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Supplement plans

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Supplement plans in Maine have to have the same benefits as all of the other plans in Maine of the Same Type.  Plan F, Plan C, Plan G, Plan N.  We can go over these plans with you and give you the choice of Cost and Company.

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Supplement plans in Maine are Community Rated.  This means that the price  does not depend on your age. 

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Are you currently on a Supplement plan?  We represent most Supplement plans and we would be happy to compare plans and pricing.

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Please Schedule a meeting over the phone or in person here.

Here are highlights about the coverage:

  • Part A coinsurance and hospital costs: All plans cover 100% of costs up to an additional 365 days after you exhaust Medicare benefits

  • Part A hospice care coinsurance or copayment: All but Plans K and L cover 100%; Plan K covers 50% and Part L covers 75% of costs

  • Part A deductible: Six Medigap plans cover 100%; three cover a lower percentage and one (Plan A) doesn’t pay for the Part A deductible

  • Skilled nursing facility care (SNF) coinsurance costs: Some Medigap plans cover 100%, while others cover a lower percentage or not at all

  • Part B coinsurance or copayment: All but Plans K and L cover 100%; Plan K covers 50%, and Part L covers 75% of costs

  • Plan B deductible: Only two plans cover 100% (Plans C and F), while the rest don’t cover the Part B deductible at all

  • Care outside of U.S.: Six Medigap plans help pay for 80% of costs; the other four don’t cover that care

  • Out-of-pocket limits: Only two Medicare Supplement plans (Plans K and L) have out-of-pocket limits, while the rest don’t have those limits

What Does Medicare Supplement Not Cover?

Medigap doesn’t cover everything. Medicare Supplement plans likely won’t cover:

  • Dental care

  • Glasses

  • Long-term care

  • Prescription drugs (you can buy a separate Part D plan for that coverage instead)

  • Private nursing

  • Vision care

Medicare Supplement companies can also deny coverage for pre-existing conditions for up to six months after you buy coverage for any conditions that were treated during the six-month look-back period before the Medigap policy begins. Following the pre-existing condition waiting period, Medigap plans must cover the pre-existing conditions.
 

How Does Medicare Supplement Work?

You must enroll in Original Medicare (Parts A and B) to get Medicare Supplement. Medicare Advantage beneficiaries aren’t eligible for Medigap.

When you receive care, the medical office sends the medical claim to Medicare, which pays what it owes. Medigap then picks up its portion if you agree to have the medical claims sent directly to the Medigap company. Once Medicare and the Medigap company pay their portions, you’ll get a bill for what you owe.

Medicare Supplement policies renew each year unless you stop paying premiums, the company goes bankrupt or out of business, or the company finds that you were untruthful on your application.

What Does Medicare Supplement Cost?

Medicare Supplement costs are between $32 and $550 per month on average. Plan F and G may be high-deductible plans and cost less than plans with comprehensive coverage.

Plan A is another low-cost plan, but it doesn’t offer as much coverage as other plans. For instance, Plan A doesn’t help pay for SNF care, the Part A deductible or Part B deductible, which is standard in other Medigap plans.

What Impacts Medigap Costs?

Costs are affected by multiple factors:

  • Age

  • Insurance company

  • Location

  • Plan type

  • Tobacco use

  • Underwriting process

Medigap companies have the option to set rates when the policy is first issued, to use the person’s current age or to not use age as a factor.
 

Who Is Eligible for Medicare Supplement?

Medicare Supplement eligibility is connected to whether you have Original Medicare coverage. If you have Parts A and B, you’re eligible to buy Medicare Supplement.

A Medigap plan helps cover out-of-pocket costs that Original Medicare doesn't pay, such as copayments, coinsurance, and deductibles, providing greater financial security. It also offers the freedom to choose healthcare providers who accept Medicare without being restricted to a network. 
 

Benefits of a Medigap Plan Comprehensive Coverage

  • Medigap plans help cover out-of-pocket costs not included in Original Medicare, such as:

    • Medicare Part A and Part B deductibles

    • Coinsurance and copayments

    • Hospital costs beyond Medicare coverage

Flexibility in Provider Choice

  • With a Medigap policy, you can choose any healthcare provider that accepts Medicare. There are no network restrictions, allowing you to see the doctors you prefer.

Guaranteed Renew-ability

  • Medigap policies are guaranteed renewable, meaning your coverage cannot be canceled as long as you pay your premiums on time. This is especially reassuring if you develop health issues later.

Considerations for Medigap Plans Premium Costs

  • Medigap plans typically come with higher monthly premiums in addition to your Medicare Part B premium. It's essential to budget for these costs.

Enrollment Restrictions

  • You can only purchase a Medigap policy without medical underwriting during your Medigap Open Enrollment Period. Missing this window may lead to higher premiums or denial of coverage.

Opinion:

Choosing a Medigap plan can provide significant financial protection and flexibility in healthcare choices. However, it's important to weigh the costs and limitations before enrolling.

What Plan F covers.  What Plan G covers.  What Plan N  covers.  choosing a Medigap plan

Let us help you choose a Medigap plan.  Plan F, Plan G, Plan N, you decide.
Which Company?  You decide.  Book a Free consultation below.

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