What Will I Have to Pay for Medigap Coverage?

For many Medicare beneficiaries determining how much they have to pay out of pocket for Medicare and Medigap can be quite tricky.  It’s figuring out what essential coverage, Medicare Parts A, B, and D, is going to cost, only to find out that these three plans don’t fully cover you.  Not only will additional Medigap coverage have a monthly premium, you will also need to determine how much the deductible and co-insurance will run.  With most Medigap plans, beneficiaries can expect to be responsible for up to 20% of their outpatient medical expenses.  It is important when planning for retirement that these estimated costs are considered so that you can be financially prepared.

Choosing a Medigap Plan

Medicare’s standardized supplemental insurance plans date back to 1990.  Since then it has been simpler for Medicare recipients to compare the costs of these plans between providers which is clearly important for a number of reasons.  Of the ten standard plans available there are two high premium plans that have more complete coverage then any of the other eight, Medigap Plans F and G.  The benefit of choosing one of these two plans is that although the monthly premium is higher there is little to no out of pocket needs.

Participants that want a lower monthly premium and are okay with sharing the cost of treatment as they go along should consider Medigap Plans K and N.  These plans both offer lower monthly premiums however offer fewer benefits.  Participants will share more of the expenses as needed along the way.

There are a number of factors that go into determining your monthly premium.  If you are enrolled in Medigap within your open enrollment period, you will not pay more based on pre-existing conditions however other factors do play a role.  These include age, gender, tobacco usage, the policy you choose, when enrollment takes place, and discounts for more than one enrollee in a household.  This will depend strictly on the carrier who is allowed to set rules for these discounts.  A Medigap broker will help you determine which carrier is offering you the most coverage at the best rate.

Where you are located is another factor in determining the amount you will pay for Medigap plans.  From state to state, zip code to zip code, Medicare supplemental plans premiums vary a great deal.  Consider this: Medigap Plan F in Fort Worth, Texas can run between $149 – $180 per month for a non-tobacco using 65-year-old male whereas the same coverage in Los Angeles, California will run between $169 – $190 per month.  Medigap in Florida is even costlier as this same person would most likely pay between $275 – $336 per month. This may just be one of the many reasons that many Medicare enrollees in FL choose a Medicare Advantage Plan instead.

It is also crucial to consider healthcare related expenses that are not covered through Medicare or Medigap what-so ever.  Medicare does not help pay for expenses related to long-term care which is always a shock to seniors.  It also limits the type of care and equipment it will pay for often have strict stipulations in place for home health care needs and medical equipment.  Often in order for these items to be covered a doctor must be in charge of prescribe them and proving that they are necessary. Certain dental needs, vision care, and hearing costs may also not be covered as well.

The experts at eMedigap Plans, powered by Omega, have all the answers you are looking for when it comes to your Medigap Supplemental Insurance needs.  More information can be found at http://emedigap-plans.com.

2019 Changes in Medicare

2019 is bringing on some big changes in the world of Medicare.  If you are a Medicare enrollee it is important to take note of the changes.  This will help make sure you are getting the coverage that you need.  Medicare has been around for over 53 years but that doesn’t mean that it stays the same from year to year.  Each year it is important to review your Medicare coverage.

Open Enrollment Changes

Medicare Advantage Plans will have an open enrollment period between January 1 – March 31.  At this time participants will be able:

  • Drop Medicare Advantage and return to Original Medicare
  • Change from one Medicare Advantage Plan to another Advantage Plan
  • Enroll in or drop Medicare Part D, standalone prescription drug coverage

Closing the Gap in Medicare Part D

Medicare Part D, prescription drug coverage requires seniors with high prescription drug costs to pay more for medication once they have reached a certain dollar amount spent each year.  There is a gap that occurs between when enrollees hit the initial spending cap and catastrophic coverage begins.  This will no longer exist in 2019 for brand name prescriptions.  In 2020 the gap will close for generics as well.

Telehealth Care

More consultations will take place between patients and caregivers will happen over the phone or via the internet.   Participants in Medicare with end-stage renal disease and being treated or strokes will have access to this same telehealth care services.

