Medicare Supplement insurance: Knowing the assured issue periods

‘Guaranteed Issue’ periods are present in Medicare Supplement insurance which allow people to apply for a specific plan without being denied the coverage. It may however exclude the pre-existing conditions or could charge the person more due to the presence of any kind of health conditions. Such guaranteed issue rights are said to be mandated Federally by Centers for Medicare and Medicaid Services. At the same time, it applies to all the Medicare enrollees who are in any of the specific situations.

Generally, the GI rights tend to occur when the person’s existing healthcare coverage in certain way has been changing or the person is losing his coverage involuntarily. There are some insurance providers, who may develop their very own GI situations. The Federally prescribed GI situations are stated to be seven in number which is followed by visiting In case, the person falls into any of the periods, then would be able to register with the Supplement plan on Guaranteed Issue basis.

Knowing the situations

They are as follows:

  • He has a union or employer coverage which makes AFTER Medicare payments and is termed to be an ending coverage.
  • He has Medicare SELECT policy. He is moving out of service area of the plan. It is possible to keep the existing policy, however, has the right, on GI basis for switching to the new policy.
  • He is enrolled with Medicare Advantage plan. The plan could be leaving Medicare program, have servicing stopped in the specific area. It could also be that the person is out of range of the service area of the plan because of moving out.
  • He has enrolled with PACE or Medicare Advantage plan initially, but has the desire to switch back to the original Medicare ( as well as Medicare Supplement insurance plan) within a year of getting enrolled.
  • The Medicare Supplement provider from where the person has availed the plan has gone bankrupt, causing him to lose precious coverage. It could also be that he has lost his supplemental plan coverage for none of his fault.
  • Medigap or Medicare Advantage policy is desired to be dropped, since rules or not followed by the company or the person has been misled in some way.
  • He has dropped the Medicare Supplement for switching to the Medicare SELECT or Medicare Advantage policy initially. After being lesser than a year, he has plans to switch to Medigap policy.

Also few specific GI situations may have specific plan requirements, which one can enroll with.

Why Medicare Supplement Insurance matters?

Medicare Supplement Insurance is considered to be factoring in those expenses related to medical care, which are not covered usually within the medical insurance policy. As the person takes up any health insurance plan, he is not able to figure out as to what coverage type may be needed in the forthcoming years. The typical health insurance plans are not likely to provide coverage for everything.

Critical expenses left by insurance with employers

When looking for Medicare Supplement Insurance through employers as health plans, some crucial medical costs are definitely left out. With uncertainty band pay cuts gripping people everywhere, medical insurance is something that majority of the people are worried about. The question is how much coverage is sufficient? Would it be enough for covering all future medical expenses?

Since Medicare does not provide coverage for all types of expenses, it is possibly better to avail Medicare Supplement Insurance for covering those expenses. With costs being very high and increasing with time to avail quality medical care, it has become important to get them covered to avoid financial hassles and out of pocket expenses later. This will enable the person to pay up the original medical cost. Visit to compare plans and quotes online. With the Medicare and Medigap policy, all medical related costs gets covered and the person can have peace of mind of not having to pay up the bills on his own.

Getting hold of supplemental insurance

For deriving health supplemental insurance, what the person needs to do first, is to figure out what may be required. Checking out own medical records to identify those areas where medical related expenses could be required in the future can help finding a good supplemental insurance to become easy. Also, the person needs to keep in mind the following aspects to get the right supplemental coverage:

  • Is the original insurance coverage sufficient for meeting all medical expenses?
  • Is further coverage required for being protected financially from expenses which are not covered by the original health insurance plan?
  • What type of supplement plan would better suit the requirements and also assist in saving precious money, while offering the necessary coverage as and when required.

In case, the person is not able to derive answers for the same, he can also refer the different websites put up by the providers to get the answers. If still the person is confused about the type of supplemental plan to be derived, he can call up the authorized agents to seek their expert assistance.

What is Medicare and social security all about?

There are many Americans who are of the opinion that Medicare is considered to be a one-size-fit-all program, which does not offer any kind of opportunity for customization or choice. However, doing some research can help the person to understand the functioning of the program and to know the effective ways for including them in a financial plan for the long term which can expand significantly their value.

Misconceptions related to social security

Some misconceptions are present with regards to social security scheme offered. It is that taxes of the workers are withheld in personal accounts to be used for those workers having earned them. the fact is that taxes paid by today’s workers to the social security tends to support today’s retirees along with other recipients of Social security scheme like disabled workers, dependents of beneficiaries and survivors of workers having died.

When working and paying social security taxes, the person stands to earn credits towards his future benefits. Number of credits from Social Security that is required for securing retirement benefits depends upon the person’s birth year.

About Medicare

This program is stated to be funded with payroll taxes, besides monthly premiums charged from those availing benefits of this program. It is also considered to be health insurance program exclusively created for people of age 65 and above. Even some young people having specific disabilities may qualify for it. The program assists with costs of healthcare, although all medical expenses and many long term-care are not covered by it. Anyone not on medicare and needing health coverage should visit to see what their best options are.

