2017-2018 Medicare Insurance Enrollment Period – Are You Prepared?
Medigap Insurance 2017 for Seniors in Grindstone, PA
Overtime, we plan to expand this site into a large hub of Medicare resources that you can use to make the best decision for you and your family. Whether it’s reading an article or contacting an insurance broker, we aim to provide you the necessary resources to accomplish your goals. We would like everyone to be able to access this information freely and easily, so please check back frequently to learn more about the various options available to you.
You may be thinking – what’s the difference between Medicare and Medigap? What is the difference between Medicare Advantage and Medigap? What is the Medicare donut hole for Part D? These are all perfectly reasonable questions that many people aged 65 and up have when they are trying to determine the type of plan or insurance that they should elect during enrollment. It can be a daunting task because there are many things to consider such as your current health, your financial situation, retirement planning, and whether or not you will also need life insurance. Fortunately, there are experts available to answer your questions so that you can feel relieved that you are selecting the best medigap plan for your needs.
We also encourage you to get your family members involved. Sons, daughters, brothers and sisters should help you in your effort to secure a better future where all of your needs are met at the best price.
Insurance Agents That Serve 15442
One of the first things you should do is contact a broker when searching for the right Medicare benefits. There are a variety of plans on the market with different benefits and you could end up spending a lot of money without getting the benefits you originally planned to receive. You could also be missing out on insurance coverage that could have been easily identified had you worked with an insurance agent!
BGA Insurance Group helps seniors in Philadelphia find a Medicare supplement plan that’s right for their needs. They also offer retirement planning, long-term care and financial consulting.
One of the initial decisions you will want to make is whether or not you are going to continue working after age 65 or if you will retire. You will lose your employer benefits if you decide to retire and would therefore need to signup for Medicare Part B. Once you hit age 65, you will receive a Medicare card in the mail with you name and Medicare number effective for Part A. There will not be a premium for Part A but there is a premium for Part B.
Speaking to an agent first can allow you to correctly identify all of your needs and align them with the best possible plan. You will always need to take the correct steps to signup for Part B if needed, and an insurance agent can help you walk through enrollment!
Geriatric Expertise – Senior Planning
The Aging Adult guide is the leading provider of geriatric Medicare assistance and health plans. We can help any seniors involved with geriatric psychology, mental health issues, declining health and special needs.
Let’s Break it Down
Medigap is private health insurance that is standardized by the government and helps pay healthcare costs that are not covered under Medicare. The various Medigap plans will cover different services and costs.
In general there are a few ideas to understand when learning about Medigap policies in Pennsylvania:
- Medigap is a form of private health insurance that you may buy on your own. It “fills in the gaps” of your Medicare coverage
- If you have elected to go with Medicare Part C (Medicare Advantage), then you are not able to select Medigap in Grindstone
- You will need to purchase a plan for yourself and your spouse on an individual basis
In order to purchase one of these supplements, you must first have Medicare Parts A & B. The private insurance that you will obtain will help you with some of the related healthcare costs that are not covered by Medicare such as deductibles, co-payments, and coinsurance. When you have a medical expense, Medicare Parts A & B will take care of any approved amounts first, and then your Medigap policy will pay the part that it covers.
It is important to understand that each Medigap plan covers a different set of services and costs. In general, Medigap policies do not cover long-term care, dental, vision, eyeglasses, hearing aids, or private-duty nursing. Make sure you understand the details of any insurance coverage that you are considering so that you understand the specific details about what is or is not covered in Pennsylvania.
Also, these plans do not have any networks, and they do not require any referrals. If a physician accepts Medicare, then he or she will accept a supplement. These plans do not include prescription drug coverage.
Private Insurance Companies Serving Grindstone
Private insurance companies handle the providing of Medigap policies. These companies may charge differently for a policy, but the benefits remain the same. For example, if you sign up for plan B, it will always have the same specific benefits regardless of which company sells it.
