Medicare Supplemental Insurance Plans in TN
(OFTEN REFERRED TO AS MEDIGAP PLANS)
At The Grace Agency LLC in TN, it is navigating healthcare coverage, especially as you age, can feel overwhelming. Medicare is a vital resource, but it often leaves gaps in coverage that could lead to unexpected out-of-pocket expenses. That’s where Medicare supplemental insurance plans come in.
How The Grace Agency Can Help
Our team is here to help you understand the right Medicare supplemental plans, also known as Medigap, to ensure you have the coverage you need. We will take the time to understand your situation.
At The Grace Agency, we treat every client like family. By enrolling in the right Medicare supplemental insurance plan, you can protect yourself from the financial burden of unforeseen medical expenses and get the comprehensive care you deserve.
We know that every individual has different needs, so we offer plans tailored to your specific health and financial circumstances. Our goal is to ensure you have a clear understanding of your options.
We're here to help you every step of the way, so contact us today.
Medicare Supplemental Insurance, or "Medigap," is a type of private insurance designed to help cover some of the costs that Original Medicare doesn't, such as copayments, coinsurance, and deductibles. These plans usually only cover the 20 percent gap that Original Medicare doesn't cover without any additional benefits. Medigap plans are labeled with letters (A,B,C,D,F,G,K,L,M & N) and each lettered plan offers a different combination of benefits. These plans are standardized in most states, meaning each plan with the same letter (like Plan A or Plan G) offers the same basic benefits, regardless of which insurance company sells it. However premiums may vary between companies and locations. Plan A covers basic benefits like Part A coinsurance, hospital costs and Part B coinsurance. Plan F and G offer the most comprehensive coverage ( Plan F is only available to those eligible for Medicare before January 1, 2020). Supplemental plans are popular for people who do not want to be limited to a network of doctors or their doctor is not in any network. On a Supplemental plan you can see any doctor who accepts Medicare. Supplemental Plans also charge a monthly premium that can and most of the time will increase yearly so it is important to compare rates in your area annually.
Key Points:
- Available Plans: Medigap plans are labeled A through N, each offering a different combination of benefits.
- Eligibility: You must have Medicare Part A and Part B to purchase a Medigap plan.
- Premiums: You pay a monthly premium to a private insurance company for your Medigap policy, in addition to your Part B premium. These monthly premiums are typically higher but with NO OR LOWER out of pocket costs for Medical services when you receive them.
- Coverage: Medigap policies do not come with prescription drug coverage, so you need to purchase a separate Part D prescription drug plan to avoid a 1% late enrollment penalty. Prescription drug plans cost an additional monthly premium. Supplemental plans also do not cover the annual Part B deductible of $240 dollars.
- Standardization: All Medigap plans are standardized, meaning Plan A offers the same coverage, regardless of which company sells it.
- Doctor and Hospital Network: Supplemental plans have no network restrictions; you can see any doctor, specialist or hospital who accepts Medicare.
- Travel: Medicare Supplemental Plans offer coverage anywhere in the U.S. where Medicare is accepted. Some Supplemental plans may cover emergency care outside of the United States, depending on the plan you choose.
What to know about Guaranteed Issue Rights
Guaranteed Issue rights are protections that ensure you can buy a medigap policy in certain situations, without being denied access or charged a higher premium due to pre-existing conditions.
Here’s when they apply:
- During your Medigap Open Enrollment Period:This is a six-month period that begins the month you turn 65 and are enrolled in Part B. During this period, you have a guaranteed right to buy any Medigap plan sold in your state regardless of any pre-existing conditions.
- If you have a guaranteed issue right: You can buy a Medigap policy even if you have health problems. During the guaranteed issue Open Enrollment Period (OEP), insurance insurance companies cannot charge you higher premiums due to past or present health conditions.
- Special Election Period (SEP):This election is used if you gain or have any change of level in your Low Income Subsidy (LIS) or Medicaid status. It can be used if you lose your current health coverage, such as when an employer stops providing health insurance, or if your Medicare Advantage plan stops coverage or you move out of its service area. If your Medigap insurance company goes bankrupt or misled you, you have a guaranteed SEP to get a new plan. If you move out of your Medicare SELECT plan’s service area, you can use an SEP to switch to a different Medigap plan. These SEPs usually have specific timeframes, typically 63 days from the loss of coverage or other qualifying events, during which you must apply for a new Medigap plan to have guaranteed issue rights.
- Medicare Advantage Trial Rights: If you joined a Medicare Advantage plan when you were first eligible for Medicare at age 65, you have a trial right for the first year. If you choose to switch back to Original Medicare within the first 12 months, you have a guaranteed right to buy a Medigap plan.
When should you consider a Supplemental Plan?
- If you want predictable out-of-pocket costs for medical services.
- If you frequently visit doctors, specialists or hospitals and need coverage for copays and deductibles.
- If you travel frequently and want coverage anywhere in the U.S.
- If you don’t want the network restrictions of Medicare Advantage Plans.
Click here To learn about Medicare Advantage
CALL: 866-768-3813 to speak to a licensed agent today!
Calling the number above will direct you to a licensed sales agent. The information above is a brief summer. Visit medicare.gov for more. The benefit information provided on this website is a brief summary, not a complete description of benefits and you must continue to pay your Medicare Part B premium. Limitations, copayments and restrictions may apply. Benefits, formulary, pharmacy network premium and/or copayments/co-insurance may change on January 1 of each year.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact State Health Insurance Program ( SHIP’s ) 1-877-839-2675, medicare.gov or 1-800-MEDICARE to get information on all your options. Carrier Plans are contracted with Medicare for HMO, PPO and PDP plans and with select State Medicaid programs. Enrollment in many Medicare Plans depends on contract renewal.