Enhanced Handbook

Each and every year Medicare sends each enrollee a handbook that give the details of their coverage for the current year.  In 2019 the handbook will also include:

  • In order to choose the right program checklists and flowcharts will be added
  • The online Medicare Plan Finder tool will be easier for seniors to access and use
  • The online coverage wizard will help enrollees to compare Medicare and Medigap costs and coverage
Removal of the Therapy Cap

Up until 2019 there have been limited coverage available for Medicare participants needing speech, occupational, and physical therapy.  Congress has removed this cap in 2019.

The experts at eMedigap Plans, powered by Omega, have all the answers you are looking for when it comes to your Medigap Supplemental Insurance needs.  More information can be found at http://emedigap-plans.com.

Changes to Consider During 2019 Medicare Open Enrollment

There are many changes coming to the world of Medicare in 2019.  Most of these changes will involve coverage in Medicare Advantage and Medicare Part D.  From more health care plans to choose from to lower premiums and added benefits now is a good time to start reviewing your current plans and future options.

An Increase in Medicare Advantage Plan Choices

In 2019 Medicare expects to see an increase of upwards to 600 new Medicare Advantage plan options varying between locations.   More than ninety percent of Medicare enrollees will have the option of ten or more Medicare Advantage plans to choose from in their area.  Medigap Plan D, prescription drug coverage is also upgrading and offering Plan D business plans in 2019.

Medigap Plan D, Prescription Drug Coverage, Premiums Decrease

Enrollees in Medigap Plan D can expect to see a decrease in plan premiums by $1 a month in 2019.  It is important to remember that when looking at coverage there is more to the cost than just the initial premium.  Some plans offer a low premium, but the cost of prescriptions co-pays is much higher than a higher costing premium plan.  A Medicare Supplemental Insurance Agent or the Medicare Plan Finder online are tools available to assist you in comparing all ten Medigap rates and plans.

Preferred Pharmacies

Medigap Plan D will include more preferred pharmacies.  When choosing a plan that offers a preferred pharmacy you can expect to pay lower premiums and decreased co-payments.  If you go outside of the preferred pharmacy to have prescriptions filled, you will be paying a premium.  If you are adamant of sticking with a certain pharmacy, you will need to see if a plan option exists with them as the planned pharmacy.  If not, you will need to change pharmacies or pay the additional cost of prescriptions.

Less Expense in The Donut Hole

The coverage gap which makes participants pay more out of pocket for prescriptions known as the donut hole, will close in 2019.  When your total prescription drug expense reaches $3,820 you will pay 25% of the cost of brand-name (37% of generic) up until you have reached $5,100 in which you will then only be responsible for 5%.

Medicare Advantage Premiums Decreasing

In 2019 the premium for Medicare Advantage will run on average $28 per month, down $1.81 from 2018.  There will also be more zero premium options available with Medicare Advantage coverage.  It is always good to note that often lower-premium policies have a smaller network of providers.  If this does not bother you than this may be a good option to help cut costs.

The experts at eMedigap Plans, powered by Omega, have all the answers you are looking for when it comes to your Medigap Supplemental Insurance needs.  More information can be found at http://emedigap-plans.com.

Medigap Plans – Two Popular Plans Ending In 2020

Are you enrolled in Medigap?  Do you turn 65 soon and know you will be applying for Medicare and enrolling in a Medigap policy?  If so it is important to note that two of the most popular Medicare Supplemental Plans will no longer be available to enroll in.  Medigap Plans F and Plans C are being discontinued as an enrollment option as of 2020.

Medigap insurance is purchased to cover the medical expenses that are not covered under Original Medicare.  Believe it or not Medicare Insurance doesn’t cover 100% of copayments or deductibles and also has limitations to what it will cover.  Private insurance companies offer Medigap plans, also known as Medicare Supplemental Insurance Plans, were created to fill in these voids.  Currently in 2018 there are 10 different Medigap plans available.  Each of the ten plans offers a different combination of insurance benefits.  This allows participants to decide the combination of benefits that is right for their health needs and budget.

