elderly man wearing eyeglasses and magnifying glass sitting at work bench tinkering with tools

What Medicare Supplemental Insurance Can Do That Medicare Can Not

Getting older is never any fun passed the age of 21. But oftentimes with age comes maturity, experience, and perspective. And by the time you find yourself approaching the golden age of 65, you’re probably able to look back at your earlier years and note a few things you wish you had done differently—drink less alcohol, quit smoking earlier, save more money and spend it wiser; invest more time with the people you love, and in taking care of yourself.

Don’t put taking good care of yourself on the backburner anymore.

Making Sure Your “Golden Years” Are Golden

Throughout our lives, there are a number of birthday milestones that stand out— one, 13, 16, 18, 21, 40, 65, and if you’re lucky, many more beyond that. Each of these years has their own reasons for being special, but few birthdays carry the same significance that turning 65 does.

Beginning three months prior to your 65th birthday, you become eligible for a seven-month open enrollment period where you can enroll in Medicare benefits. If you miss your initial open enrollment period, you will still become eligible again during the general open enrollment period which begins January 1st and ends March 31st, with coverage beginning July 1st.

According to a Money Crashers article written by Michael Lewis, “There is a direct correlation between healthcare costs and age: The older you are, the more likely it is that you will need medical care. The elderly are more apt to suffer chronic conditions that require treatment for years, and accidents are more common, often requiring complicated treatment. As a consequence of the high healthcare costs for older Americans, private insurers prior to 1965 either did not offer health insurance to the elderly, or charged such high premiums that insurance was not affordable. Medicare was created to solve a human welfare crisis that threatened to unravel the social and economic fabric of the nation.”

The truth is, that while highly beneficial, Medicare Part A and Part B may not necessarily cover everything you may need as you get older. A prime example of this is the often-cited fact that Medicare does not cover basic eye health, most forms of dental care, and hearing aids. And while many may be under the impression that they won’t need something like a Long-Term Care Insurance policy because Medicare will cover the costs, unfortunately, it won’t because while Medicare Part A will cover care in a nursing home, it will not cover custodial care meaning, the activities of daily living such as getting dressed, bathing, eating, etc).

Investing In Your Health With Medicare Supplemental Insurance

A Medicare Supplemental Insurance policy can help you fill in the gaps left behind between the services and care that you need and the services and care that Medicare is willing to pay for.

If you or a loved one is approaching the age of 65, it may be wise to discuss with your doctor if all of your medical needs will be covered by Medicare. Oftentimes, people assume that Medicare will cover them no matter what and ultimately find out otherwise. In order to avoid any surprises, it is always wise to consult with your primary care physician about your individual health needs now and any that you may be at risk of developing in the future.

For more information regarding Medicare Supplemental Insurance (Medigap) and what it can do for you or someone you love, please visit https://spark.memberbenefits.com/medicare-supplement/.

grandfather blowing out birthday cake candles at a birthday party with family

Waiting to Enroll in a Medigap Policy Could Cost You

Throughout our lives, we have a number of birthdays but only a few age milestones ever really stand out—thirteen, sixteen, eighteen, twenty-one, forty, and sixty-five. The milestones get fewer as we age, but few are as important as the final one.

If you or someone you love is soon to turn 65, there are a number of things to start to consider. While the potential for retirement is one, another really big decision to make is how much, or how little insurance you will need.

Three months prior to turning 65, you become eligible to sign up for Medicare.  Once you review your options and make your selections between Part A, B, C, and D you must then decide if these plan benefits will be enough for you.

About Medicare Supplemental Insurance (Medigap)

For those who feel they need additional coverage and benefits, supplemental Medicare insurance (otherwise known as Medigap Supplement Plans) is there to help offset any additional costs you may not have foreseen when you originally signed up for Medicare. In fact, Medicare Supplemental Insurance is sometimes called Medigap coverage because it helps to fill in the gaps in coverage that Medicare can sometimes leave behind.

Your open enrollment eligibility to sign up for one of these policies begins on the day your turn 65 and are covered under Medicare Part B. To be eligible to sign up for a Medigap policy, you must be covered under Parts A and B of Medicare.

Your open enrollment period ends six months after your 65th birthday. So what happens then? What happens if you choose to not sign up for a Medigap policy within that specific time frame but still wish to purchase it?

