Mind the Gap: Things to Know Before Picking the Best Medicare Supplement Plan


Whether you have just turned 65, are about to turn 65, or are looking after a loved one who already has, keeping abreast of Medicare policy changes and picking the best Medicare supplement plan can seem like a daunting task.

While the basic Medicare supplement plans (Plans A – N) are standardized at the federal government level, there are still many variations and nuances that occur at the state level.

For example, some states may charge different rates for males than they do for females; some states won’t ask questions about the applicant’s health but will make up for any incongruity with extremely high monthly benefit premiums; and other states may charge different rates for smokers than they would for non-smokers. The point is each individual state is free to determine the best way for their citizens to access Medicare supplement plans and there are different options in picking the best Medicare supplement plan for you.

As the old saying goes, the best defense is a strong offense, and the same principle holds true when it comes to applying for Medicare insurance. The best course of action is to educate yourself on your specific state’s Medicare policies and speak with a Medicare insurance specialist if you have any additional questions. That being said, however, there are still a few things you should know right off the bat.

1) Hold Your Horses! – When applying for Medicare insurance there is a required course-of-action. Before you purchase a Medicare supplement plan you must be enrolled in both Medicare Part A and Medicare Part B. What do you need to do in order to qualify for Medicare Parts A and B? Simple! Unless you’ve already become elMedicare Supplemental Gap Plansigible for Medicare because of a disability you must wait till you turn 65 and then you may apply. Another great thing about Medicare is that there is no enrollment deadline; you can apply for it at any point during the year.

2) Medicare Advantage or Medigap? –  While there are many differences between the two, the main thing to remember is that you can’t have both! Medicare supplement plans—also called “Medigap” plans—work alongside Medicare Parts A and B, filling in the gaps between what an individual needs and what their Medicare actually covers. Medigap plans are typically not HMOs or PPOs and they tend to cost a little more, however, a supplement plan will give you more freedom and fewer (if any) co-pays.

On the other hand, Medicare Advantage is a choice that exists for those who are unable to afford a Medicare supplement plan. Medicare Advantage essentially acts as a replacement for Medicare Parts A and B, but it will provide a few additional benefits that Medicare Parts A and B do not. The most important attributes to remember about Medicare Advantage are that Medicare Advantage is typically an HMO or PPO and you will have more co-pays than you would with Medigap. Which choice is best for you will depend on your specific preferences, budget, and health status, which is why it’s vital you compare Medicare supplement plans before making a final decision.

3) Still Unsure Where to Go From Here? – If you have already turned or are about to turn 65, you’ve probably been receiving mass amounts of Medicare insurance literature, which can be quite confusing. This happens for a couple reasons, one main reason being that insurance companies make huge reimbursements by enrolling individuals in their Medicare Advantage plans so if you’ve just turned 65-years old and are being inundated with material that’s mostly about Medicare Advantage, this is why. The important thing to focus on is that there are many other choices in addition to Medicare Advantage; there is a variety of Medicare supplement plans available and, of course, there is also Medicare Part D—the Medicare prescription drug plan. This is why it becomes even more crucial to compare Medicare supplement plans before making a final decision.

If you still feel like you’re on your own don’t worry! There are plenty of resources available to help steer you in the correct direction. Some places, like www.Medicare.gov, are rich with resources but answers to your specific questions may be buried among the mountains of information. This is why it is best to also consult with a national group that specializes in Medicare insurance and can quickly and correctly answer anything related to Medicare enrollment, choosing the best Medicare supplement plan—whether it’s Medicare Advantage, a Medicare supplement plan, or a Medicare Part D (prescription) plan. In addition to answering your questions and steering you in the right direction when it comes to initially choosing a course of action, these specialists will act as advocates for you through your entire relationship with them, providing a healthy buffer between you and the ever-changing Medicare red tape.

Author Bio: Simone is an independent researcher and writer for the Senior Advisors Group, a national agency specializing in Medicare insurance and Medicare supplemental plans. Simone’s focus is on health, wellness, travel, and Medicare. Her writings and opinions can be found in various industry forums and blogs.

Please Note: Articles posted by guest writers are monitored but in no way do they reflect the opinion nor is this publication affiliated in any way with the subject or promotion of a subject.