Two Most Popular Plans

Medigap Plans F and Plan C remain the most popular plans offered because they both cover the full deductible of Medicare Part B.  This means that if enrollees participate in Medigap Plan F or C they do not have to pay the Medicare Part B deductible. In fact, Medigap Plan F is the most complete Medigap coverage available to participants including: doctors fees, medical tests, and hospital fees.  Medigap Plan C is very similar to Plan F however does not cover extra fees that doctors charge over what Medicare allows.  These two plans, Medigap Plan F and Medigap Plan C are the most enrolled in plans available, more than 53% of enrollees have coverage under one of these two plans.

Litigation was passed by Congress in 2015 that states in 2020 private Medigap insurers are no longer going to be allowed to offer any Medigap plans that cover the Original Medicare Part B deductible.  Participants that enroll in either Medigap Plans F or C will be allowed to keep their coverage for the rest of their lives, but no new enrollees will be allowed to enroll in either of these plans. Critics believe Medigap Plan F makes it too easy for Medicare enrollees to see a doctor without considering the cost.

The Future Of these Two Plans

For participants that are able to enroll in Medigap Plan F and Plan C before they no longer exist may seem like a no brainer.  While it appears that you would want to lock in the coverage while you still can participants should note that premiums could increase over time as there would be no new enrollees.  This occurs because the participants enrolled in these plans will continue to age without the younger, healthier participants enrolling to offset the expense.  As premiums rise participants enrolled in these Medigap plans may no longer be able to afford to stay enrolled.

Choosing a Medigap plan is crucial as it is difficult to switch once you are enrolled.  During your open enrollment plan, companies cannot consider pre-existing conditions in deny coverage or set the costs of premiums.  After this six-month period which begins on the 1st day of the month you turn 65 because there is not a guarantee that you won’t be charged more based on your health.

While Medigap Plans F and Plans C are being phased out there are still an abundance of Medigap coverage to choose from when picking a plan that will help participants fill in the health care gaps left from Original Medicare.

The experts at eMedigap Plans, powered by Omega, have all the answers you are looking for when it comes to your Medigap Supplemental Insurance needs.  More information can be found at http://emedigap-plans.com.


Avoiding Late Enrollment Penalties

No one wants to pay more for something than they need to.  This is true of all things, Medicare included.  To avoid having to pay late enrollment fees when enrolling in Medicare and Medigap there are a few important dates to keep track of.

Three months BEFORE you are to turn 65, you should start receiving information about Medicare’s open enrollment period.  The enrollment period lasts for the three months before, the month of, and for the three months after your 65th birthday.  If participants enroll outside of this period, they are subjected to a late enrollment penalty.

Enrollees should understand that there are several different late penalty fees that can apply.  If enrollment is delayed for Medicare Parts A, B, and D a late penalty fee can incur.

Late Enrollment Penalty – Medicare Part A

Most often participants automatically qualify and are enrolled in Medicare Part A when the patient turns 65.  Medicare Part A is premium-free health care.  Automatic enrollment occurs if the participant or their spouse worked at least ten years in the United States.  If participants do not meet this requirement a premium must be paid when they become eligible, otherwise a late enrollment penalty applies.  This penalty increases the monthly penalty up to ten percent.  The premium increase will need to be covered for double the number of years in which you could have had Medicare Part A but didn’t.

Medicare Part B – Late Enrollment Penalty

 Medicare Part B works similarly to Medicare Part A.  Most participants are automatically enrolled in Part B.  If you are not automatically enrolled in Medicare Part B you must enroll when the participant becomes eligible.  If you do not enroll within the allotted time frame enrollees will be required to pay a late fee.  The penalty has the potential to increase up to ten percent for every year the participant could have signed up but did not.  Medicare Part B is elective coverage.  Enrollees are not required to participate in Medicare Part B, but it is encouraged.

Late Enrollment Penalty – Medicare Plan D (Medigap – Prescription Drug Coverage)

Participants are not automatically enrolled in and must take the initiative to enroll in Plan D, prescription drug coverage within the same open enrollment period of Medicare Part A and B.  If enrollees do not sign up during this period of time and do not have any other credible prescription drug coverage a late enrollment penalty will apply.  The Medigap Plan D penalties are a bit more complicated then those associated with Original Medicare.  Plan D’s enrollment penalty multiples one percent of the national base beneficiary premium times the number of months that participants were not enrolled in prescription coverage.


