supplement to Medicare. Medicare Supplement plans pay deductibles and copays not covered by Medicare A or B. If you have Medicare Part A and Part B and do not have retiree health coverage you may want to consider a Medigap insurance policy. If purchased, the two will work together to pay covered health care costs. If you would like to discuss when you should apply for Medicare A and Medicare B, contact Baygroup Insurance at 410-557-7907, we will be happy to educate you. Another great resource is the Medicare and You booklet that is issued by Centers for Medicare and Medicaid.
Some examples of services that are not covered with Medicare are: hospital stays, skilled nursing services, blood, and some hospital co-payments. A Medigap plan can help pay for the out-of-pocket costs associated with these and other services.
There are many Medigap plans available (Plan A, B, C, D, F, F high-deductible, G, K, L, M and N). Plan F, High Deductible Plan F and C are only available to those that are Medicare eligible prior to 1/1/2020. We can help you understand the benefits offered by each plan and select the plan that best meets your needs. Plans F and G are the only plans that cover Part B "Excess". It is exactly like Plan F, but it doesn't cover the "Part B" deductible ($233 in 2023.
When enrolling into a Medicare Supplement and a stand-alone prescription drug plan (PDP), these will be two separate plans with two separate premiums which will each need to be paid. There will be two separate plan ID cards. There will be separate plan documents and separate benefits.
Medicare Supplement - 6 months after your Part B effective date, your health will not impact insurability. Guaranteed Issue Period is 2 months after losing Group Credible Coverage, only certain plans qualify. Other than these two periods, medical underwriting applies.
Part D - Whether you take prescription drugs or not, you should enroll in a Prescription Drug Plan during your initial enrollment period. Open enrollment is from 10/15 to 12/7, each year for the following calendar year. There is a 1% penalty calculated on the "national beneficiary base premium" which is $32.74 in 2023 for every full month that you could have been in a standalone prescription drug plan and was not. This penalty is "for life"—once you enroll the penalty will be added to your new Medicare Part D premium.
All plans are different. Medicare.gov has a terrific tool to compare various plans. We recommend you do this evaluation of plans each year. Formularies change and possibly your prescriptions have also.
Medicare Advantage - If you are unhappy with your plan, you can change to another plan or switch back to Original Medicare (and join a stand-alone Medicare Prescription Drug Plan) once during open enrollment (January 1 to March 31). Any changes you make will be effective the first of the month after the plan gets your request.
HSA's and Medicare
If you enroll in Medicare A and/or B you cannot contribute to your H.S.A, but you may withdraw money from the H.S.A. to pay medical expenses (deductibles,copays, coinsurances, A, B, D premiums and Medicare HMO premiums. However, premiums for a Medicare supplemental policy, such as Medigap, are not eligible expenses.
Reaching 65 years of age also enables you to use your funds for non-qualified medical expenses, including Medicare Supplements, with no penalties. Instead, these funds will be taxed as ordinary income.
By claiming social security benefits after age 65, an automatic retroactive coverage period for Part A is triggered. The retroactive period is limited to 6 months or the entitlement date for Medicare, whichever is shorter. H.S.A. contributions made during this Part A retroactive period may result in an IRS penalty
Nice to Know...
Some diabetes supplies and services are covered by Medicare Part B such as blood sugar (glucose) test strips, monitors, insulin if administered with an insulin pump, lancet devices and lancets. Learn more. If your diabetes supplies are covered by Medicare Part B, do not include this in your input for Medicare Part D. This may impact which Part D plan you select.
It is important to retain your Medicare card in a safe place at home. To provide proof of Medicare coverage at a medical appointment, carry your Medicare Supplement or Medicare Advantage card. You may need to take your Medicare card to a first appointment with a doctor.
Ways to reduce prescription drug cost - questions to ask pharmacist
- What the cash price is?
- Will pill splitting save me money?
- Shop around - local pharmacies may be less than chain stores
- Check out www.GoodRx.com