Ben­e­fits of own­ing a Medi­care sup­ple­ment in­sur­ance pol­icy

Record Observer - - Senior Satellite -

With all the choices you have for your health care cov­er­age, it is im­por­tant to un­der­stand how each one works, its ben­e­fits and your share of the costs. Here is a brief look at how Medi­care sup­ple­ment in­sur­ance dif­fers from other cov­er­age.

1. Low Out-of-Pocket Costs

Ev­ery year, your Medi­care sup­ple­ment in­sur­ance pol­icy ben­e­fits co­or­di­nate with your Medi­care ben­e­fits to help you meet your el­i­gi­ble health care ex­penses, de­pend­ing on the plan you choose. What’s more, you can be sure your ben­e­fits won’t de­crease.

Find out how other health plans work be­fore join­ing. Some an­nu­ally change their ben­e­fit struc­ture, which can de­crease your ben­e­fits and in­crease your out-of-pocket costs, so bud­get wisely.

2. Choose Your Doc­tors and Hospi­tals

With your Medi­care sup­ple­ment in­sur­ance pol­icy, you alone se­lect all of your health care providers to use when­ever and wherever you choose. You don’t have to worry about your doc­tor or hos­pi­tal leav­ing a provider net­work at any time. And, you never need a re­fer­ral to see a spe­cial­ist.

Other health care plans may have lo­cal net­works that pos­si­bly could pre­vent you from re­ceiv­ing care from the peo­ple you’ve grown to know and trust. Read each plan closely. Some let you see any­one as long as the provider ac­cepts the plan’s pay­ment terms. Oth­ers let you go out­side the net­work, but you pay for ser­vices yourself and usu­ally pay more for them. Providers can leave and join net­works.

3. Cov­er­age Re­new­able

Your Medi­care sup­ple­ment in­sur­ance pol­icy can­not be can­celed. It will be re­newed as long as you pay the pre­mi­ums on time and is Guar­an­teed make no ma­te­rial mis­rep­re­sen­ta­tions (pre­mi­ums are sub­ject to change).

Con­tracts be­tween the gov­ern­ment and some health plans are re­viewed an­nu­ally. As a re­sult, plans may change or not be re­newed, forc­ing mem­bers to choose another health care op­tion.

4. Providers Ac­cept Pa­tients with Medi­care Sup­ple­ment In­sur­ance

Your Medi­care sup­ple­ment pol­icy en­ables you to see any doc­tor or provider who ac­cepts Medi­care.

On the other hand, not all providers in a health plan net­work take new pa­tients or ac­cept its pay­ment terms. Talk with your doc­tors about their re­la­tion­ship with a health plan be­fore join­ing.

5. Your Cov­er­age Goes With You

Just like Medi­care, your Medi­care sup­ple­ment in­sur­ance cov­ers your health care needs any­where in the United States. Some Medi­care sup­ple­ment in­sur­ance plans even pro­vide limited med­i­cally nec­es­sary emer­gency care out­side the coun­try. That way, you may travel with con­fi­dence or live part of the year any­where you choose.

With some other health care plans, there may be charges for care no mat­ter where you go. Care­fully check all the plan’s travel rules and re­stric­tions. Guar­an­teed Is­sue

Cov­er­age Some­times when you ap­ply for Medi­care sup­ple­ment in­sur­ance cov­er­age, you don’t an­swer any ques­tions about your health and your pol­icy is guar­an­teed is­sue. One time is dur­ing your Medi­care open en­roll­ment pe­riod. Some other times are when*:

1. You or your Medi­care Ad­van­tage/Pri­vate Fee for Ser­vice Plan move out of the ser­vice area.

2. Your em­ployer dis­con­tin­ues its group re­tiree health cov­er­age

3. You leave a Medi­care Ad­van­tage plan within a year of join­ing.

*For more sit­u­a­tions, see the Guide to Health In­sur­ance for Peo­ple with Medi­care

Medi­care Medi­care pays a por­tion of your health care costs for hos­pi­tal­iza­tion, skilled nurs­ing fa­cil­ity care and physi­cian’s ser­vices and sup­plies. How­ever, it does not pay all of your ex­penses and re­quires you to pay de­ductibles and coin­sur­ance for many ser­vices.

A Medi­care sup­ple­ment in­sur­ance pol­icy can help pay some of the charges Medi­care doesn’t cover.

For more than 40 years, Medi­care has been a sta­ble in­sur­ance pro­gram for mil­lions of Amer­i­cans. Con­se­quently, Medi­care sup­ple­ment in­sur­ance plans have played a sig­nif­i­cant role along­side Medi­care. Folks like this com­bi­na­tion be­cause Medi­care sup­ple­ment in­sur­ance is sim­ple to un­der­stand, af­ford­able, of­fers na­tion­wide cov­er­age and al­lows pol­i­cy­hold­ers to keep their health care providers.

Mike Zim­mer is Pres­i­dent of Bay State In­sur­ance Agency Ltd. in Centreville. He may be reached at 410758-1680.


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