In terms of costs, you will be responsible for a monthly premium. The insurance company will set its pricing that are subject to approval from the PA Insurance Department. Here are some helpful ways to consider how the policies are designed:
- With community-rated pricing, the premium is not determined by your age
- The same premium is charged to all participants
- Age-specific premiums – if you buy the coverage while you are younger, you will pay a lower premium. If you buy it when you become older, you will pay a higher premium
- Attained age premiums are available and will increase as you get older. In many cases, these will start out as the least expensive but may become the most expensive as you age. For the most part, premiums may increase simply due to inflation and other factors each year
There are additional factors that can impact the pricing of your Medigap policy:
- High-deductible option (Plan F) – If you buy the plan that has the high deductible option, you will be responsible for all deductibles, coinsurance, and co-payments each year until you have reached the high deductible, at which point the policy will take over and cover your benefits. The Consumer Price Index has a direct influence, and the deductible will adjust accordingly each year. The premium for this policy can be much lower than other plans that do not incorporate the high deductible plan.
- Medical Underwriting – When deciding how much to charge you for insurance, the insurance company will consider your medical history. During your open enrollment period, companies may or may not use medical underwriting.
- Some insurance companies will offer discounts if you are a non-smoker for example. You might be able to pay your premium yearly as opposed to monthly, purchasing a policy for your spouse as well as yourself, or having multiple policies that might include long-term care policy
- Medicare SELECT – Certain hospitals or certain doctors are required under these policies (with the exception of emergencies) and are available for all Medigap plans. SELECT plans usually require a lower premium and if you don’t use a SELECT provider you usually have to pay all or some of what Medicare does not pay. Not all companies will offer Medicare SELECT
Open enrollment periods and guaranteed issue rights can also affect your premium depending where you live in Pennsylvania.
Open Enrollment 2018 – When Does It Start for Seniors in Grindstone?
There is an open enrollment period specific to each individual. It will begin on the first day of the month in which you enrolled in Medicare Part B. This period will last for six months and during this time an insurance company must offer all plans that it offers and may not use your medical history or medical underwriting to refuse to sell you a policy or charge you more. They also may not make you wait for benefits to start although sometimes they might make you wait for coverage if you have a pre-existing condition.
During the first six months of your coverage, some pre-existing medical conditions may not be covered unless you had prior coverage such as Medical Assistance, individual health insurance, Medicare or group health insurance in the area 15442.
You will get the best price for a Medigap policy during your open enrollment period. This enrollment period is different than open enrollment for Medicare Advantage Plans.
Important Facts About PA Medigap
- Medicare Parts A & B are mandatory
- You must drop a Medicare Advantage Plan (Part C) before your Medigap policy starts
- In addition to your monthly Part B premium, you will be required to pay the private insurance company a monthly premium for Medigap
- Only one person is covered. If you and a spouse want coverage, you must buy a separate policy
- You are permitted to buy a policy from any licensed insurance company in Pennsylvania
- Standardized Medigap policies are guaranteed renewable even if you have a medical problem. The insurance company is not permitted to cancel your policy as long as your premium is paid
- In the past, some policies covered prescription drugs, but anything sold after January 1st, 2006 does not include prescription drug coverage. You can join Medicare Part D if you need a prescription drug plan
- If you have a Medicare Medical Savings Plan (MSA), it is against the law for anyone to sell you a Medigap policy
FAQs Common for PA
I changed my mind after receiving my current plan – what should I do?
You may review your policy for 30 days once you obtain it. Within this timeframe, you may return it, and the insurance company will refund the premium in full.
If I have Medicare Part C (Advantage) but will be returning to Original Medicare – can I sign up for Medigap?
You may apply for a Medigap plan before you Medicare Advantage plan ends.
I have end-stage renal disease (ESRD) or disability but am under age 65. Can I select a Medigap policy?
Insurance companies in PA are required to sell you a policy if you are within your open enrollment period.
Can I cancel my policy?
You must contact your insurance company directly to cancel your plan, and your insurance agent may not do this for you.
If I have health problems, is there a risk that my insurance company will cancel my policy?
Standardized policies are guaranteed renewable. As long as you pay the premium the company cannot cancel your plan.
Do these policies cover Rx drugs?
Any policy purchased after January 1, 2006, does not include prescription drug coverage. You must join Medicare Part D to receive this benefit.
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The post Medicare Premiums 2017-2018 for Grindstone Pennsylvania originally appeared on The Aging Adult Guide