The different parts of Medicare

  • Part-A: It assists by making payment to provide inpatient care at skilled nursing facilities or hospitals, following hospital stay, including some hospice care or home healthcare forms.
  • Part-B: It is regarded to be the basic medical insurance that assists in paying up for services from outpatient care, durable medical equipment, certain preventative services, home health care and physicians.
  • Part-C: It is also called ‘Medicare Advantage’. Such plans can be availed from private insurance providers in certain areas. Those having Part A & B could select to receive all health care services via a reputed Part-C provider company. The plans tend to combine doctor visits and hospital stay coverage.
  • Part-D: It assists in covering the expenses related to prescription medication.

There are many who have been trying to take full benefit of such programs. Having the programs integrated into the overall financial plan could help the person to derive maximum benefits and to have a happy and satisfied life.

Statistics of Medicare

Life is unpredictable and thus health is also unpredictable due to that. Thus there is a need of an assurance that you will be able to have the sufficient money when you need for health purposes. In United States, there is a social insurance program named as Medicare. It is purely administered by the federal government of United States. The program was started in 1966 and at present it is including 30 of the private insurance companies throughout the country. Medicare is for those who have reached the age of 65 and above and those who have earlier paid for the insurance. It provides health insurance to the younger people who have any disabilities.

You might be wondering that how much the Medicare would have provided. As per the statistics, health insurance by Medicare was provided to almost 48 million Americans in 2010. The figure included the people who had been in their retirement period and 8 million young people with disabilities. An average has been calculated on the basis of the past data and it shows that Medicare covered the half of the health care for those who were enrolled. The remaining of the charges was used by people with their supplement insurance plans. There were some of the charges that were out of pocket.

Evolvement of Medicare

New reports say that the relative Value update committee and the American medical association together decide on the pay standards for the patients of Medicare. The Relative Value Update committee includes the physicians who are associated with the government. Before the development of Medicare, the older people used to pay 3 times than the younger people for the health insurance. That program was not appropriate and thus in 1965, Medicare was established. It started with providing the health insurance coverage to people of 65 and above. Medicare Supplement Plans 2017 offer a great way to supplement your coverage and get medical bills paid.

Medicare supplement Plans 2017   In 1966, Medicare expanded its scope and added many of the waiting rooms, hospitals and other practices and the payments were done to the heath care providers. Medicare always expanded its scope with the passage of time and after 1980 it also added the provision of health insurance for younger people with disabilities. Those who have disabilities receive the social security disability insurance. In 2003 the President passed the Medicare program which covered all the drugs and it came into effect in 2006. After the development of Medicare, the science has developed and the life expectancy of people has increased.

Source of finance for Part A

Medicare is the insurance plan that is provided by the government of United States to its residents. Now it is obvious that to gain the benefits after the age of 65 you need to pay something before that. Nothing is free. The thing that you must be wondering would be that how the government would be managing the cost of providing the Medicare services to the residents. The government has planned everything and the taxes are levied on people which help them to incur the cost of Medicare services. Medicare has many sourced for the financing purpose. There are 4 parts of Medicare and all four gain the financing from different sources.

Part A of Medicare is funded from the payroll tax which is 2.9% and it is levied on the workers and employers. Till 1993 the government used to ask for the compensation upto a limit. It worked in similar way as the Security tax works in United States. From 1994 the compensation limit has been removed and it was declared that the self employed individuals would have to pay the entire 2.9%. The tax was to be paid on the net earnings and half of the tax was deducted from the income tax. In 2013 some reforms took place and with that some changes occurred in the tax of Medicare. It was declared that the rate was increased to 3.8% for those earning more than 200000 dollars.

Source of finance for Part B and D

The parts B and D of Medicare were funded by the premiums of Medicare and from the general fund revenue. With the reforms, surtax was added in Part B premium for those who had higher incomes. It was partially used for funding Part D. In 2010, surtax was added in premium of Part D for seniors who had higher incomes.

The government declared in 2011 that it will be spending about 15% of the Federal budget for the Medicare purpose and it is expected that it will increase to 17% till 2020. It is expected that the enrollees will increase from 48 million to 80 million in 2030 and the Medicare spending will be increased from 560 billion dollars in 2010 to 1 trillion dollars in 2022. Government is trying its best from the beginning to give the best health care services to the people who have reached their retirement. The policy makers have offered various proposals which can help in reducing the Medicare costs for the senior finance.

Switching from Medicare advantage plan

Joining new plan

Medicare Advantage plan is the plan that covers more than the original Medicare. There are many benefits of the Medicare advantage plan and some rules and eligibility of enrollment is also to be considered. Life is not consistent and in the same way sticking to a single plan is also not sure. There are chances that you will wish to switch from one plan to another. You can switch to other plan when you already have the Medicare advantage plan and there are some steps to be followed for that.

If you want to switch to a new Medicare advantage plan, it is very simple to do. You just need to join the plan in one of your enrollment periods time. If you do so then you will be automatically removed from the old plan when the coverage f the new plan begins. So you don’t need to do much to switch to another plan.

