A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can pay certain health care costs that Original Medicare doesn't cover, such as copayments, coinsurance, and deductibles. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
Medigap policies are very different from Medicare Advantage Plans. These Medicare Advantage plans, also known as Part C, are an alternative way to receive Medicare benefits. Medigap policies supplement Original Medicare benefits.
Plans of a letter name offer identical benefits to all other Medigap plans sold by that same name, even when sold by other carriers. In other words, they are "standardized". Cost is the primary difference when comparing options.
When to Change Plans
In Oregon, Medicare beneficiaries can change plans and carriers at any time of the year if they qualify medically. If applicants cannot qualify medically to move to a new Plan (normally to obtain a lower premium), Oregon provides a 30 day "birthday window" each year where a new policy may be obtained without medical underwriting. The approval of the new policy is guaranteed, as long as certain conditions are met. This law went into effect on January 1, 2013 and is known as the "Oregon Birthday Rule".
Coverage and Cost Control
Two very important questions everyone with a Medicare Supplement should ask themselves are 1) how much coverage do I want/need and 2) am I overpaying for that coverage? For example, we have found that it rarely makes sense for our clients to stay on Plan F. Not only will Plan F be discontinued on Jan. 1, 2020 (for new applicants) but we expect prices to rise faster than they do with other Plans. For those wanting a high level of coverage, we normally recommend looking closely at Plan G.
When we talk about overpaying for coverage, we're referring to the Standardization of Medigap Plans. Plan G with carrier X has identical coverage to Plan G with carrier Y. But premiums can vary substantially. Our process utilizes a "quote engine", which allows us to compare prices from all carriers doing business in a given area. If you're concerned about rising costs or just want to keep on top of price increases in the future, we invite you to submit a request for a free quote. Click the link below. We promise to never pressure you. That's not how we operate here.