Medigap plans in Connecticut (Also called Medicare Supplement) confuse many people but it is actually very simple to understand once you understand the key points. This post is intended to provide a general overview of “Medigap” to help consumers make an educated decision when choosing one. We will start with the basics of the things you need to know about Medigap plans and then touch on the basics.
HOW A MEDIGAP PLAN WORKS:
The first thing to understand is how a Medigap plan works. A medigap plan works as a secondary coverage to Medicare A and B (also called original Medicare). Original Medicare parts A and B provide coverage for Medical Services. In general, original Medicare coverage 80% of medical costs. The Medicare supplement plan covers what original Medicare does not. As a result, medical providers will bill orginal Medicare and the cost share (patient responsibility) is then sent over to the Medigap company.
WHAT MEDIGAP COVERS:
Medigap plans will only provide coverage on benefits that original Medicare covers to some extent. If Medicare does not provide any coverage for a procedure, the Medigap plan also will not provide coverage (There are some exceptions to this). There are a number of different plan in CT with plans A – M offered. Each lettered plan covers a different percentage of the costs that original Medicare does not cover. Some plans cover everything that Medicare doesn’t such as Plan F. Others only cover 75% such as plan L.
Supplements in the state of Connecticut are standardized which makes life much easier when choosing a plan. This means that they plans can not vary in the benefits they provide. For example, if you purchase a Plan F supplement, the coverage will be the same regardless of the company you choose. The only difference will be in the monthly cost of the plan. Some companies will add additional, value added benefits such as Silver Sneakers or other programs but the mandatory coverage must be the same for every plan.
Medicare Supplements do not cover drugs. If you want drug coverage, you must purchase it separately. (Called a Medicare Part D plan or “PDP plan)
WHO CAN BUY A MEDIGAP PLAN:
Medigap plans are guaranteed issue in CT. This means that you can enroll in any available plan regardless of your health or age. The only requirement is that you are on Medicare A and B. If you are willing to pay the monthly premium, you can have a plan. For people age 65 and older, the price is the same for everyone regardless of how old you are. (Example: If the AARP plan N costs $152.00 a month for a 65 year old, it costs the same for an 85 year old) People on Medicare under the age of 65 are also eligible for a supplement but they can have fewer choices if they are under the age of 50.
POPULAR PLANS AND COMPANIES:
Medigap comes down to plan type and price. If one company offers a plan L Medigap for less than the other companies, you should go with the one offering it for the least. Benefits are standardized so they can not be cutting out any benefits. They just have the best price. Having said that, the more popular plans over the last 24 months are Plan F, Plan N , Plan L and High Deductible Plan F. United AARP and Anthem BCBS currently have the lowest costs in CT which makes it easy to find the lowest cost company once you determine which supplement you want.
HOW CROWE & ASSOCIATES CAN HELP YOU:
Crowe and Associates is an independent agency based in Brookfield CT. The agency is A rated with the BBB and is contracted to sell just about every Medigap plan in CT including, AARP , Anthem BCBS, Humana, Mutual of Omaha, Aflac, etc…. The companies pay me commission directly and I charge my clients nothing. I sit down with clients (in person, over the phone or by email) and help them determine which plan is going to work best for them. I also let them know if a new company comes out with the same Medigap they have at a lower price. I can help you understand Medigap and help you determine which plan is best for your specific situation. Feel Free to call my office at 203-796-5403 or email me at [email protected]