If you want to switch to original Medicare then you need to contact the current plan provider and ask for the details and procedure to follow. The Medicare prescription coverage is already included in the Medicare advantage plan but if you have any other plan then you need to consider the drug coverage. You can also have a Medicare supplement insurance policy. You can switch from a plan to another in certain periods of the year only. You cannot switch at any time. Be sure to compare the Medicare advantage 2016 plans in your area to see which fits your needs the best.

Important points to be considered

You should talk to your union or employer before joining the Medicare advantage plan. In some of the mediocre advantage plan it is possible that you will lose your employer and union coverage. In case you lose the coverage of your own self then you will lose the coverage of your partner or any other dependent. In some cases you will be able to use the employer or union coverage with your Medicare advantage plan. In case you drop your employer or union coverage then you will not be able to get that coverage back. So you need to take care when you are switching from a plan to another and also when you are planning to drop the plan.

At some times it is also possible that at the end of the year the plan decide to leave the Medicare program. If this happens then you will be returned to the original Medicare. If you join other Medicare advantage plan then you will face no problem else you will get back to the original Medicare.

Costs of Medicare Supplement plans

Premiums of Medicare supplement

The original Medicare offers a wide range of benefits in terms of coverage of the certain hospitals and medical costs. It does not cover all the services and other things that the beneficiaries may need. Thus for this purpose, Medicare supplement plans are available. The Medicare supplement plans fill the gap of the coverage which is not covered by the original Medicare. Almost very next person is enrolled in some of the Medicare Supplement plan.

The cost with the Medicare supplement plans are to be paid in addition to the Part A which has deductible of 1260 dollars and coinsurance Part B is also to be paid. The Medicare supplement plans are offered by the private companies and thus the costs are different for every plan and location. In case if Medicare, it is run by government and thus the costs does not differ and remains same for all.

The out of pocket cost differ but the plan coverage and the benefits are standardized in the Medicare supplement plans. There are different lettered plans in supplement plans. The Medicare Supplement plans have 3 types of premium rating system. Community rated is when the person is charged with the same premium every month irrespective of the age. Issue age rated is when the person is charged the monthly premium based on the age. Attained age rated is when the premium is as per current age and it increases with the increase in age.

Who can enroll in supplement plans?

Enrolling in the Medicare Supplement plan is possible anytime but the best time is during the Medicare supplement open enrollment period. The benefit of enrolling in this period is that the medical examination of the person is not needed. A person is eligible for this scheme when he reaches the age of 65 and is enrolled in Medicare Part B.

There are some companies that offer special discounts for women, married people and non smokers. The companies also provide benefits to those who pay the premium yearly and through the electronic funds transfer. Some of the companies offer the deductible options for some of the Medicare Supplement plans which results into low premiums and high pocket costs. These costs are before the beginning of plan coverage. The Supplement plans are provided by the private companies and so the cost varies at location and as per plans. Thus it is advisable to compare all the plans and select the right option as per the needs.

Hospital insurance – Medicare Part A

Medicare is the health insurance that is been used by the people after their retirement. There are 4 parts in Medicare; Part A, Part B, Part C and Part D. Part A of Medicare cover the hospital insurance. It covers the inpatient stays in hospital and it also includes the room, food and test costs. Medicare Part A covers the maximum stay as the hospital inpatient stay or the series of stays to 90 days. For the first 60 days the payment will be done by Medicare except one co-payment and from 61 to 90 days it will require a co-payment of 322 dollar per day.

Medicare part A

Medicare Advantage plans 2017There is beneficiary known as lifetime reserve days which is after 90 days and can be used by some people. The lifetime beneficiary needs the co-payment of 64 dollar per day. In the entire lifetime the beneficiary can be used only for 60 days. Some reforms have taken place in the terms of co-payments done. The co-payment for 61 to 90 days has been changed to 302 dollar soon and the beneficiary with no payment from Medicare can be taken. So, the government is trying to make the changes that benefit the public most. Many people choose a Medicare advantage plan in lieu of Regular Part A Medicare. To learn more visit

Some services can be taken as the inpatient one which gets reimbursed under the Part A of Medicare and some services can be taken as outpatient one which will not get reimbursed under Part A. The service which will be reimbursed and which will not be reimbursed is decided earlier and they are the midnight rule. In 2013 the centers of Medicare declared the rule of eligibility for the inpatient services which became effective from October 2013.

If there is a situation when a physician admits a Medicare beneficiary as inpatient for more than 2 days with the explanation that the patient needs hospital care then the Medicare Part A will be appropriate. But if it is declared that the hospital care is less than two midnights then the Medicare part A payment will not be appropriate. The time which the patient spends in the hospital before getting admitted as inpatient is considered as the outpatient time. The hospital can consider the pre-inpatient time when it is determined that the patient’s care will take more than two midnights. There are many other considerations in the coverage of Medicare Part A. The benefits are good for those who have reached their retirement.