Taking the Stress Out of Financial Planning

Supplemental Medicare Coverage

by Sophie Peters

Medicare covers a significant portion of medical costs, but not all. They don't cover deductibles, copays, prescriptions, and a variety of other medical expenses. Considering how expensive medical costs are, this adds up to quite a bit of money. That's why many people get Medicare supplements to help cover these costs. As almost everyone has medical needs, especially after the age of 65, supplemental coverage is recommended for everyone who can get it. 

Qualifications

There are three qualifications to get supplemental medicare insurance:

  • Enrolled in Medicare Part A and Part B

You can opt for Medicare supplements as long as you have both Part A and Part B Medicare. Part A Medicare refers to insurance for hospital care, and Part B Medicare refers to insurance for medical costs. 

  • Over 65 or under 65 with a qualifying condition

In most cases, you must be over 65 to qualify for Medicare. However, there are certain situation in which you can get Medicare before the age of 65. People under 65 with disabilities or end stage renal disease (ESRD) also qualify. 

  • A resident of a state that offers Medicare supplemental insurance

Things Not Covered

Medigap policies don't cover:

  • dental
  • eye care
  • hearing aids
  • long-term care
  • prescriptions
  • private nursing
  • vision

If you want these types of coverage, talk to your representative about additional optional policies. Medicare Part D will cover prescriptions, and you may find things to cover the rest. Expect to pay multiple premiums for all of the coverage that you will need.  

Types of Medicare Supplemental Insurance

There are several levels of supplemental insurance. There are typically ten options ranging from the most basic plan (A) to the most inclusive (N). All policies will carry the benefits of the ones before it with additional benefits. Talk to your representative to determine which option would be the best for you and your situation. As long as you pay on time, most policies cannot be cancelled because of age or health conditions. 

How Premiums are Determined

There are generally three ways for companies to determine your premium:

  • Community-rated- These plans don't cost more based on age, and they won't increase with age. However, they can increase due to inflation and other majors. 
  • Issue-age rated- These policies base the premium on the age of the person getting the coverage. Cost will not increase as you get older. 
  • Attained-age rated- These policies will go up with age. 

Other factors that determine cost:

  • health 
  • marital status
  • zip code

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