Understanding and using your Medicare coverage can be a difficult process. Often individuals are surprised to find that Medicare doesn’t cover certain services and may incur out-of-pocket expenses. This is one reason that consumers seek out Medicare Supplements, also known as Medigaps.
Available in all states, Medigaps provide coverage for some items that traditional Medicare (Part A and Part B) does not cover. This can include services and procedures, as well as certain out-of-pocket expenses. All Medigaps provide the same core benefits, but there may be variation policy to policy.
Despite their added benefits and flexibility, Medicare supplements are highly regulated and follow many of the same requirements that traditional Medicare does, making them useful for the consumer, but no less complicated.
Medigaps involve an open enrollment period for guaranteed coverage; outside this OEP, options may be limited and subject to medical underwriting. For most individuals, their Medigap open enrollment period begins once they are enrolled in Medicare Part B and will last for six months. This means that many individuals will only have one shot to get their supplemental coverage right.
As an experienced Medicare supplement provider, I work with my clients to find their best Medigap options. It is important to consider your total retirement picture as you make this decision and to have a dedicated financial professional to guide you through the process.
Parts of Medicare
- Part A – Hospital Insurance (such as Hospital Care, Skilled Nursing Facility Care, Nursing Home Care, and Hospice)
- Part B – Medical Insurance (Medically Necessary Services and Preventive Services)
- Part C – Medicare Advantage Plans (Medicare Benefits offered by private organizations)
- Part D – Prescription Drug Plans
Medicare Part A and Medicare Part B are often referred together as Traditional Medicare
Initial Enrollment Period
A beneficiary’s Initial Enrollment Period (IEP) begins 3-months before turning age 65, the month they turn 65s, and the three months after, for a total of seven months.
Waiting until the month an individual turns 65 may cause a delay in Part B (Medical Insurance) coverage.
Not signing up for Part B coverage when first eligible may cause a beneficiary to face a late-enrollment penalty for when Part B coverage is claimed.
Open Enrollment Period
Oct. 15th – Dec. 7th
During the Open Enrollment Period (OEP), all Medicare beneficiaries can change their Medicare health plans and prescription drug coverage.
For most beneficiaries, Medigap OEP lasts from the first day of the month they turn 65 or older and enroll in Part B, lasting six months.