Medicare Supplement Enrollment

Medicare Supplement Enrollment

Pays in addition to Original Medicare

A popular choice is a Medicare Supplement plan.  Because CHOICE MATTERS and sometimes you need and want additional coverage beyond your Original Medicare coverage, this is where Medicare Supplemental plans come in.

MEDICARE SUPPLEMENT OPEN ENROLLMENT 

The best time to buy a Medicare Supplement plan is during the six-month Open Enrollment Period. Open Enrollment automatically starts the month an individual turns age 65, and is enrolled in Part B. Applications submitted during Open Enrollment are approved guarantee issue regardless of your health status.

This means if you have a health condition, insurers cannot 1) refuse to sell you a policy, 2) impose a waiting period before benefits begin or 3) charge you extra premium for your policy.

Supplemental Enrollment Period

MEDICARE SUPPLEMENTAL PLANS

There are multiple private insurance companies who offer Medicare Supplemental plans. Ebpcolorado.com represents top-rated insurance companies, including Aetna, Anthem, CIGNA, Humana, and UnitedHealthCare (Sponsored by AARP).  Medicare Supplemental plans are standardized (A-L). Each plan has a different set of basic and extra benefits.  Not all companies or states offer all plans.  While benefits are standardized, insurance companies may have different rating methods.

Consider the following information before enrolling in a Medicare Supplemental plan.  This is a partial list of the some of the features of a Medicare Supplemental plan. Please refer to the appropriate insurer’s enrollment literature for a complete list of plans offered, benefits, and features.  For advice on how you can effortlessly buy a policy, click here_____.

  • Medicare Supplemental plans are voluntary.
  • Medicare Supplemental plan members can receive care from any provider who ACCEPTS MEDICARE, regardless of their geographical location if they are accepting new patients.
  • Some Medicare Supplemental plans have No Copays, Coinsurance or Deductibles, and some do.
  • No Referrals are required. Members can self-refer to any provider who ACCEPTS MEDICARE.
  • Individuals who apply for a Medicare Supplemental plan within six months after Turning Age 65, have GUARANTEE ISSUE coverage, regardless of their health
  • Individuals who apply for a Medicare Supplemental plan six months AFTER turning age 65 are medically screened. On a case by case basis, applications may be accepted, rated-upB , or denied.
  • Medicare Supplemental plans do not cover prescription drugs. Applicants who want and need prescription drug coverage, must apply for a stand-alone Rx plan, called a PDP plan.
  • Again, Medicare Supplemental plan are standardized. For a list of the Medicare Supplemental plans in Colorado, click here_____.
  • Not all companies and states offer all available plans.
  • The premiums for Medicare Supplemental plans are based on the applicant’s age, smoking status, gender, and geographical location. The premium may increase in subsequent years.
  • Medicare Supplemental plans pay in addition to Original Medicare benefits.
  • Some Medicare Supplemental plans offer worldwide emergency coverage.
  • Medicare Supplemental plans ARE NOT Medicare Advantage plans.
  • Medicare Supplemental plans are guaranteed renewable as long as you pay your premium.

Some benefits not covered by Medicare Supplemental plans include:

  • Long-term care
  • Vision care
  • Dental care
  • Hearing aids
  • Private-duty nursing
  • Outpatient prescription drugs

The above benefits may be offered separately by private insurance companies.

PART D PRESCRIPTION DRUG PLANS (PDP) ENROLLMENT

WHEN CAN I ENROLL?

  1. During your Initial Enrollment Period (IEP)

Eligible individuals can enroll three months before their birthday month, during their birthday month, or three months after their birthday month.  This is a seven-month enrollment period.  This enrollment period is for Medicare Part A and Part B, as well as for Medicare Advantage (MA, MAPD), and prescription drug (PDP) coverage.

enroll-period-1075x118-new-note

EWorking individuals, age 65 or older, have different enrollment periods for Parts D if they are covered under a union or employer’s group plan. Their enrollment period begins when the individual retires or terminates coverage, whichever occurs first. Reference section, WHAT IF I’M COVERED BY A UNION, OR EMPLOYER’S GROUP PLAN?

 

  1. During the Annual Election Period (October 15 thru December 7), for a January 1 effective date.
  1. During a Special Enrollment Period. Reference SEP section.

DOES “MEDICARE” REQUIRE A PREMIUM FOR A STAND-ALONE PRESCRIPTION (RX]) PLAN?

Yes.  Under Medicare you pay a premium if your modified adjusted gross income is $85,000 (individual) or $170,000 (joint) or greater as reported on your IRS tax return.  If applicable, the appropriate premium is automatically deducted from your Social Security benefit, or paid through direct quarterly billing by your insurance company.

  • You may also check with Social Security to determine what this premium is, if applicable.
    • Contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778) 7 AM to 7 PM Monday-Friday for information.

 

 

PRESCRIPTION DRUG PLANS (PDP)

Under your Medicare coverage, you may need and want separate coverage for prescription medications. You can buy a PDP plan as a stand-alone prescription drug plan.

  • PDP plans are optional.
  • Individuals must live in a service area covered by the plan.
  • Individuals must be enrolled in Medicare Part A and/or Part B to be eligible.
  • Offered by private insurance companies.
  • Individuals enrolled in Veterans medical coverage, may choose to enroll in a stand-alone PDP plan to obtain Rx coverage.
  • Individuals enrolled in a Medical Supplemental plan may choose to enroll in a stand-alone PDP plan to obtain Rx coverage.
  • Individuals enrolled in a MA or MADP plan may not choose to enroll in a stand-alone PDP plan.
  • Some Medicare Advantage plans include prescription drug coverage, some do not. This is an important distinction.

A Individuals who have worked less than 40 quarters can enroll in Medicare Part A.  The premium depends on how many quarters the individual has worked.  The average monthly premium for Part A coverage is $413.

B Premiums may increase.

C Reference insurance company’s literature for a complete list of preventive care benefits paid at 100%.

D Your or your spouse’s union or employer group plan.

E Different enrollment periods (Part B and D) apply for working individuals age 65 or older.

FIf your Medicare Supplemental enrollment application is submitted six months after your Initial Enrollment Period.

 

Helpful Links

Centers for Medicare and Medicaid Services www.cms.gov

Medicare & You Handbook www.medicare.gov/publications/pubs/pdf/10050.pdf

Your Medicare Benefits www.medicare.gov/publications/pubs/pdf/10116.pdf

 

By design, the information on this web site is incomplete and is meant as a “summary only” of the some of the key decision points when enrolling in original Medicare, Medicare Advantage, PDP, or Medicare Supplemental plans. The purpose of this information is educational, and to sell Medicare Supplemental, Medicare Advantage (MA, MAPD), and Prescription Drug plans (PDP).  Upon request ebpcolorado.com will research any questions and concerns you may have.  Contact 303-290-9226. Thank you.

Ebpcolorado is a licensed health insurance broker certified to sell Medicare products.

There is absolutely no substitute for right choices that put a smile on your face. Ebpcolorado is passionate about our services.  Association with us means incredible products and personalized hands-on help, and incredible products and personalized hands-on help JUST MAKES SENSE. Customize your choices today.