Some participants may qualify for a special enrollment period.  This occurs if enrollees are eligible for Medicare but choose not to participate because you are still working.  This situation exempts Medicare participants from penalties.

The experts at eMedigap Plans, powered by Omega, have all the answers you are looking for when it comes to your Medigap Supplemental Insurance needs.  More information can be found at http://emedigap-plans.com.

What Every Senior Needs to Know About Medigap Prescription Drug Coverage

Up until 2006, many Medigap plans included prescription drug coverage.  This is no longer the case.  Today if you would like prescription drug coverage you must enroll in Medigap Part D, prescription drug coverage.

Medigap Part D provides individuals with prescription drug coverage.  In order to enroll in Medigap Part D you must be a participant in Medicare Part A and Part B.  Medicare Supplemental Insurance Part D coverage can be purchased by any private insurance company that is authorized by Medicare.

Why do you need Medicare Supplemental Insurance Plan D, prescription drug coverage?

  • Medicare Part B includes limited outpatient prescription drug coverage. It doesn’t cover most of the drugs that you need to get at the pharmacy.  Drugs that are needed as part of a daily regimen for chronic conditions such as high blood pressure require Medigap Part D to be covered.
  • Even if you do not use prescription drugs right now, you will have to decide about Medigap Part D. It not only lowers your drug costs today but provides you will essential protection against high costs in the future or being denied coverage at a later date.
  • If participants don’t join Medigap drug coverage when first eligible but decide the need it at a later date they can be required to pay a late penalty (depending on the circumstance) and/or have to pay increased monthly premiums.

How do participants go about enrolling in Medicare Prescription Drug Coverage, Medigap Part D?

In order to enroll in Medigap Part D you must already be enrolled in Original Medicare, Part A and Part B.  Participants must also live in the service area of the plan that provides prescription drug coverage.

Things you should know before joining Medigap, Medicare Supplemental Insurance Part D.

  • In addition to the premium that is paid with Medicare Part A and Part B, participants must pay for Part D. Some enrollees qualify for financial aid.
  • Consider all of your options for drug coverage before making a decision. Prescription drugs coverage varies a great deal in the drugs that are covered, how much you will pay, and what pharmacies you can use.
  • You may not be able to make changes to your plans for a year so choose carefully when you sign up.
  • Understand that the drug plan you have today may change from year to year. It may not cover the same prescriptions from year to year.

The experts at eMedigap Plans, powered by Omega, have all the answers you are looking for when it comes to your Medigap Supplemental Insurance needs.  More information can be found at http://emedigap-plans.com.

The Many Reasons You Should Use A Broker When Signing Up for Medigap

The road to finding the perfect fit from a Medigap policy is long and hard.  With all the decisions that need to be made it is advisable for seniors to meet with a Medigap broker before choosing a plan to accompany your Medicare Part A and Part B insurance.  Below we have listed the top reasons that it is necessary to use a Medigap broker when looking for supplemental insurance.

  • A Medigap Broker Offers a Centralized Location to Compare All Available Plans

With more than 30 private insurance companies offering Medigap’s 10 available plans there is a lot to consider.  To make an educated decision a Medigap broker supplies you with a full list of plans and providers in your area and will help advise you based on price, customer ratings, the company’s reputation, and forecast for the future.

  • Medigap Brokers Loyalty Lies with You, Their Customer Not the Insurance Provider

Medigap brokers are only paid when you sign up for a plan.  No matter what insurance provider they choose, they will get compensated.  Their allegiance is with you their customer, they want to ensure that you are completely satisfied with your insurance.  If you are not happy with the company that is providing you with insurance, it is then the brokers job to mediate the situation.

  • A Medigap Broker Is Your Direct Representative to Call with Concerns

Although there are often very few issues that arise once you have picked a Medigap plan occasionally a problem may arise.  When they do, you have a direct contact to solve them.  A Medigap broker has a direct financial interest in making sure you are completely satisfied.

  • Medigap Brokers Complete Most of the Enrollment Work for You

Seriously, have you looked at the enrollment form you are required to fill out to enroll in Medigap coverage?  Yep, it can vary between ten and fifteen pages!  No one has the time for that.  A Broker helps complete the application with minimal work needing to be done directly by you.

