Medicare’s Annual Enrollment Period (AEP) runs from October 15 through December 7 each year, giving Medicare beneficiaries an opportunity to review their health coverage and make changes for the coming year.
For some people, that may mean leaving a Medicare Advantage plan and returning to Original Medicare. If you’re considering that move, it’s important to understand how Medicare Supplement insurance, also known as Medigap, may fit into your coverage strategy.
Not sure where to start? You’re not alone. Medicare Supplement insurance can seem complicated at first, especially with multiple plans, enrollment rules and coverage options. Here are eight key things to know.
1. Medicare Supplement insurance only works with Original Medicare.
Medicare Supplement insurance helps pay for some of the out-of-pocket costs that Original Medicare (Parts A and B) doesn’t cover. Depending on the plan you choose, it may help with expenses such as deductibles, coinsurance and copayments.
Because Medicare Supplement plans are designed to work alongside Original Medicare, you must be enrolled in Medicare Part A and Part B to apply.
Related: Is Original Medicare Enough? Understanding Your Coverage Options
2. Medicare Supplement insurance is offered by private insurance companies.
Original Medicare is administered by the federal government, but Medicare Supplement insurance is sold by private insurers.
The good news is that Medicare Supplement plans with the same letter designation provide the same standardized benefits regardless of the insurance company offering them. However, premiums, pricing methods and customer service experiences can vary from one company to another.
That’s why it’s important to compare your options carefully and work with a knowledgeable professional who can help you evaluate plans.
3. You’ll have several plan options to consider.
Depending on where you live, there may be multiple Medicare Supplement plans available, identified by letters such as A, G and N.
Each plan offers a different level of coverage, which can make comparing options feel overwhelming. Understanding how the plans differ and how they align with your healthcare needs and budget can help you make a more informed decision.
4. There are no provider networks or referral requirements.
One feature many people appreciate about Medicare Supplement insurance is flexibility.
Like Original Medicare, Medicare Supplement plans generally allow you to see any doctor or hospital that accepts Medicare. You typically don’t need referrals to see specialists, and your coverage travels with you anywhere in the United States where Medicare is accepted.
5. Coverage is guaranteed renewable.
Once you’re enrolled, your Medicare Supplement coverage is generally guaranteed renewable as long as premiums are paid on time and the policy remains in force.
Even if your health changes over time, your coverage can’t be canceled because of health conditions, providing valuable predictability as healthcare needs evolve.
6. Your enrollment timing matters.
For many people, the best time to purchase Medicare Supplement insurance is during their Medicare Supplement Open Enrollment Period.
This six-month window begins when you’re both age 65 or older and enrolled in Medicare Part B. During this period, insurance companies generally cannot deny you coverage or charge higher premiums based on your health status.
If you apply later, you may be required to answer health questions and go through medical underwriting, and acceptance is not guaranteed unless you qualify for certain consumer protections or guaranteed issue rights.
7. Prescription drugs usually require separate coverage.
Most Medicare Supplement plans sold today do not include prescription drug coverage.
If you want help paying for prescription medications, you’ll typically need to enroll in a separate Medicare Part D prescription drug plan. Reviewing your medication needs each year can help ensure you have coverage that continues to meet your needs.
8. Filing claims is usually simple.
In most cases, Medicare processes your claim first and then automatically sends the information to your Medicare Supplement insurance company through an electronic claims crossover process. That means less paperwork for you. Just present both your Medicare card and your Medicare Supplement insurance identification card when receiving care.
Understanding Your Options
Choosing Medicare coverage isn’t always straightforward, especially when you’re comparing Original Medicare, Medicare Advantage and Medicare Supplement insurance.
If you’re considering a change during Annual Enrollment Period, taking time to understand your options can help you make more confident decisions about your healthcare coverage and potential out-of-pocket costs.
You don’t have to navigate Medicare alone. A Bankers Life agent can help answer your questions, explain your options and help you understand which solutions may fit your needs.
Want more? Check out our blog, Why Reviewing Your Medicare Plan Each Year Matters
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