We wish it was that easy. We could tell you “Hey, Plan X is the best plan with the best coverage and the best premium” and you could say let’s go with that and be done with choosing your plan.
Reality is that it’s a little more complicated than that. Medigap plans, or Medicare Supplement Plans, are not a one size fits all kind of deal. You need to take the time to either work with your broker, or to educate yourself as to which coverage you would prefer.
Here are a few mitigating factors when it comes down to decision time.
Unlike Medicare Advantage plans, Medigap plans do not have ratings. However, the plans are the same across the board, meaning that Plan F has the same benefits no matter which company you purchase it from. This helps when it comes to choosing your benefits package because once you narrow down your plan then you can find the best premium for your plan.
Medigap plans come in all shapes and sizes, but as of today (2018), there are only 10 standardized benefits packages which differ depending on how much of your expenses they will cover. So, generally, the more expenses the plan covers, the more expensive the plan will be.
Another way to sort through the plans is to look at the type of premium pricing the plan is listed under. There are 3 types of premium pricing are:
- Community-rated: meaning the same premium is charged to everyone regardless of age. Most Medigap professionals consider this plan to be the least expensive over time, although it does not look that way when you are initially enrolling.
- Issue-age-rated: this is based on your age when purchased. It will not go up as you age. It will only go up due to inflation.
- Attained-age rated: the premium here starts low but goes up as you age. Over time this kind of policy is the most expensive.
One last item to consider: Medigap plans can reject you or charge you more for a pre-existing condition at certain times. So basically, in all 50 states, you have guaranteed acceptance for a Medigap policy for 6 months before and 6 months after the 1st day of the month that you are enrolled in Part B and are at least 65. During this (Open Enrollment) period you cannot be turned down or be charged more because of a pre-existing condition. After this period you are only entitled to guaranteed issue Medigap in the following situations:
- Your Medicare Advantage plan shuts down or you move away from its service area.
- Your retiree plan shuts down.
- You joined Medicare Advantage at 65 but decided to switch back to original Medicare within 1 year.
- Your Medigap plan shuts down.
Although a pre-existing condition does not factor into your initial search it is something that, if you have a known pre-existing condition, could cause your premiums to go up or your application to be rejected after the open enrollment period.
Sorting through the different plans and premiums while also having to factor in a possible pre-existing condition can be quite the daunting task. Hopefully, this helps shed some light on a few of the ways you can navigate the waters of Medigap insurance plans. Now it’s all just figuring out where to start.
If you have any questions or would like some assistance with your search please do not hesitate to reach out to us at https://carolinaadvisors.com/contact/ or call us at 843-602-9584. We are always here to help!