The simple truth of it is, you may not be able to. In the event you are able to purchase a Medigap policy in your state after the initial six-month-period of open enrollment eligibility, it may cost you a great deal more than you were originally quoted to secure the same coverage you would have gotten if you had signed up immediately following your 65th birthday. In short, there are no positives to waiting to secure a Medigap Supplemental Insurance.

Why Buy Medigap coverage?

Medicare Parts A and Part B do not offer you 100% medical coverage from the age of 65 on. While Medicare does cover a great deal of expenses that could otherwise be quite costly and stressful, it does not cover everything.

According to Medicare.gov, Medicare Parts A and B fail to cover the following:

  • Long-term care
  • Prescription drugs (Medicare Part D helps cover this)
  • Most dental care services
  • Eye exams pertaining to eyeglasses
  • Cosmetic surgery
  • Acupuncture
  • The vast majority of Chiropractic services
  • Exams and fittings related to hearing aids
  • Routine foot care, not including injuries where a podiatrist might be necessary

For many, Medicare Part A is free and is designed to help enrollees pay for inpatient services, however, according to Medicare.gov, enrollees have a $1,316 hospital inpatient deductible for each benefit period.

While Medigap will not assist enrollees in paying for long-term care, it will assist with coinsurance, deductibles, copays, and serious vision issues such as cataracts surgery which can all greatly help senior citizens looking to minimize their out-of-pocket medical expenses.

For more information on Medicare Supplemental Insurance (Medigap) and what it can do for you or someone you love, please visit https://spark.memberbenefits.com/medicare-supplement/.

elderly man surrounded by happy family

The Unexpected Costs of Medicare

For many patients, Medicare is incredibly helpful. It reduces overall procedure costs, and it can lower prescription costs. However, specialized treatment, unaccounted for fees and hidden procedural requirements may add extra costs you weren’t expecting. If you are on Medicare, be sure to understand the hidden costs, and consider adding a Medicare Supplement policy to cover what Medicare doesn’t.

What is Medicare?

Medicare is the government’s health insurance program. It covers people over 65 years old, young people with disabilities and those with End-Stage Renal Disease. The Medicare program exists across four “parts”, titled Part A, Part B, Part C and Part D. Each part offers coverage for different costs, including:

  • Hospital insurance
  • Medical insurance
  • Medicare Advantage Plans
  • Prescription drug coverage

Unexpected Medicare Costs

While Medicare may seem comprehensive, its wide-ranging brackets fail to reveal several costs. In a recent article, U.S News Health revealed that Medicare Part A requires beneficiaries to pay the following expenses in the event of a hospital stay:

$1,260 for their first 60 days of stay.
Over $315 per day after two months of stay.

Additionally, Medicare’s Part B utilizes a payment regimen based upon monthly premiums, and many individuals may experience payments. If an individual’s income is lower than $85,000 per year, Part B premiums are instituted at approximately $147 per month.

What Doesn’t Medicare Cover?

Patients may be surprised to discover a variety of medical provisions not covered by Medicare. While the system does, in fact, cover many preventative and necessary procedures, visits and treatments, it doesn’t cover a slew other options.

In fact, supplemental coverage is vital when trying to save money where Medicare is considered. Those without supplemental coverage will end up paying expenses out of pocket, and they’ll pay full prices, even with Medicare’s attachments.

While Medicare can assist a patient’s procedures and costs, it doesn’t cover certain areas. Unfortunately, patients may be unaware of Medicare’s “coverage end-zone”. For example, the following medical provisions are not covered through Medicare Parts A through D, and must be covered separately:

  • Eye exams
  • Eyeglasses
  • Hearing aids
  • Hearing exams
  • Cosmetic surgery
  • Dental care

Additionally, several routine procedures aren’t covered by Medicare provisions. In essence, Medicare serves public patients through intensive treatments, prescription insurance, and hospital stays. However, diagnostic treatments, remedial therapy, and even hospital-based amenities may not be covered.

Does Medicare Supplement Insurance Help With Uncovered Balances?

Yes. In fact, Medicare Supplement Insurance is commonly called “Medigap” by private companies because it fills the “gap” in coverage that Medicare leaves. It helps with coinsurance, copayments, deductibles and other healthcare costs. Many people experience difficulties with full Medicare coverage, but Medicare Supplement Insurance can help.

If you’re eligible for Medicare benefits, or if you’re close to fulfilling Medicare requirements, visit the Spark Health Insurance Marketplace to review your Medicare Supplement Insurance options.