  • A Medigap Broker Adds Valuable Services

Once again, Medigap Brokers only get paid when they keep providing you services, so they are going to do what ever it takes to keep you informed and happy with the services they are providing.  This means that when annual reviews are needed it is not on you to remember; brokers contact you and make sure that are informed of all the latest news and updates within the Medicare arena.

  • Medigap Brokers Are Free to You

The best part of using a Medigap Broker is that their services do not cost you any additional money.  Medigap enrollees do not directly pay you for your services.  Instead a portion of the premiums that are paid to enroll in Medigap is allotted to cover their services.  Why not use a service that is being paid from your premiums whether you use them or not?

The experts at eMedigap Plans, powered by Omega, have all the answers you are looking for when it comes to your Medigap Supplemental Insurance needs.  More information can be found at http://emedigap-plans.com.

What Is Medigap Insurance and Why is It Useful?

Medicare is a good basic health coverage program for the elderly, which helps eliminate some of the high cost of medical care. However, while Medicare covers a lot of the health care costs it does not cover all the costs which is where the Medigap insurance comes in.

What is Medigap Insurance?

Medigap insurance is insurance you buy from a private insurance company that is licensed to carry this type of insurance. Like other types of insurance, you pay monthly premiums to the insurance company for this additional insurance.

In order to get Medigap insurance you must have both Medicare part A and part B but cannot have a Medicare Advantage policy or have a Medicare Medical Savings Account Plan. Your Medigap insurance premium must be paid in addition to the premium you pay for your Medicare part B. In addition, Medigap insurance only covers one person, so if both you and your spouse have Medicare and want Medigap insurance, you both must carry a policy, and both have to pay premiums for the coverage.

Why Is Medigap Insurance Useful?

Medicare pays 80% of your medical bills after you have paid the Medicare part B deductible. That means 20% of your medical bills need to be paid by you. Medigap insurance helps cover the other 20% of the health care costs that is not covered by your Medicare insurance including those co-pays and deductibles and health care you receive when you are visiting outside the United States.

There are some things that Medigap insurance won’t cover including:

  • Prescription Medication- (since 2006)
  • Vision care
  • Dental care
  • Hearing aids
  • Eye glasses
  • Private Duty Nursing care

Medigap Insurance is Renewed Even if Your Health Deteriorates

As long as you continue to pay your Medigap insurance on time every month, your Medigap insurance can’t be denied even if your health deteriorates and your medical bills rise. This gives you a feeling of security when seeking health care.

Additional Information Regarding Medigap Insurance

There is some additional information regarding Medigap insurance you should be aware of if you are considering getting a Medigap insurance policy. Any Insurance company that sells you a Medigap insurance policy must clearly identify the policy as Medicare supplement insurance.

There are several Medigap insurance policies available and all Medigap insurance policies must offer the same basic benefits, but some policies offer additional benefits along with the basic benefits.

In addition, any insurance company that sells Medigap insurance must offer Plan A and either Plan C or plan F. However, they do have to offer every Medigap plan that is available, so you need to learn about the various plans so that you choose the plan that is right for needs.

Medigap insurance can help you offset the rising costs of medical care as you grow older. While you do have to pay monthly premiums for your Medigap insurance the cost of these premiums may be offset by the amount of money you save in medical bills. Only you can decide if Medigap insurance is right for and which policy will best meet your needs.


Learn more about Medigap plans and rates at http://emedigap-plans.com.  Medigap Insurance brokers will help you compare Medigap Insurance rates and plans.  To talk to an expert in Medigap coverage call toll free 888-452-7949!

Health Insurance Plans Available Through Medicare

Medicare and Medigap are health insurance plans sponsored by the federal government.  Being regulated by the government means that there is not a lot of leeway.  Much of Medicare is standardized and is the same throughout the United States however, Florida is unique.

The state of Florida is one of four states that allows the pricing of Medicare Supplemental Insurance Plans to be based on the age of enrollees.  “Issue Age” standard states that your Medicare Supplement rates cannot increase every year as you age.  The price can fluctuate because of normal inflation which on average is between three to four percent each year.

