Medicare Supplemental Insurance is Helpful for Most


Last updated 8/21/2014 at 9:19pm | View PDF

Medicare supplemental insurance is available through many companies with a variety of plans.

For those nearing the eligibility age for Medicare of 65, it would be wise to carefully review your options of Medicare and also of supplemental insurance, said Karen Munger, an independent insurance agent in Visalia.

“In general, Medicare does not cover all the medical costs you may incur,” Munger said.

In most cases, once the deductible is met Medicare will pay 80 percent of the allowable charges for a procedure, leaving the remaining 20 percent the responsibility of the patient. In the case of hospitalization and/or surgery, this can become quite costly. And for a hospitalization longer than 60 days, Medicare coverage may be reduced or not applicable at all.

The cost of supplemental insurance, also known as Medigap policies, can vary along with what they will pay. Plans are lettered, Munger said, and coverage is uniform with all companies.

“They are standardized,” she said.

However, the costs can vary, and companies may add enticements or add-ons. Some add-ons may include annual gym memberships, or other health-related type of bonuses. Each lettered plan has different options in what they may or may not cover, with the best coverage coming from under the “F” plan. These supplemental plans probably will not cover dental work, vision checks or eyeglasses, or hearing aids.

The newly implemented Covered California health plans have no effect on Medicare or Medicare supplementation, Munger said.

For a person just entering the Medicare coverage program, it is important to get supplemental coverage right away. If there is a lapse in coverage, a health questionnaire may become required and coverage is not guaranteed, she said. This can occur whether you are becoming age eligible for Medicare or if you leave another plan, such as coverage from your employment, and starting on Medicare, regardless of your age.

Medicare supplement plans are stable, Munger said, and have automatic renewals each year.

“It doesn’t hurt to shop around,” she said, “and get the best deal you can get.”

If a gym membership or another add-on isn’t needed, then look at another company that may cost less.

And even if someone has been on Medicare for a while without supplementation, Munger said it would be wise to review the options available. Without pre-existing conditions, coverage should be granted, and some plans may offer coverage without covering a particular pre-existing condition. Insurance should be guaranteed renewal as long as premiums are paid.

For those who cannot afford supplementation, there are low-income assistance programs through MediCal. An insurance agent, or a Kings-Tulare Area Agency on Aging representative, can also provide assistance.

To contact a K-T-AAA counselor, call 1-800-434-0222.


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