Frequently
Asked Questions About Medicare Supplement Insurance
Medigap FAQ
1.
What is Medicare Supplement (Medigap) Insurance?
Medicare Supplement, or “Medigap” Insurance, is a private health
insurance policy designed to help pay some or all of the costs that are not
covered by Medicare Parts A and B.
2. What Do Medicare Supplement Policies Cover?
Medicare Supplement Policies cover medical procedures approved by Medicare
and are performed at or by a Medicare Provider, but do not normally cover
procedures not approved by Medicare. (Some plans will cover some additional
expenses, such as home recovery).
3. Who is Eligibile for Medicare Supplement Insurance?
Anyone who is covered under both Medicare parts A and B is eligible for Medigap
Coverage. Insurance Companies reserve the right to set further qualification
criteria but can not exclude any person who is in an Open Enrollment or Guaranteed
Issue situation. Run an Instant
Medicare Supplement Insurance Quote to see what is available.
4. When should I apply?
The best time to buy a Medigap policy is during the 6-month period that begins
on the first day of the month in which you are both age 65 or older and enrolled
in Part B (though some states have additional open enrollment periods).
After this initial enrollment period, your option to buy a Medigap policy
may be limited, as your application could be subject to medical underwriting.
If you apply for a Medigap plan during the 6-month open enrollment period
when you first turn 65, your application is guaranteed to be accepted, regardless
of your past or present medical history.
5. What Medicare Supplement Insurance Plans are Available?
Insurance companies can only sell "standardized" Medigap policies
that offer the same benefits, regardless of which insurance company you get
it from. There are 12 different standardized policies-Plans A through
L. All companies offer the base plan (Plan A), and may or may not offer
other plans B-L.
See
Medigap Plans>>
6. What if I Have Pre-Existing Conditions?
Some Medicare Supplement Insurance Companies do have a pre-existing conditions
provision that limits their liability on previous medical problems for a pre-defined
period of time after the policy is issued. Some companies will not exercise
this option. If you were previously covered under an employer-sponsored
health plan or other Medicare Supplement policy, then the pre-existing condition
limitation may not apply.
7. Are There Pricing Differences for the Different Plans?
Yes, Medicare Supplement Insurance prices do vary depending on your zip code,
the insurance company that underwrites it, and of course the plan you choose.
8. Do I Have a Choice of Doctors and Hospitals?
Medicare Supplement Insurance does not limit you on the doctors or hospitals
that you may choose, but you do have to choose a provider that accepts Medicare.
9. How Are Claims Paid?
Because the Medicare Supplement Insurance companies link directly to Medicare,
the claims process is very easy and mostly automated. Medicare sends
a copy of the claim and how it was paid (known as a Medicare Explanation of
Benefits or MEOB) to your Medicare Supplement provider each time they pay
a claim. This insurance company uses this information to determine how
much they will pay. When
a claim is filed, you will receive a Medicare Summary Notice (MSN).
Below is a sample Medicare Summary Notice (MSN) for Part B services and information
on how to read it. The MSN is not a bill. Do not send money to
Medicare or to the provider until you get a bill.
- Date:
Date MSN was sent.
- Customer
Service Information: Who to contact with questions about the MSN. Provide
your Medicare number (3), the date of the MSN (1), and the date of the service
you have a question about (7).
-
Medicare Number: The number on your Medicare card.
-
Name and Address: If incorrect, contact the company listed in (2), and the
Social Security Administration immediately.
-
Be Informed: Messages about ways to protect yourself and Medicare from fraud
and abuse.
- Part
B Medical Insurance - Assigned Claims: Type of service. See the back of MSN
for information about assignment. (Please Note: For unassigned services, this
section is called "Part B Medical Insurance - Unassigned Claims.")
- Claim
Number: Number that identifies this specific claim.
-
Provider's Name and Address: Doctor (may show clinic, group, and/or referring
doctor) or provider's name and billing address. The referring doctor's name may
also be shown if the service was ordered or referred by another doctor. The address
shown is the billing address, which may be different from where you received the
services.
-
Dates of Service: Date service or supply was received. You may use these dates
to compare with the dates shown on the bill you receive from your doctor.
-
Amount Charged: Amount the provider billed Medicare.
-
Medicare Approved: Amount Medicare approves for this service or supply.
- Medicare
Paid Provider: Amount Medicare paid to the provider. (Please Note: For unassigned
services, this column is called "Medicare Paid You.")
-
You May Be Billed: The total amount the provider may bill you, including deductibles,
coinsurance, and non-covered charges. Medicare supplement (Medigap) policies may
pay all or part of this amount.
-
See Notes Section: If letter appears, refer to (16) for explanation.
-
This is not a bill: This is not a bill.
For a comprehensive
summary of Medicare benefits, rights and protections, and answers to the most
frequently asked questions about Medicare, download Choosing
A Medigap Policy. Medigap
Insurance in the News
(Jefferson City, MO) -- Governor Jay Nixon urged Missouri seniors to familiarize themselves with a new insurance law that goes into effect Saturday.
Publ.Date : Fri, 27 Aug 2010 16:56:48 -0700
It remains my view that the plan will cost much more than predicted, and will deliver much less than we have been promised. When this inevitable result occurs, the nation will collectively develop acute carpal tunnel syndrome from the wild finger pointing we will all be engaged in.
Publ.Date : Mon, 30 Aug 2010 02:10:10 -0700
Bill requires consumers get prorated refunds.
Publ.Date : Mon, 30 Aug 2010 08:13:52 -0700
In this case of the VA health system, socialized medicine works, but it's doubtful that it will serve as a model for health reform in the U.S. We blindly reject "socialism" without knowing what it is.
Publ.Date : Tue, 31 Aug 2010 21:01:22 -0700
Now easier to navigate, LowCostMedigap.com contains the most up to date, impartial Medigap information. The laws changed in June 2010. Do not let outdated information cost you when searching for Medicare supplemental insurance.
Publ.Date : Mon, 30 Aug 2010 00:01:00 -0700
CURLEY'S DINER POETS Offshoot of Poem Alley, group meets weekly at 7:30 p.m. at Curley's Diner, 62 W. Park Place. Call 203-327-3716. 203-348-2020 MEDASSIST/CHOICES Free help with health insurance, Medicare supplements, Medicaid, private insurance, receiving entitlements from insurance policies and filing claims.
Publ.Date : Wed, 01 Sep 2010 01:05:32 -0700
For those of us in our 50s and 60s, age 65 looks like goalpost shining in the sun. At 65, you are eligible for Medicare and can set aside worries about the cost of health care. But it's not really that simple. While Medicare can cover the lion's share of most people's medical expenses, it doesn't cover everything, and it's not entirely free. There are ways to reduce the costs, but many people ...
Publ.Date : Tue, 31 Aug 2010 11:23:26 -0700
JEFFERSON CITY - Governor Nixon touted new insurance protections for Missouri senior citizens today, one day before they go into effect. The new law guarantees customers get refunds on premiums if they change companies for long-term care and medigap insurance.
Publ.Date : Fri, 27 Aug 2010 20:35:57 -0700
SPARTA The Sussex County Department of Human Services, Division of Senior Services will host free training for volunteers who wish to become counselors for the State Health Insurance Assistance Program (SHIP).
Publ.Date : Tue, 31 Aug 2010 23:36:53 -0700
|
|