Medicare enrollees also have the option to enroll in Medicare Advantage instead of Original Medicare and the addition of supplemental insurance.  Only 3 out of 10 Medicare participants choose Medicare Advantage.  Most participants choose this option especially when they are on a limited, fixed income.  The state of Florida has a rate higher rate of enrollment in Medicare Advantage plans.  In fact, two out of five Florida enrollees participating in Medicare choose Medicare Advantage.  The insurance coverage with Medicare Advantage is often not as comprehensive as what participants would have with Medicare and Supplemental Insurance Plans however, it is a more affordable option.

As mentioned previously, Supplemental Insurance Plans are standardized throughout the United States.  Thus, meaning no matter what insurance company the insurance is purchased through or what state it is purchased in the coverage of the plans remains the same.  Unlike with Medicare Advantage, Supplemental Insurance Plans do not limit the doctors and specialists you can visit.  Another major difference is that Medicare Advantage Plans are not standardized, although they are regulated.  With Advantage Plans you are limited to doctors and specialists within your network.  There are higher co-pays and deductibles than with Supplemental Plans however the premium each month is lower.

Unlike other states, Florida has a different pricing structure on their Medicare Supplemental Insurance Plans. The plans that are priced the best are those with the best coverage.  These plans include, Medigap Plan F, Plans N and Plan F-HD.  If you are new enrollee within Medicare in Florida it is vital to investigate these three different supplemental plans before committing to a Supplemental Insurance Plan.  Medigap Plan F covers one hundred percent of your Medicare expenses; other than your premium enrollees do not have to cover out-of-pocket costs.  So, although the initial policy can be quite expensive it can pay off in the long run.

Learn more about Medigap plans and rates at http://emedigap-plans.com.  Medigap Insurance brokers will help you compare Medigap Insurance rates and plans.  To talk to an expert in Medigap coverage call toll free 888-452-7949!

Does Medigap Cover Issues with Mental Health

As people get older and become eligible for Medicare, they may be concerned about which parts of their health care costs will be covered and which parts they will be completely responsible for.  This is especially true when it comes to coverage for mental health, as those visits can become quite expensive over time.

Medicare Part A does cover mental health care, but each inpatient service will require the patient to pay their deductible.  There is also a coinsurance charge for any days of hospitalization past sixty, and no one will receive benefits for over one hundred and ninety days of mental health hospitalization in their lifetime.

Medicare Part B will cover outpatient mental health services, but there is a deductible that everyone is required to meet as well as copays.  However, one mental health screening is allowed each year at no cost to the patient.

At this point, many seniors will be wondering how they will be able to afford to pay for their medical bills, but that is where Medigap insurance can be a huge help.

Inpatient hospitalizations are still the same with Medigap as they are with Medicare Part A as to how many days are covered.  However, there is a chance that extended visits will be approved through a person’s Medigap coverage.  Medigap will cover all of Medicare Part A’s coinsurance and copays, and most of the Medigap plans will cover the deductible as well.

The exceptions to the inpatient deductible being paid out by Medigap are that Medigap Plan A will not cover it at all, and Plan K requires the patient to pay fifty percent while Plan L requires a person to pay twenty-five percent.

Almost every Medigap plan will cover the copays and coinsurance that a person is responsible for from their Medicare Part B coverage, but only Medigap Plans C and F will cover the deductible portion of Medicare Part B.  Medigap Plan N will require the patient to pay a copay for each of their doctor’s visits, while Plan K requires the patient to pay fifty percent, while Plan L requires a payment of twenty-five percent from the patient.

As for all the excess charges that a person receives, mainly from a doctor that doesn’t accept Medicare assignments, those are only covered by Medigap Plans F and G.

This shows how important it is for seniors to purchase the proper Medigap insurance as soon as they are eligible for it.  Everyone will want to do their research to see which option will benefit them the most, so that they do not find themselves drowning in medical debt due to purchasing the wrong type of Medigap insurance plan.

Learn more about Medigap plans and rates at http://emedigap-plans.com.  Medigap Insurance brokers will help you compare Medigap Insurance rates and plans.  To talk to an expert in Medigap coverage call toll free 888-452-7949!